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guide to low back pain

Build a Stronger Back

guide to low back pain

A Comprehensive Guide To Low Back Pain: Everything You Need To Know

Overview

Low back pain is one of the most common complaints that drive regular people and athletes to hospitals and private clinics.

According to the National Institute of Neurological Disorders and Stroke (NINDS), around 80% of all people experience low back pain for at least one time in their lives. By far, people between the ages of 30–50 are the most susceptible age group.

Unfortunately, the lower portion of the back has complex anatomy, with various structures, which eventually makes the diagnosis quite difficult.

In medicine, doctors define acute back pain as a sensation of discomfort that lasts between a few days to less than 3 months. Exceed this time frame, and we’ll be dealing with chronic back pain.

In this article, we will cover the causes, diagnosis, and treatment options of low back pain. We will also discuss the impact of strength training on this condition.

The causes of low back pain

Lumbar strain

This is an umbrella term that describes an injury to one of the following structures:

  • Tendons
  • Ligaments
  • Muscles 

When the pressure applied to these structures exceeds normal values, microscopic tears occur. These will send signals to the brain, producing a sensation of pain.

According to the latest guidelines, experts don’t recommend staying in bed for a prolonged period of time.

Lumbar radiculopathy

Commonly known as sciatica, lumbar radiculopathy takes place when the disks become weak, which forces the soft portions to herniate.

Patients with lumbar radiculopathy get triaged to opt for medical or surgical treatment (e.g., minimally invasive lumbar spine surgery). 

Arthritis

Arthritis describes an active inflammation of the joints (e.g., elbows, wrists, knees). When this condition affects the lower back, we refer to it as spondyloarthropathy.

With time, the vertebrae might fuse together, leading to severe restriction in the range of motion and continuous pain.

The symptoms of low back pain

While most of you are familiar with the classic symptoms that accompany back pain (e.g., stiffness, immobility), this section will focus on the potentially dangerous symptoms that require specialized care as soon as possible.

Fever

When your fever starts simultaneously with back pain, it may be an indication of a spinal infection (e.g., osteomyelitis) that’s eroding the bony structures.

Eventually, this causes osteolysis (i.e., the breakdown of bone). In left untreated, you could develop a more severe condition known as sepsis (i.e., the spread of the infection in the bloodstream).

If you experience high-grade fever with back pain, make sure to contact your primary care physician.

Numbness and weakness

Numbness and weakness of the lower limbs with back pain indicate direct damage to the nerves, which is a surgical emergency that requires immediate attention!

Loss of sphincter control 

The loss of sphincter control manifesting as urinary or bowel incontinence may reveal serious nerve damage to the nerves that usually control the muscles around your sphincters.

Fortunately, receiving the proper medical/surgical care in time should alleviate these symptoms. However, patients may need physical therapy in some cases.

Diagnosis of low back pain

The diagnosis of low back pain is straightforward. However, identifying the etiology of the pain is somewhat tricky.

To make the diagnosis, the physician will take into account the information gathered from:

  • The history of the patient 
  • The findings of the physical examination
  • The test results (e.g., blood tests, imaging tests)

Based on this data, the origin of the pain will be determined along with the underlying medical condition that’s triggering it.

The treatment of low back pain

Depending on the origin of the pain, there are two major ways to address this condition:

Medical treatment

This involves the prescription of pharmacological drugs, such as acetaminophen and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).

In some cases, the physician will opt for more potent drugs, including corticosteroids, narcotic painkillers, and muscle relaxants. 

Surgical treatment

For the most part, doctors prefer to avoid surgery since it can lead to serious complications. However, surgical therapy might be the only option for a group of patients.

Here are the common procedures performed to fix low back pain:

  • A discectomy 
  • A foraminotomy
  • Intradiscal electrothermal therapy (IDET) 
  • A nucleoplasty 
  • Radiofrequency lesioning 
  • Spinal fusion 
  • A spinal laminectomy

Practice mindfulness 

Practicing mindfulness (e.g., yoga, meditation) increases the release of endorphins.

These chemicals have potent analgesic (i.e., pain-relieving) properties on the central nervous system, which reduces pain, stress, and anxiety.

