Lower back pain is more common than neck pain. However, lower back dysfunction is crippling because it impedes the very ability to walk. Our lower backs hurt because: 1) we use them very little, 2) when we do use them, we only use a fraction of their full range, and 3) we have spent our lives breathing shallowly, whenever we engage our lower backs. Let’s reverse this.
Back pain is the second leading symptom for physician visits in the US. It is estimated that Americans spend more than 50 billion each year on lower back pain alone. This preventable ailment is taxing our wallets, our healthcare system, our economy, and our very sense of personal agency. Lower back pain derives from the same ailments we have been discussing all along: dormancy and frailty.
My lower back was treacherous. The muscles surrounding my lumbar vertebrae were in such bad shape that they would hurt every time I coughed or sneezed. I would severely strain my lower back every year because of stress, lack of sleep, or improper exercise, leaving me unable to walk for days at a time. A few times I was bed ridden for a week crawling back and forth to the bathroom on my hands and knees. Since the day I began antifrailty training, this has never happened again. The dormant muscle that used to lock up when I threw my back out, has been transformed into springy, mobile, load-accepting muscle. I unlocked my entire lumbar region by combining antifrailty, with spinal decompression, stretching, and therapeutic massage. This section will touch on each of these and give you the information you need to start transforming the base of your tail.
How tense is your lower back? Use your fingers to feel the tense, dormant muscles along your iliac crest (the bony prominence above your butt) in the activity below.
|Lower Back Activity #1: Diagnose the Extent of Your Lower Back Dormancy|
|Press your index and middle fingers into your lower back 2-6 inches above each butt cheek. Feel the muscles covering the sacrum and the iliac crest of your pelvic bone. You will likely feel large tense cords of muscle fibers right over the sacroiliac joint. Ideally this muscle should be smooth and flat with no perceptible knotting.|
|Duration: One minute. Proficiency: Four sessions a week for 24 weeks. Maintenance: Once per month|
As you know from Chapter 13, the lower part of our spine, called the lumbar region, is naturally curved backwards. This backward bend is known as lumbar lordosis. The lower back is bent lordotically in order to support the legs, and absorb impact. In lordosis, the top of the pelvis is tilted forward as if you were pouring a bowl of soup from your waist out in front of you. In most people this lordotic curve is excessive making it structurally unsound. When the lordosis is excessive it is called “anterior pelvic tilt” or “pelvic anteversion.” Generally, the more pelvic tilt one has, the less pelvic mobility is available to them.
When my back had excessive lordosis my belly button was very far from my nipples. Observe your belly button in your default stance, and then flex your glutes, push your hips forward, and watch your belly button approach your nipples. Squeezing the glutes resets your pelvis-lumbar relationship back to where nature intended it to be. You want to do this frequently throughout the day.
You want to optimize lumbar mobility, and to do this you must provide antifrailty to the lumbar region by bending, extending, and flexing it in every direction. You can start counteracting excessive lordosis by teaching the lower spine to curve in the opposite direction. To do this flex the hips inward, and up toward the face (lumbar kyphosis). This rotates that soup bowl backwards so that soup is no longer pouring out in front of you. I like to think of this posture as “shrimping up” because it involves curling the bottom half of the spine in toward the stomach. Becoming stronger and more flexible at these while standing dramatically improves lower back integrity.
Recruiting Your Butt Muscles
All you need to do to set your pelvis in a neutral position is simply contract your buttocks. Squeezing your butt makes it so that you don’t have to worry about whether or not your pelvic posture and tilt are correct. Muscles in the lower back and hips largely take on tension because they are compensating for weakness and underusage of the gluteus muscles. Because the glutes are offline, other muscles, poorly suited for the job, are forced to support the core and stabilize the trunk. The glutes should have some form of contractile tone with every movement you make. Pilates emphasizes the “neutral spine” where you suck your stomach in, flex your abdominals, and relax the lumbar spine by holding the glutes in a light contraction. During Pilates workouts, practitioners try to maintain this “core engagement” throughout every exercise. This core engagement should be generalized to everything you do, and it will trim your abdomen and increase the tone and size of your butt.
Perform Antifrailty for the Lower Back
Performing antifrailty using yoga poses is an excellent way to find dormant lower back muscles that will benefit from being contracted. Cow, cat, and birddog poses are the bread and butter of lower back health. You want to move through the full range of motion of these poses briefly every day.
