Bulletproof Your Back With McGill's Big 3

                      

This week I have been emailed by a high level Athlete with Lower Back pain who is having difficulty returning to her full training.

Lots of Rehabilitation will talk about activation of Transverse Abdominis.

However, this athlete is an Ex- Dancer who already knows how to perform pre-activation of the TVA.

The question relates to the fact that this strategy is not helping her.

All we need is “stiffness” in the abdominal wall rather than “sucking in.”

For athletic populations I am a big fan of Dr Stuart McGill’s work.

McGill’s Big 3 Exercises are an excellent way to start your back rehabilitation or perform injury prevention.

The Big 3 consist of:

1.     Controlled ¼ curl up with one knee flexed (hold at the top)

2.     Side Plank (10 seconds with maximum stiffness)

3.     Bird Dog (Quadruped)

The Controlled Curl-Up:

This exercise trains the abdominals without moving your lumbar (lower) spine or cervical (upper) spine.

• Lie down on your back with your legs out straight. Bend your right leg and plant that foot on the floor next to your left knee.

• Put your hands under your lower back. They will prop your lower back up, which allows you to keep a natural curve in your spine.

·        Curl your head, neck, and shoulders off of the ground. Try to keep your neck as still as possible while you lift your head up. Don't tuck your chin or let your head fall back.

·        Try to hold yourself up at the top for 5 to 10 seconds.

·        Lower yourself down. Do half of the repetitions with your right leg bent and half with your left leg bent.

The Side Plank

• Lie on your side, with your elbow underneath your shoulder. Curl your feet back so that your knees are at a 90-degree angle. To make this exercise harder, straighten out your legs instead of bending them.

• Lift your hips off of the ground, putting your weight on your elbow and knees.

• Hold that position for as long as you can. Try to maintain a straight line from your head down to your feet. Make sure that your hips are in line with the rest of your body.

• When you can no longer hold that position, drop and switch to the other side, once again holding for as long as you can.

The Bird Dog

·        Get on the floor on your hands and knees in a quadruped position. Make sure that your back is relatively flat.

·        Raise your left arm forwards and at the same time extend your right leg straight back.

·        Raise your arm and leg until they are in line with your torso. To increase activation of your back muscles even more during this exercise, you can clench a fist of the arm you're raising.

·        Lower your arm and leg. Once you complete the desired amount of repetitions on that side, switch to the other side and repeat.

Also try “stirring the Pot” (in a Plank position) on a Swiss ball.

With the back muscles, what is more important is ENDURANCE rather than strength!

(See yesterday’s blog on the Biering Sorenson Extension Test)

Try integrating McGill's Big 3 into your training and Bulletproof your Back.

Video: www.youtube.com/user/uwaterloo

What is the Biering Sorensen Extension Test?

                    

Dr. Fin Biering-Sorenson, a Danish spine expert, found that the key to preventing lower back pain is to build up "isomeric endurance".

The ability of the lower back muscles to maintain moderate levels of force ... for prolonged periods... without significant fatigue.

In the British Military, we used this test as an objective marker for non-specific lower back pain. Of all the tests we used, this one was the most effective as a predictor of lower back pain re occurrence. I would like to share this test with you so that your athletes can benefit.

In 1984, following a study by Biering-Sorensen in Denmark, a new test was designed for evaluating the isometric endurance of trunk extensor muscles. This became known as the “Sorensen test” and gained considerable popularity as a tool reported to predict low back pain within the next year in males. The test consists in measuring the amount of time a person can hold the unsupported upper body in a horizontal prone position with the lower body fixed to the examining table:

To build up your client's isomeric endurance and Bulletproof their back:

1.     Lie them face down on a bench and strap their legs or sit on their legs if they are OK with that.

2.     Their legs should be supported by the bench with their upper body extended over the edge.

3.     Keep their upper body parallel to the floor, with their arms folded against their chest, for as long as they can.

Repeat this test regularly until they have built up enough endurance to maintain a horizontal position for 120 seconds or 2 minutes.

