Understanding back pain is one of the most important aspects of managing and hopefully reducing it in the long run.
Back pain can come in flexion based, extension based, rotation based, and compression based. This assumes we are not talking about medical diagnoses.
Most back pain issues are chronic, non specific, and annoying as hell.
When I ask about back pain with clients, I never hear “Oh I have sciatic pain from a bulging disk that only really flares up when I round up.”
More often it goes “My back always hurts.”
A lot of people have accepted their back pain as a part of their life because it is a tricky thing to look at.
MRI’s and X-Rays can be extremely confusing. They can show nothing with someone that is in pain and also show an issue on someone who has no symptoms, creating a new scare.
The part that seems to get ignored most often is the proper alignment and strengthening of movement in proper alignment.
Chiropractors are great for realigning the spine and pelvis. Great chiropractors have a basis of movement knowledge (or refer out to a good trainer/coach) and assist with strengthening the structures to keep the alignment.
A client of mine has two herniated disks in his back. Every 6 weeks or so, I can pick up on when he needs an adjustment because he is not moving like himself. After the adjustment we work on core stability to reinforce the pattern.
Now for those that do not have a definite diagnosis, there is a way to decipher what kind of movement pain you have.
*Please be aware that this does not screen for issues of the vertebral disks or structures of the spine, etc. It is only meant to give you an idea of what kind of bias you have. You should seek out the proper medical professionals whenever you are in pain.
Determining Flexion Based Back Pain
Figuring out your back pain is done in two steps.
The first step is to look at your posture and lifestyle habits.
• Do you work at a desk all day?
• Do you spend a lot of time in the car?
• Are your shoulders rounded over?
• Does sitting for a long period of time increase symptoms?
If the answer to all of these questions is yes then you are most likely to have flexion based back pain.
The second step is to move into the pattern.
Bend over and touch your toes. A flexion bias would make symptoms worse here.
Put your hands on a desk and perform the same bend over (obviously not to your toes). If that creates less symptoms then you do not tolerate flexion very well.
Exercises in Extension for Flexion Based Issues
The following exercises are extension based and will help to improve core stability for those with flexion intolerance.
The key to all core exercises is to find a neutral spine by allowing a slight curve in the back. If you were to lie on the ground you should be able to slide your hand under your low back up to your knuckles.
After finding the neutral you must brace by squeezing all of the abdominal and low back muscles (think about bracing for a punch in the stomach) and breathing through the brace.
You can then perform the movements once you are braced in neutral.
The following exercises promote extension through the spine.
3. Double Leg Lowers
4. OH Pallofs
For those with chronic, undiagnosed, flexion based back pain, these exercises will promote extension.
As with anything, talk with your healthcare professionals before trying anything you are not sure of.
Relieving that annoying, lingering pain that no one can figure out sometimes just consists of building stability.
If the joints are stable they will be in normal alignment and avoid the postures that create symptoms.