The Lumbar spine, also referred to as the “Lower Back” or “Low Back” is made up of 5 vertebrae – L1, L2, L3, L4 and L5. Each of these levels are structured with an Intervertebral Disc to transmit compressive forces, Bones to absorb forces, Ligaments to hold the bones in a normal structure, Muscles to assist in motion, as well as Spinal Nerves that exit the intervertebral foramen which send strength, energy and function to various parts of your body. The lumbar spine has a normal curve called a lordosis, that goes backward and is elliptical in shape. When you have this proper lordosis, in conjunction with the other structures mentioned above, your lower back is strong, stable and functions optimally.
Unfortunately, we live in a world that neglects their spine, sits in wrong positions, carries and lifts improperly, is on phones and computers for hours and commonly ignores micro and macro traumas. So, because of these habits, it is very common (NOT NORMAL!!) that many people develop lower back pain or discomfort throughout their life. Now some people are wise enough to get a structural evaluation, find out the cause and correct it; while the larger majority does not do the same. Think about the people in your lives. Would you agree that more people are more likely to do something to get rid of the symptom, but not really address the underlying cause? What are some treatments they may use? How many do you think go to the medical doctor for a muscle relaxer, pain reliever and/or anti-inflammatory? How about the ones that may be a little more proactive and get a massage or use a TENS or electrical stimulation unit with some ice or heat? These are all great options, but what are they doing? They are just addressing the symptom! They do not address the underlying issues that are causing the pain in the first place. The purpose of this article is to give you more options on how to be aware, proactive and prevent this from occurring in your life.
Here are 6 Key Rules for Low Back Health:
(First I will list them, then I will break each one down)
- Maintain a Neutral Posture
- Appropriate Timing
- Optimal Spinal Loading
- Reduce the Reaction Moment
- Maintain Spinal Stability
- Other Issues
1. Maintaining a Neutral Posture
The best way to prevent low back injury is to ALWAYS be aware of your posture. Your posture is evident in all aspects of your life. Think about all the times in your life when your posture is important. What is your posture while standing? How about when you are sitting, lifting, walking, running or even sleeping?
During each of these moments, you need to ask yourself …
“Am I in the ideal posture right now?”
Now in order to understand what is the “ideal” posture, you must know what normal is right?
Here are some examples:
- Standing Posture:
- From the Front: Imagine a plumb line down the middle of the body, all regions should be aligned and symmetrical.
- From the Side: Imagine a plumb line that goes from the middle of the ear, to the middle of the shoulder, hip, knee and ankle. Don’t forget about the natural curves as well!! (Seen on X-Ray)
- Cervical Spine / Neck- Backward (Lordosis)
- Thoracic spine / Mid Back – Forward (Kyphosis)
- Lumbar Spine / Low back – Backward (Lordosis)
- Look at your posture and the posture of the people in your life. Do they look normal? If not, they should be correcting that before any degeneration or symptoms come.
2. Seated Posture:
While in the seated position, especially at the desk, you should always be aware of your posture. First, think about your feet they should always be flat on the floor. Now, think about the angle of your hips and knees, they should ideally be at a 90 degree angle. Next, think about your lower back, make sure you are supporting the normal lumbar lordosis, you should not be slouching! Check out the image below for more cues.
3. Sleeping Posture:
This is one of the most important times to think about the ideal posture because when you sleep you are in the same position for hours, so its crucial you make sure its in the right position.
There are 3 types of sleeping positions (2 ideal, 1 not ideal):
- On your back – This is the most desirable, although most difficult way to sleep. While laying on your back you should use a pillow under your head to supporting your neck and another one under your leg to support the lumbar curve.
- On your side – This is the next best position. You should supporting your spine with pillows between your knees and under your head.
- On your stomach– This is the least desirable, although most common. I highly recommend that you DO NOT sleep on your stomach. This places the most stress on your spine and you are more likely to wake up with pain and discomfort and set yourself up for a lifetime of low back pain and weakness.
4. Posture while Lifting:
When lifting anything, whether it is box, a weight in the gym or even your children, please be sure to be aware of your posture while doing it. Make sure that before you lift, you are bending at your knees (not your hips), your back is straight, upright and you are not rounding at your shoulders. This will give you the most ideal posture, not only to prevent injury but to give you strength as well.