Exercise

As we mentioned above, current guidelines advise against complete immobility after injuring your back. 

You see, moving around helps your body heal faster, especially when targeting the right muscle groups.

For instance, the abdominal muscles significantly reduce the pressure applied to your back. Therefore, you should prioritize exercising these to reduce the frequency of low back injuries.

Get better sleep

Healthy sleep improves hormonal balance, restores your energy, and relieves pain. Sleeping sufficient hours will also promote the tissue-repair biochemical cascades, which helps you get back on your feet quickly.

The prevention of low back pain

Here are some practical tips to prevent low back injuries:

Warming up

As you already know, warming up is the most important step in every exercise session. You can start by doing some low-impact exercises, such as jogging, cycling, or simply walking.

This will allow the synovial fluid to move around your joints, especially those under high tension (e.g., hips, knees, elbow).

In the latest guidelines of sports injuries, researchers recommended to follow these movements to reduce the risk of musculoskeletal injures:

  • Forward running (1-2 laps)
  • Forward run with zig-zag (1-2 laps)
  • One leg jump over a line
  • Jumps in place

Cooling down

The cooling down phase is as important as warming up.

Your primary goal is to gradually decrease your cardiac output and heart rate, which allows your muscles to recover.

According to guidelines, the optimal cool-down routine consists of 5–10 minutes of light jogging, walking, or knee-to-chest pose.

Interestingly, cooling down properly reduces the risk of delayed onset muscle soreness (DOMS).

Listen to your body

Telling the difference between good and bad pain is a crucial skill that you need to learn.

Some of you might be thinking: “what’s a good pain?”

A good sensation of pain is the discomfort you feel during exercise; it is a sign that your muscles are undergoing so much pressure, which is exactly what you want to feel when working out.

Conversely, sudden pain that’s sharp and intense is a warning sign that something is not working right.

How does strength training improve low back pain?

Most people think that immobilizing their spine after feeling pain is the best approach to heal. However, researchers believe that stretching and exercising after a physical injury to your back might accelerate your recovery.

This is not to say that you should push yourself in the gym when you suddenly feel pain in your lower back. On the contrary, if you experience any unusual feeling of pain in the gym (regardless of its location), you should stop what you’re doing to avoid exacerbating the situation.

Strength training exercise for back pain

To reduce your risk of injury

For most of the week, people often engage in a sedentary lifestyle, which makes them susceptible to numerous diseases (e.g., obesity, diabetes, cardiovascular disease) and musculoskeletal injuries (e.g., knee pain, low-back pain).

While incorporating strength training in your weekly routine might help you break out of this vicious cycle, training too hard puts your back at risk for injury.

Therefore, when you target your back, it will become more resilient to intense workouts, which reduces the risk of injury.

To improve posture

Exercising your back can help you get rid of bad posture by correcting the “hunched form” you get after sitting for long hours on your desk.

By strengthening your back muscles, you’ll be able to maintain the alignment of your spine, which improves your overall posture.

To temper down lower back pain

Back exercises combined with a good stretching routine can significantly reduce your back pain. This is due to the strengthening of the muscle fibers and the higher threshold of tension your back can handle.

Top 5 back workouts with dumbbells 

Back exercise for strength

This exercise focuses on building the strength of the back muscles, which means it’s based on loading with progressively heavier loads.

Here’s an example:

Pullup powered dumbbell

As you do your regular pull-up exercise, try to add some weight by attaching a dumbbell to your lower body, using a leash, or just locking it with both of your feet.

The extra weight will make the pullup much more challenging, which puts extra stress on your back muscles, and eventually, builds strength.

Each time you get too comfortable with the current weight, try to increase the load.

Back exercise for power

The two most important elements to increase power are speed and explosivity that you can get from various exercises.

Here’s an example:

Dumbbell dead row

  • As the dumbbells sit on the floor, place yourself in a position similar to the deadlift. 
  • Lift the dumbbells off the floor, using the strength of your legs.
  • Once the dumbbells are above your back with the elbows extended, lower the dumbbells back to the floor and repeat.

The best thing about this exercise is that it doesn’t have any momentum to count on, which creates explosivity by using your arms and legs to lift the dumbbells from the floor.