Strengthen the Hip Flexors: Child’s, Happy Baby, and Pigeon Poses
Strengthening the hip flexors on the front side of your waist is imperative for lower back health. To do this, while practicing the poses below, focus on bringing the knee closer to the chest in a way that creates a firm contraction in the frontal portion of the hip (the hip flexor). If you breathe through the subtle pinch in the hip flexor, you can get it to contract fully. Doing this regularly will cause your hip flexors to become much stronger and provide integral support for your lower back.
Backward Bends Are Needed to Straighten Your Spine
The best way to counteract lumbar lordosis is to gradually introduce your body to global back extension. You can start doing this by watching TV lying on the stomach. To make this easier you can prop yourself up on the elbows or place a pillow under the chest. To make it harder try pressing the pelvic bone into the ground, balancing yourself on your pelvis. When you need something harder still, you can try gently lifting the feet, or even the knees off of the ground. Use the back extension exercises that used a basketball from Chapter 13 to complement these. The simple act of lying on your stomach on the floor will make you feel stiff at first so remember to perform a forward bend afterward as a counter pose. With time, work toward a full “upward dog” pose. If you can breathe slowly and fully (diaphragmatically) while doing the upward dog you will dismantle the vertebral tension.
Downward Dog Pose
Downward dog is another very helpful pose. After you get the mechanics of downward dog, try “walking the dog,” by assuming the pose and bending one knee at a time. Next, try shifting the butt left and right while holding downward dog. Pivot as much as you can with your hips while doing this. You can also access many normally inaccessible muscles in the neck from this position as well.
The sacroiliac joints of the hips articulate very subtly allowing each ilium (leg bone) to glide three to four millimeters forward and backward relative to the sacrum. This is a tiny amount of movement but its presence or absence affects every lower body motion. In people where it moves it allows one to twist the trunk below the waist. If you can sit in a chair and turn to look over your shoulder, you want the turning motion to extend from the neck all the way down to the sitz bones. If the rotation stops at your waist then you know that your sacroiliac joint is locked up. Trunk twists will aid in unlocking the sacroiliac and allow the hips to move with the legs during walking, making every lower body movement more graceful, sensual, and stable.
Wagging your Tail
Next I’m going to describe a way to engage your hips that can lead to better hip mobility. I think of it as wagging the tail. To do this you tilt your pelvis from side to side. This is called pelvic incline or list. One hip goes up while the other goes down, and then you reverse it. A good way to master the movement is relax on your back and pull one leg in toward you and push the other away. Then do the opposite. Practice varying the extent, intensity and speed until you develop coordination. Once you have mastered this hip swivel, you can even do it while seated. This will lead you to plenty of achy muscle. Combining tail wagging with antifrailty will help to restore motor control, and fluid motion to the hips, pelvis, and sacrum.
Standing, One Leg Up
While standing place one foot flat on a surface that is between knee and waist height. This will allow you to leverage your way into hip frailty that you may have previously been oblivious to. From here you can also perform side (oblique), stomach (abdominal), and single glute isometric contractions.
Rock and Roll on the Floor
An excellent way to resituate your lumber vertebrae is rock from your tailbone to your neck. Lie down on your back and pull your knees into your chest. Start to roll forward and backward. Attempt to roll from one of the positions depicted in the drawings below to the other. To do this properly you want your neck and lower back in kyphosis. You should find that as you rock into the first position pictured below, where the man is has his weight on his neck, that the lumbar region is subject to an intense pulling sensation. Use this for antifrailty.
Squats, lunges, power cleans, snatches, and deadlifts are advanced weightlifting techniques that create formidable strength, but also a high risk for injury. I recommend performing these with absolutely no weight as a way to create sustainable strength. Performing between ten and 50 reps per day, is a great way to improve force and power production in the body. Just ensure that your back is stabilized so that various forces acting on the disks and vertebrae are distributed in a balanced manner and not loaded disproportionately onto the weakest segments.
When performing squats you want your back flat, feet straight, knees slightly outside your feet, and knees behind your toes. Take a wide stance with your feet just outside the shoulders, keep your shins as vertical as possible, not tilted forward. Put your hands at chin height out in front of you. Flex your butt when standing after each squat. At the bottom of the squat you want to maintain lumbar lordosis without kyphotic rounding. When you do this during a squat you get an incredible stretch at the sacroiliac. I recommend performing supported squats where you hold a rail, table top, chair leg, pair of door knobs, TRX bands, or gymnastics rings.