These are just a few examples but always remember your question …
“Am I in an ideal posture right now?”
2. Appropriate Timing
Believe it or not, the timing of when you lift something is important. It is NOT recommended to lifting or carry anything immediately after:
- Waking up in the morning
While sitting, driving or stooping, especially if not done properly, the compressive forces are increase in your lower back. This will temporarily weaken your core muscles and if you try to lift something heavy, you are at an increase risk of injury. This is probably one of the most common ways people “blow out their back.”
Waking up in the morning may be surprising to you, but while you sleep, your body rehydrates your discs thus making you taller in the morning. This may sound good, but the problem is if you do not have an ideal posture in your lower back, you actually wake up stiffer and are more likely to have pain upon waking. This is why when you wake up, it is very important to get your body moving, stretch your legs and lower back and definitely limit flexing your body forward. This will minimize the strain on your lower back and decrease your risk for a lower back injury.
3. Optimal Spinal Loading
Optimal spinal loading, when is too much?? Optimal tissue repair requires an envelope of loading, not too much, not too little!
In general, biological tissues respond to loading stress as a U-shaped function. Too little stress will not stimulate tissue adaptation and too much stress will overload tissue leading to injury. The optimal load is not too much, not too little, and is unique to the individual. An exercise or movement that builds one individual may overwhelm another.
4. Reduce the Reaction Moment
The reaction moment is directly related to the position you are when pulling, carrying or lifting something. Here are a few examples of this being evident in your life.
- When opening a door, it is safer and less stressful for you to pull the door knob in towards your spine rather than parallel to the body.
- If you are vacuuming a room, it is safer to push the vacuum while in front of you in the middle of your body rather than on the side of you.
- When you a carrying something, it is safer to hold it closer to your body rather than away from your body
5. Maintain Spine Stability
(Stiffness = Stability)
- Spinal stability comes from having the proper posture, as well as having good core strength. This is commonly forgotten and is probably the leading cause to low back injury. Many people think they have spinal stability if they work out their core, but if they don’t evaluate their spinal structure and they have an abnormal posture, they could be strengthening in the problem. When your posture is straight from the front and you have the normal lordosis from the side, your strength and stability is at its best and you will decrease your risk of injury to the lumbar spine.
- Core Strength: Remember, the core is not just your abs! I cannot tell you how many times I hear people only training their abs for their “core workout.” This is the biggest mistake you can do and will guarantee you to blow out your back at some point. The core musculature is the abdominals and obliques from the front and the lower back muscle and gluteus muscles from the back.
Some great exercises for core strengthening include the following:
- Abdominal Crunches
- Side Planks
- Superman Exercises
- Anti-Rotational Exercises
- Side Crunches
- Low Back Extension Exercise (Remember to keep body parallel, DO NOT hyperextend your lower back)
6. Other Issues
- Exercise: Strength training alone is not ideal. You want to be sure to training using a combination of functional exercises and endurance training. This will give your body the most strength and stability.
- Psychology: Research has shown that those who “hardly ever” enjoy their job were 2.5 times more likely to report Low Back pain than those that did enjoy their job. Think your emotional health effects your body?!
- Nutrition: What you put in your body everyday will effect your body. An unhealthy diet will increase the amount of inflammation in your body. Inflammation causes pain and tightness in your lower back.
- Hydration: If you are chronically dehydrated, you will increase your risk for muscular injury. Drinking 1/2 of your body weight in ounces of water per day is a great way to decrease your risk for dehydration.
- Smoking: Smoking not only increase your risk for cancer but it also DEHYDRATES your discs! A decrease in hydration of your discs increases your risk for herniation, arthritic changes and other spinal related conditions.
Summary for Low Back Health:
- Maintain Good Posture
- Find a Postural Corrective Chiropractor (www.cbppatient.com)
- Timing is Everything
- Don’t Lift Immediately after Sitting, Driving, Stooping, or Waking up in the Morning
- Optimal Loading
- Too much overloads the spine
- Too little weakens the spine
- Not too much, Not too Little
- Reduce the Moment
- Keep things close to your body when lifting
- Maintain Stability
- Structure dictates Function – Posture is the Window to your Spinal Structure
- Core Strength maintains Structure – Keep that core strong
- Walk, Relax, Drink Water, and Don’t Smoke!
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