To make this exercise more efficient, try to increase the weight as much as you can handle.

Back exercise for metabolic effect

The focus of metabolic exercises is to create the burning sensation that comes with repeated movements of the dumbbell.

While the bent-over dumbbell row might seem like a good option in this situation, it places too much strain on the lower back, which is why we opted for another variation.

Here’s an example:

Chest supported touch rows

  • Place yourself on the incline bench (protects the lower back).
  • Put two dumbbells on the floor and grab another two in your hands (4 dumbbells in total).
  • As you do the dumbbell row, your goal is to touch the ones you placed on the floor to target the lats.
  • Once you’re nearing failure, ditch the dumbbells in your hands and grab the ones on the floor to keep the metabolic effect going.

Back exercise for a total-body workout

Obviously, to do a total-body workout, you need to involve the majority of muscle groups. Consequently, the exercises in this category are complex and include several movements.

Here’s an example:

The Manmaker

This exercise can be divided into three major categories:

The pushup phase

  • Place yourself in a pushup position while grabbing the dumbbells.
  • Perform one pushup and move on to the next phase.

The renegade row phase

  • While keeping your back straight, do a renegade row for both sides of your body.

The jumping phase

  • Once you finish the renegade row, bring your feet forward and switch to a standing position.
  • Lift the dumbbells above your head, then go back to the pushup position.

Back exercise for hypertrophy

As the name implies, this exercise focuses on increasing muscle volume, which is best performed by targeting specific regions of the back to reduce the interference of other muscle groups.

Here’s an example:

Dumbbell pullover

The dumbbell pullover is one of the best exercises that strengthens your lower back muscles and your lats.

Check out this blog post for a comprehensive guide on the dumbbell pullover.

Other back exercises

Kettlebell swings

Not only will this exercise help you build a strong core, but it will also strengthen your back muscles. 

Make sure to perform the swings with your feet slightly widened, knees bent, and kettlebell held with two hands between your feet. 

Once you’re in position, lean forward without compromising spinal alignment.

Swing the kettlebell backward until it’s just behind your feet, then swing it again until it reaches the shoulders’ level.

Wide-grip pull-ups

This exercise is a variety of regular pull-ups. 

Instead of placing your hands at the shoulders’ level, you should widen your grip. 

It is crucial to do this exercise in the right form, as it can lead to muscle strain.

Dumbbell single-arm row

This one is a classic. 

It involves working both sides of your back and strengthening the weaker spots. It is important to keep your shoulder in the right position.

Doing this exercise frequently produces excellent results in people who suffer from lower back pain.

Farmers’ walk

Farmers’ walk is a simple exercise that conceals numerous benefits. This exercise strengthens the muscles of your back, shoulder, and forearms. 

To perform the farmers’ walk, you need to hold one dumbbell with each hand as you walk for short distances.

Takeaway message

Low back pain is one of the most common injuries in the field of fitness and people with a sedentary lifestyle.

We hope that this article managed to simplify this complex topic into understandable bits. We also hope that you are now more aware of the role of strength training in treating and preventing low back injuries.

If you have any questions, concerns, or just something that you want to add, please don’t hesitate to share your thoughts in the comment section below.

Learn more about strength training exercises by clicking on this link.

dumbbell pullover

The Dumbbell Pullover: Build a Wider Back With This Exercise

Overview

The conventional dumbbell pullover is an upper body exercise that strengthens the muscles of the chest (pectoralis major), wing-shaped muscles in the back (latissimus dorsi), the core (abdomen), and upper arm (triceps) muscles.

Depending on the movement and variation you choose to perform, the stress will get applied to a certain group of muscles, leading to more hypertrophy in that specific area.

Overall, the dumbbell pullover is one of the best resistance workouts that’s adopted by sports physiologists as a postural exercise to fix spinal misalignment and increase the flexibility of the upper body, which is especially beneficial for people with desk jobs.

In this article, we will briefly discuss the importance of targeting your latissimus dorsi muscles (i.e., lats) and how you can use the dumbbell pullover to achieve that.

Why is it important to target your lats?

The latissimus dorsi muscles, or lats, are the large wing-shaped muscles that connect your arms to the vertebral column.

