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, 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,
With
good stuff maynard😊🖒
Hi Dr. Horschig, I’ve been following your work and Dr. Stuart Mcgill’s, but cannot seem to turn off the hamstrings on the bridge. For a bilateral leg bridge Dr. Mcgill cues with a “squeeze a coin between your butt” (he’s okay with some external rotation in the femurs, but does not tolerate any pelvic tilt on this cue), and then has the patient perform the bridge, and even has loose hamstrings on his demo participant sometimes while the glute is active. If the patient is having trouble turning off the hamstrings, he might have them put their toes up against a wall or some other obstacle, aim to push the toes away and “up” a bit, and lightly rake the quads with his fingers (seems to be an attempt to get a agonist/antagonist relationship going to help turn off the hamstrings). I’m trying to do this myself, but the motor pattern of turning on the hamstring on the bridge seems to be inextricably wired together with the movement and they always fire up. Any other ideas to help teach better motor patterns? I’ve been looking into the Feldenkrais Method, but not sure if anyone has created an audio lesson specifically for re-establishing gluteal dominance. Thanks in advance for anything you can share! If things work out, I’ll try to catch you when you come to Toronto!
Workout saves you from so much trouble. Even most of the pains go away due to exercises.
Great post tho. Thanks for sharing.
[…] How to perform a single-leg glute bridge: […]
[…] […]
[…] or a variation of them, in our warmups before we get on the erg or in the boat. I also like The single Leg Bridge Test (which I failed). I am now doing the corrective exercises most […]
When I have the right leg on the ground I feel my lower back on left side tighten trying to keep the hips level but fails..what is going on there? The other side works normal enough…
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This test looks so painful. It needs to be stronger and cooler flagle wordle.
It’s necessary to build a stronger leg bridge test. Do you think so? That’s wonderful flagle wordle.
Your body’s ability to coordinate itself during barbell training can be better understood by solving each of these challenges. If you were able to feel pain in the low back, this indicates that you are most likely arching your back before moving your hips. Very efficient.
An understanding of how your body coordinates itself during barbell training can be gained from each of these exercises funny shooter 2. If you felt pain in the low back, it indicates that you are probably arching your back first and then moving your hips. Excellent performance.
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