Everyone should do squats and deadlifts without weight. Doing ten of these every day without weight will inevitably teach the body to do it properly. Only add weight once you have mastered it and can do it without any pain. Most people don’t have the ability to perform a full-range, butt to ankle squat. Many exercise professionals advise against lowering the butt below the knees when squatting. I recommend lowering your butt to rest on your heels, but only if you do so in a slow, controlled manner, with diaphragmatic breathing and nothing but body weight. Squatting down completely in this way will give you a full lower back stretch in your L5/S1 removing tension from your lower back.
Studies have shown that low back exercises are the most beneficial when they are practiced daily. Even more importantly, endurance exercise is recommended over exertive exercise for its protective value. In other words, use low intensity (body weight or less) and high repetition (15 to 100) to bring these muscles to fatigue. It will develop your unrealized strength.
Static Squat and the Founder
Holding a static squat with your butt at the level of your knees is an age old yoga technique. In martial arts this is done with the legs somewhat spread in a pose called “horse stance,” which is used to strengthen the lower back and create a feeling of “groundedness.” Another version of the static squat called the “founder” pose, has been popularized by a system called “Foundation Training” developed by Eric Goodman. The founder helps to isolate and strengthen the epicenter of lower back frailty.
|Lower Back Exercise #2: Hold a Static Squat|
|With legs shoulder length apart bend your knees, but keep your butt above your knees. Hold a static squat while placing the lower back into different configurations. From this position introduce complete lordosis in your lower back, and then complete kyphosis. Hold the squat while moving carefully back and forth between the two.|
|Duration: One minute. Proficiency: Four sessions a week for 24 weeks. Maintenance: Once per month|
Release the Hamstrings
Tense hamstrings tug insidiously on the sitz bones, and in doing so place a lot of pressure on the lower back. This constant tug forces the pelvis into excessive lordosis. This in turn allows the hamstrings to adapt to a shorter than normal resting length. This is why stretching the hamstring muscles is very important for lower back health. Try it from your back with a towel or belt wrapped around your foot as pictured below. A ubiquitous disorder called “lower cross” syndrome is marked by short and tight hamstrings and groin muscles, and weak and underdeveloped buttocks and abdominals. Hamstring and hip flexor stretches will relieve the former, and squats and sit ups will strengthen the latter.
Activating Your Core
Many fitness and physical therapy experts advocate diaphragmatic breathing. This is because it is a fundamental demonstration of core and stability (Nelson, 2012). In fact, diaphragmatic breathing retraining has been shown to improve abdominal strength and stability (Nelson, 2012).
Spinal Decompression and Traction
With age and pressure our vertebrae are pulled closer together, compressing the spine. It is like an inch worm that has retracted its telescoping body segments. Combining decompression (also known as spinal traction) with diaphragmatic breathing will convince your worm that it is safe to expand at full length. Decompression stretches the muscles surrounding the spinal vertebrae relieving tension and increasing circulation to the entire spine. It also exposes areas in need of antifrailty.
A great way to decompress is to use an inversion table and lie upside down, suspended by your feet, for a few minutes each day. Inversion tables are commonly recommended by physicians and have demonstrated significant clinical benefits. A second method to achieve this is to practice “stretchlying” (Gokhale, 2008) which I encourage you to read about online. Thirdly, passive motion from shaking can also aid in decompression. Passive motion can come from having someone jostle your spine rhythmically, or you can use a reciprocating “chi machine.” The jostling normally causes your spine to tense up defensively. But if you can give in to it for several minutes at a time while paced breathing the spine learns not to fight against passive forces.
Massage also has decompressive effects. Have your masseuse perform an easy deep tissue massage on your lower back. After a few visits, it should feel comfortable for them to use their elbows to press deeply into areas all around your lower back. Having a masseuse stand on your lower back can also be helpful, and this is often performed in Thai massage. If your back is very strong, you might want to ask them to stand on your pelvis and take slow small steps all the way up your spine. This is an amazing way to decompress these areas, but it can be dangerous. Decompressing the spine will help the muscles extend to their intended length. However, because they are not strong at this length they will initially be vulnerable to injury. So after any form of decompression use antifrailty carefully and remedially.