This group of muscles stabilize the spine and provide the shoulder and back with the necessary strength. The lats also assist the movement of the shoulder and arms while maintaining a good posture.

Targeting these muscles will significantly improve upper body strength and allow for a wider range of motion.

Unfortunately, most people neglect their lats, which can lead to dire consequences.

In the case of injury since a simple tear in the lats may cause chronic shoulder and neck pain, and in some cases, tendonitis (i.e., inflammation of the tendons) of the shoulder articulation.

For this reason, you need to ensure that your lats are put under sufficient physiological stress to strengthen the muscle fibers and reduce the risk of traumatic injury.

How does the dumbbell pullover help with this process?

To increase the focus on the lats muscles, you need to do a slight variation of the dumbbell pullover by adjusting your position on the bench.

Instead of lying down in alignment with the bench, you need to place your upper back on the side of the bench while maintaining that position with the help of your lower body.

In other words, the only two parts of your body that will be in contact with the ground are your feet and a small portion of your upper back.

Make sure to create a 90-degree angle between your spine and the long-axis of the bench.

(watch the video below for illustration)

Once you’re in the correct position, here’s what you need to do:

  • Place one dumbbell in each hand then extend your arms over your chest with the palms facing each other.
  • Extend the weights back and over your head while inhaling.
  • Reach full extension in 3–4 seconds, where the dumbbells will be behind your head.
  • As you reach full extension, exhale and return your arms to the initial position.
  • Do this exercise for 10-12 repetitions.
waiter's bow exercise

Beginners Guide: How to Hip Hinge | The Waiter’s Bow

Waiter’s Bow is a great progression when learning the proper way to hip hinge. What makes this exercise different from a regular good morning is the placement of the workload. Typically, the workload for a good morning is on the back of the shoulders. For this exercise, the weight will be held in the front, close to the collarbone/upper chest area. This movement can be favored for a novice lifter for a couple of reasons.

  • The Waiter’s Bow has an easier set up than a typical good morning again, weight placement.
  • If you are new to lifting then putting a barbell on your shoulder blades might be intimidating or even just uncomfortable.

Therefore, making the Waiter’s Bow a better option. Also, just like the banded good morning, this exercise can be used a warm-up/ activation before the main lift or as an accessory movement.

how to perform the Waiter’s Bow

To start the exercise, begin by selecting a dumbbell and holding it by the hexes or the ends of the weight. Arms should be bent and the weight will rest right under your collarbone. Keep your chest pushed out and shoulders pulled back. Allow your knees to be slightly bent and begin to push your hips back into a hinge position. Make sure your knees only bend somewhat or this movement could easily turn into a squat. Maintain a flat back until you reach the perpendicular position. Stand back up to the start and squeeze your glutes. Repeat for desired reps and be conscious of the 3:1:1 ratio.

banded good morning how to guide

Banded Good Morning: Develop Stronger Links In Your Posterior Chain

The banded Good Morning is an exercise used to strengthen the posterior chain.  The hamstrings, glutes, and low back can be activated without heavy compression on the spine when performing the banded good morning.  This movement can be programmed into a fitness routine to introduce proper hip hinge execution without the use of eccentric loading. The low impact benefits of the banded good morning allow the user to develop new movement patterns, making it an ideal exercise for the novice lifter.  Banded good mornings are also good for warming up the glutes and hamstrings before moving on to more advanced exercises or as an accessory movement after your main lift. This exercise is best performed for high repetitions.

how to perform the banded Good Morning

begin with a large resistance band around the back of your shoulders. Make sure your shoulders are retracted and your chest is pushing out. This allows for better form during the movement. Grab the band and step on it with both feet. Stand up so there is tension on the band. Begin with knees slightly bent, keep your hands gripping the bands and start to push your hips back. Maintain a neutral spine and allow your back to become perpendicular to the ground while still maintaining proper form. Stand back up to the start position and squeeze your glutes. Repeat for desired reps. When executing this exercise aim for a 3:1:1 ratio. This means, a slow 3 count on the downward movement, 1second pause at the bottom, and 1 second back to the standing position.

