Treating low back pain is no easy feat as there are many factors that need to be considered. A few weeks ago we finished a blog series on back pain. Today I want to add one more category to that list by discussing how to fix low back pain caused by coordination problems.
Through my years as a physical therapist I have found that many athletes sustain injuries to their low back not because they are weak but because they overload certain tissues due to lack of coordination. While light stretching, rest and ice can be helpful directly following an acute low back injury (such as a muscular strain), you must eventually treat WHY the injury occurred in order to have lasting results. There is a simple screen called the “single-leg bridge test” that can help identify coordination related injuries. I first came across this screen after reading ‘Anatomy for Runners’ by physical therapist Jay Dicharry.
How to perform
Step 1: Lay on your back with your knees bent.
Step 2: Kick one leg out straight as shown.
Step 3: Pick your hips up and hold this bridge for 10 seconds.
What muscles did you feel working hard after holding this single-leg bridge for 10 seconds? Our goal with this screen is to identify your “go-to” muscles for hip extension (the movement that drives you out of the bottom of the squat, clean, snatch, etc). If you felt anything other than your butt muscles (glutes) working hard, you have a coordination problem we need to work on.
The glutes (specifically the glute max) have two main jobs: hip extension and postural stability. Most people with coordination problems will feel their low back, hamstrings or quads working hard and possible cramping during this test.
Each of these problems gives insight into how your body coordinates itself during barbell training. If you felt the low back, it means you’re likely arching your back 1st and then moving your hips. If you felt your hamstrings cramping, it means the hamstrings are working double time to produce hip extension because your glutes aren’t pulling their weight (pun intended). If you felt your quads working hard you probably aren’t using your posterior chain at all during your workouts (not good).
When your body doesn’t fire muscles in a proper sequence, it leads to inefficient movement and can overload of certain parts of the body. This is WHY some athletes develop pain. The following exercises will address this problem.
Coordination Exercise #1: Bridge
How to Perform:
Step 1: Lay on your back with your knees bent as shown.
Step 2: Flatten your back to the ground by bracing your core as if you were about to get punched in the stomach.
Step 3: Squeeze your butt muscles FIRST and THEN lift your hips from the ground. Picking your toes up and driving your heels into the ground can help increase your glute activation during this part of the movement. Squeeze your glutes as hard as you can in this bridge position for 5 full seconds before relaxing back to the ground.
Recommended sets/reps: 2 sets of 20 for a 5 second hold. Eventually work your way up to 10 second hold or even 20 seconds.
Coordination Exercise #2: Deep Squat with Isometric Hold
How to Perform:
Step 1: Hold a weight in front of your body and perform a deep goblet squat.
Step 2: Brace your core in this bottom position and drive your knees to the side while keeping your foot in an arched position (this should turn on the outside of your hips or glute medius muscle.
Step 3: Rise a few inches and squeeze your glutes like crazy. Hold this for 5 seconds before sinking back down. This translates the glute activation from the previous exercise into something functional.
Recommended sets/reps: 1-2 sets of 5 for 5 second holds
Case Study Example
Until next time,