Compression and Massage
Compressing the muscles in your lower back by lying on top of baseballs is highly effective. To do this lie supine on the ground with your knees bent. First, try placing two baseballs at either side of your spine, just above your pelvis. You can use softballs or tennis balls if this is painful. Lift your feet into the air and use your legs to help you regulate the extent of pressure placed on the balls, and to direct that pressure into the sore spots surrounding your iliac crest. You can also use them to compress the muscles around your love handles, as well as the gluteus maximus, gluteus minimus, gluteus medius, piriformis and others. You want to rest each portion of your pelvis on the balls for several seconds at a time, ensuring that you are breathing deeply and slowly. This will deeply relax these muscles. As with the decompression exercises in the last section, it potentially leaves your lower back open to serious injury if you load these relaxed muscles too intensely too soon, so perform this after exercise or before bed. Using baseballs as pictured below will uproot the iliac knots discussed at the beginning of the chapter and expel the tension from your lower back.
Like cankles, love handles form because of dormant muscle. Press thumbs, knuckles, a ball, or a tool into the spongey, achy, dormant muscles in the area. Focus on pressing firmly into the top ridge of your posterior pelvis. Compressing and percussing these muscles will revive them, introduce mobility in your hips, and reduce the fat deposition at the site.
You will also notice that when the baseballs are pressing into your back that the pressure has changed your back’s normal configuration and is permitting stretches in new planes of motion that were previously blocked. Take advantage of this and perform antifrailty in these planes. You can attain the same effect by placing a football, basketball, or yoga block under your sacrum while lying supine.
How to Bend Over
Most people bend over from the waist. This means that they hunch their spine forward from the height of the belly button to bend down. This is bad. When bending you always want to keep the spine straight. Instead of bending at the waist bend a few inches lower, at the hips. This results in a hinge from the hip with a straight back. Hip hinging strengthens the erector spinae muscles, and it also stretches the hamstrings. Fully engage the stomach muscles to help buffer the load on the lumbar spine. Of course, if you are picking up something heavy you should squat down and lift with the knees. Otherwise lift small loads by hip hinging.
The more often you can bend over by hip hinging the better. I shoot for ten times per day. Put commonly used objects such as your phone charger on the floor so that you have to bend all the way to the ground every time you use them.
Perfecting Your Sit-ups
Sit ups are the best counterpose for any work you are doing with your spine. They will reset your vertebrae from you neck to your tailbone. They place the lower back into neutrality helping to protect individual muscles from the repetitive strain that comes from being out of alignment. For this reason it is very helpful to perform 10-20 sit ups after performing the other back exercises in this chapter. A few variations to try when doing sit ups: (1) place a small pillow under your lower back to support it, (2) straighten your legs and rest the back of your knees on the ground throughout the motion, (3) flex your buttocks as you come down from each sit up, look to each side, touch your toes. Doing sit ups on the floor can irritate muscles that aren’t used to the intense forces. Sit ups in bed are bread and butter remedial rehab for the entire spine and will accentuate all of your other efforts to improve your posture and physique. There is no reason not to take three minutes and do 50 situps in bed every day.
Remember the tense cords of muscle you found with your fingers between the lower spine and hips? When you compress, stretch, and then tone them you will develop a different diagnostic marker, dimples. The dimples demarcate mobility and strength in the sacroiliac joints. Spinal experts claim that people that have a dimple just above each buttock on either side of the spine have very healthy lower backs (Gokhale, 2008). I used the methods in this chapter for a whole year, experienced dramatic results, and yet still didn’t have these two dimples at all. I figured that those experts were wrong. No. I was wrong. After two additional years of using these methods I developed the dimples.
During the last five years I have spent a few minutes every day on reconditioning my lower back. At this point a back injury seems inconceivable. My body unconsciously knows that my lower back will not fail me. Now that I can trust my lower spine to support everything I do, immense amounts of unconscious trepidation have been relieved.
Chapter 16: Bullet Points
- Because portions of the lower back are rarely used they remain tense.
- Sit ups, yoga poses, Pilates, toe touches, trunk twists, hip hinging, hip swiveling, deadlifts, squats, and lunges will all help.
- These exercises should be performed at very low intensity, with a large number of repetitions.
- You want to bend over and touch your toes, bending from the hip not the waist, several times a day.
- You can decompress the spine by using an inversion table, by “stretch lying,” or with decompressive massage.
- You can unlock the lumbar spinal muscles, glutes, hips, and the entire sacroiliac joint through compression with baseballs, and percussion with a knuckle tool.
- Put your lower back and hips into as many unfamiliar configurations as possible.