bench supported bent over row

How to Perform a Bench Supported Bent Over Row

bench supported Bent over Row

dumbbell

The bench supported row is a good pulling exercise for beginners because there is less strain on your erector spinae as well as your low back muscles. There are a few ways to do a supported row but for this demonstration we are showing a single arm dumbbell row.

how to perform a bench supported Bent Over Row

To set up for this exercise start with a flat bench and a dumbbell on the ground. For explanation purposes we will be showing the left arm/back doing the exercise. Body positioning will be the following: right arm flat on bench with right knee also on bench. Your back is in neutral with head and neck following. Pinch your shoulder blades together and your butt can be pushed out slightly. Your left leg is extended on the ground but should have a small bend at the knee. Grab the dumbbell with a neutral grip and pull upwards. Your chest should remain pointing down towards the bench and your elbow/ arm should be grazing past your ribs. Lower the dumbbell back down.

how to perform a spit stance bent over row

How to Perform a Split Stance Bent Over Row

bench supported Bent over Row

dumbbell

The bench supported row is a good pulling exercise for beginners because there is less strain on your erector spinae as well as your low back muscles. There are a few ways to do a supported row but for this demonstration we are showing a single arm dumbbell row.

how to perform a bench supported Bent Over Row

To set up for this exercise start with a flat bench and a dumbbell on the ground. For explanation purposes we will be showing the left arm/back doing the exercise. Body positioning will be the following: right arm flat on bench with right knee also on bench. Your back is in neutral with head and neck following. Pinch your shoulder blades together and your butt can be pushed out slightly. Your left leg is extended on the ground but should have a small bend at the knee. Grab the dumbbell with a neutral grip and pull upwards. Your chest should remain pointing down towards the bench and your elbow/ arm should be grazing past your ribs. Lower the dumbbell back down.

reverse split stance bent over row

How to Perform a Reverse Split Stance Bent Over Row

reverse split stance Bent over Row

dumbbell

The reverse split stance bent over row is very similar to the split stance row. The exception to this variant is feet positioning. The stance set up for this exercise will be the same for the split stance row except that your opposite leg will be in extension. This means if your right arm is pulling the dumbbell back, your left leg will be extended out. This foot placement allows for a better torso alignment. When pulling the weight with a standard split stance there can be a tendency to rotate the pelvis which creates a false range of motion and diminishes the benefits of this exercise. By adjusting your base of support the bent over row can be performed much more effectively.  This is a super easy modification that will dramatically improve your row technique.     

how to perform a reverse split stance Bent Over Row

To set up for this exercise start by placing your hand on a box or bench  and split your stance so your back leg is straight and you’re on your back toes. Your front leg will have a slight bend. Have your spine in a neutral alignment; neck and chin are slightly tucked. Initiate movement by picking up a dumbbell with a neutral grip and pull the dumbbell into your body. The hand that holds the dumbbell is the opposite leg that extends back. Your arm should stay close to your body and your elbow will be in a 90 degree bend. When pulling up on the weight make sure to pull close to your hip area. Lower the dumbbell back down with control. 

reverse grip bent over row

How to Perform a Reverse Grip Bent Over Row

reverse grip Bent Over Row

The reverse grip bent-over row is an underhand barbell row that builds upper back strength but also puts a greater emphasis on the biceps. This exercise allows for a better range of motion in the shoulders, less strain on the trapezius muscles, and the neck and a better contraction in the lower lats. This is a 2 point row because the only points of contact will be your feet on the floor. With that in mind, this exercise will put more stress on your erector spinae muscles but will also allow you to become more stable in the hip hinge position.

how to perform a reverse grip  Bent Over Row

To set up this exercise your feet will be parallel, hinge at your hips, and allow your chest to be at least 45 degrees from the floor. Your arms are extended; grab the bar with an underhand grip. Pull the bar to sternum height while allowing your arms and elbows to glide backwards. Make sure that your abs are contracted to help brace the tension on your low back muscles.

Lower the bar back to the starting position. A common mistake with barbell rows is bringing your chest to the bar instead of the bar to your chest. Do not use your momentum to pull the bar up. If you are unstable, rocking your hips, or bouncing your chest to complete the pull or if your toes are not grounded reduce the weight or end the exercise.