16 May 3 Tips to Reduce Your Risk of Developing Back Pain

Low back pain is the 5^th most common reason for people to see a physician and impacts between 60-80% people at some point across their lifespan.¹ Another staggering statistic is the recurrent rate for those who have had a previous episode of back pain. After the initial episode of back pain, you are two times more likely to suffer another episode within the next twelve months.² Another factor to consider is, according to the Bureau of Labor Statistics, the median days away from work due to back pain is over 18.³ Given these factors, it is easy for one to see the importance of reducing the risk for developing back pain. Below you will find 3 areas that will significantly help reduce your risk for developing back pain.

Properly lifting

How many times have you heard someone say “lift with your legs and not your back?” One thing to keep in mind with this is, although it is a great cue, many do not inure their back lifting something heavy. Commonly it is lifting something light. I contribute this to not properly bracing through the core when we expect something to be light and just haphazardly bend down to pick the object up. If we anticipate the object to be heavy, we have a natural tendency to move slower, maintain a neutral spine and lift through the legs.

To lift properly you initially want to “brace” through the abdomen. To set the brace, you tighten the abdominals by bringing the stomach up and in, which engages the deep lumbopelvic stabilizers. Practicing this technique throughout the day is important because activation of these muscles has been shown to be delayed in those with a history of back pain. When you consistently practice bracing, it will become reflexive and you won’t have to think about “lifting with your legs and not your back.”

After initiating a brace, you can squat down to the object, perform a lunge down to the object or bend at the hips (hip hinge) down to the object. All these options are great and one isn’t necessarily better than another. Which you decide to use is strictly dependent on the situation (object size, object weight, available space etc).

Strengthening

When looking to do strengthening to reduce your risk of developing back pain, it is imperative to develop core and hip muscle coordination along with strength. This may sound complicated, but it’s not. Our body reflexively activates core stabilizer muscles when we perform certain motions, so all we have to train those patterns, then progressively add resistance to develop strength.

Examples include:

• Hip hinging: To perform a hip hinge, maintain a neutral spine with slightly bent knees and shift your weight backwards while bending at the hips. The buttock should go beyond the heels. When doing this, you need to follow the “single joint rule.” This rule states that only one joint moves, while the adjacent joints are fixed. This is a very safe and highly effective exercise to develop low back, gluteus maximus and hamstring strength.
• Squatting: The squat is a fundamental movement; you need to be able to perform no matter your age. To properly squat, you perform a hip hinge first, then let your knees bend. As you descend, you want your hips to go down and backwards in a diagonal.
• Loaded carries: To develop strength on one side (left or right) carrying weighted objects is a staple in any program and can easily be implemented through your daily activities. All you need is a bag of groceries, a briefcase, carry-on luggage etc and carry the object until you become fatigued. At this point, switch sides and continue. As you do this, you have to remember not to lean and keep your torso straight up.

Mobility

Maintaining proper mobility through the lumbar spine and hips is important because increased tension in muscles around the nerves can result in complaints of radiating low back pain. Below are two great techniques you can try with either a foam roller or a set of Yoga Tune Up balls. When doing soft tissue mobility, you want to spend 2-3 minutes at each area.

• Lumbar erector spinae: While lying on your back, place both Yoga Tune Up balls along the muscles in the center of your back (one on each side). Once you’ve done that, slowly bring your knees toward your chest and then lower your knees. Repeat this for 2-3 minutes.
• Hip: Sitting on either a foam roller or a Yoga Tune Up ball, find a tender spot around the back of the hip and slowly roll back and forth. Continue for 2-3 minutes.
• Hip flexor stretch: While lying on your back on your bed, bring the right knee to your chest and let your left leg hang off the bed. You should feel a stretch in the front of the hip/thigh on your left. There should be no back pain during the stretch. This stretch should be held for a longer duration 1-2 minutes on each side.

References:

1. Balague F, Mannion AF, Pellise F, and Cedraschi C. Non-specific low back pain. 2012; 379(9814): 482-491.
2. Stanton TR, Henschke N, Maher CG, Refshauge KM, Latimer J, and McAuley JH. After an episode of acute low back pain, recurrence is unpredictable and not as common as previously thought. 2008; 33(26):2923-2928.
3. Nonfatal occupational injuries and illnesses requiring days away from work, 2014. Bureau of Labor Statistics US Department of Labor website. http://www.bls.gov/news.release/pdf/osh2.pdf. Published 11/19/2015. Accessed 5/14/2016.