This is one of my favorite quotes from the guru of movement, Dr. Gary Gray. This is a fact that cannot be denied. Research has proven over and over again that physical training whether it be endurance, flexibility, strength, power is only effective in the way that you are training. Another way to say it is that exercise is sport or activity specific.
Let me share with you a story. Like him or not, Lance Armstrong was one, if not the best, road cyclist of all time. He scored off the charts with many tests of endurance that had never been seen before. To this date he has recorded the highest lactic acid threshold known to man which is a blood test that measures the level of intensity his muscles can achieve before fatigue. When Lance Armstrong retired from cycling he took up running. In fact, the month after he retired he signed up for a marathon. Without much training for the marathon he figured he would do just fine because his endurance was so high and he had so much success in the past with cycling. Well he finished last! Imagine that, one of the best endurance athletes of all time finished last in a marathon that included just regular people like you and me who by no means were top notch world class athletes. In an interview after the marathon Lance was quoted as saying it was the hardest thing he had ever done.
Now ask yourself why is that? Well science says that training the body only translates to the activity that you are training it for. So his cycling experience and training had no impact on his ability to run long distances. So that makes total sense when you listen to science. Now let’s apply that principle to how we rehabilitate and train people who have or have had lower back pain. The most traditional training is for the “Core” which usually means the stomach muscles. But remember a few chapters ago I talked to you about how in 1957 it had been disproved that abdominal strength had anything to do with lower back pain. But let’s talk about traditional core training as if it might actually help our lower back pain. The most common core exercises have us laying on our backs and flexing our trunk or flexing our legs in order to activate our stomach muscles. Some common names are crunches, sit ups, leg lifts, dead bugs, etc. The problem with this approach is that you are training your stomach muscles to flex. Now let’s do an experiment together. Stand up and flex your stomach (this looks like you are bending forward), now put your hands on your stomach. Does it feel flabby and loose, or firm and tight? For most people it will be flabby and loose, not because you are out of shape but because your muscle is doing nothing when you stand and flex forward. Flexing or bending forward is a motion that is given for free. What I mean by free is that gravity is what is bending you forward and the muscles on the back side of your body are actually decelerating you. The stomach muscles did not make you flex or bend forward. So why in the world would we train them to do so while laying on our backs? In fact, if you are going to do that then there will be no translation to stronger stomach muscles when you are standing because they NEVER bend you forward. The only time the stomach muscles bend you forward are when you are trying to get out of bed in the morning. So keep doing crunches but they will only help you get out of bed easier.
What we really need to think about is how then do we train our core muscles to help our spine function better. The answer really is it depends. It depends on the activities that you are participating. For the sake of simplicity let’s take walking as an example that we want to train someone to get better at which would include having no pain during. Walking by the way is the most common reason or activity that people have back pain with. I would say that our abdominals usually have little to do with the cause of back pain during walking but sometimes they can be related. So let’s just assume that we have a person who has lower back pain with walking and it’s because their abdominals need to be strengthened. What do the abdominals do during the walking motion? Well they control the pelvis and the spine during side to side motion, rotation right and left, and extension of the spine. So that means that if we want to train or abdominals to be stronger during walking we need to create those motions and stress the muscles during those activities so they build themselves stronger and learn how to react to those motions. It is also important to recognize that our exercises must be in a position that looks and feels like walking. That would then mean that we need to be standing and not sitting or lying on our backs. We also dissect walking and realize that 70% of the walking cycle includes a single leg stance. So it makes sense for us to have some single leg exercises. And finally I notice that when I’m walking we are moving so therefore our exercise probably should include some motion instead of holding positions for long periods of time (planks). All of these strategies then will translate into a core that is stronger and abler to help control the spine during walking. You see how easy that was.
Now if you are a runner or gardener or desk sitter who has lower back pain during those activities the training for your core would be different. It would look and feel like the activities you are having a hard time with. That is what I mean by not being random. You must be specific to the goals that you have when you are exercising. If the exercise doesn’t look like anything you ever do in your life, then you should probably stop doing it because it is a waste of time. Unless maybe you are only concerned about building muscle for aesthetic reasons which in that case it doesn’t really matter what kind of exercise you are doing. Most people however are exercising in order to be healthier and to have pain free motion.
If you are interested in finding better ways to strengthen your core that might look and feel like activities you actually want to get better at I would encourage you to visit our website where you will find many videos that instruct you on ways to strengthen your core. Clicking here would be a good start.
If you are interested in learning specific strategies to eliminate your lower back pain I can tell you it is most likely not your core or stomach that needs attention. I would encourage you to learn more by attending our lower back pain and sciatica workshop this month by visiting this page.
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