Although its discriminative validity, reproducibility, and safety seem good, debate continues to surround its ability to predict low back pain; in addition, the gender-related difference in position-holding time remains unexplained and the influence of body weight unclear. A contribution of the hip extensor muscles to position holding has been established, but its magnitude remains unknown. The influence of personal factors such as motivation complicates the interpretation of the results. Despite these drawbacks, the Sorensen test has become the tool of reference for evaluating muscle performance in patients with low back pain, most notably before and after rehabilitation programs.

The Biering–Sorensen test provides reliable measures of position-holding time and can discriminate between subjects with and without nonspecific low back pain (Latimer et al, 1999). The influence of motivation and effort exerted by the subject are limiting factors in all of the tests reviewed. These psychological factors warrant further research. . On the basis of the literature reviewed, we determined that the Sorensen is probably the most clinically useful of these tests; it is easy to perform, requires no special equipment, and enjoys the most support from the literature. (J Manipulative Physiol Ther 2001;24:110-22)

References

Latimer et al, (1999) The Reliability and Validity of the Biering–Sorensen Test in Asymptomatic Subjects and Subjects Reporting Current or Previous Nonspecific Low Back Pain. Spine: 15 October 1999 - Volume 24 - Issue 20 - p 2085

Moreau et al (2001) Isometric Back Extension Endurance Tests: A Review of the Literature J Manipulative Physiol Ther; 24:110-22)

Video: https://www.youtube.com/user/movementskill

7 Back Strengthening Exercises for CrossFit

                  

A strong back will stop you getting injured. Here are 7 of the best for CrossFit.

Not surprisingly, people with strong trunk muscles and well conditioned leg and hip muscles are less likely to develop back pain and injuries than people with weak or poorly conditioned muscles. Fortunately, your muscles will become stronger if you follow a regular exercise program that challenges your muscles to do slightly more than usual. If you are not already doing strengthening exercises, start with the exercises described here that you can consider to adopt, which focus on the spinal support muscles of the abdomen and back.

1.        Deadbug

Lie fat on your back, bend your knees, and keep your feet flat on the floor. Find the neutral position by flattening your lower back against the floor, then arching it up toward the ceiling and finding the point halfway between. Place your fingers at your sides on the bony area of your pelvis just below your waist. Now tighten your stomach muscles as if you were about to get punched. Lift one foot a couple of inches off the ground while keeping your stomach tight and keeping your back in the neutral position. Then put your foot down and lift the other foot. Keep your hands on your pelvis to make sure that you are tilting your pelvis as you lift your feet. Alternate the feet for 20 repetitions while keeping your pelvis stable. As this gets easier, you can increase the difficulty by lifting your arms as well as legs off the floor.

2.        Bridging

Lie flat on your back, bend your knees, and keep your feet flat on the floor. Find the neutral position as illustrated above. After which, lift your hips off the ground, maintaining a neutral position in the lower back and keeping the spinal straight and your weight on your upper back. Life your hips up until you begin to find it difficult to maintain the neutral position. Keep your arms at your side, palms down on the floor to provide stability so your hips do not tilt side to side. Lower to the floor and lift up 20 times. To increase the difficulty of this exercise, do alternate arm and leg lifts while bridging. You can eventually add cuff weights to your ankles.

3.        Partial Sit-ups

Lie flat on your back, bend your knees, and keep your feet flat on the floor. Find the neutral position by following the above technique. You can roll up a towel and put it under the small of your back to help you maintain the neutral position. Stretch out your arms and place the palms of your hands on the top of your thighs. Curl up your torso until your fingers touch the top of your knees. Hold this position for a moment, then curl back down. Keep the lower back on the floor the entire time the upper back moves. Now follow the same procedure by stretching both arms straight toward the left knee, then both arms toward the right knee. Repeat 10 times in each direction.

4.        Alternate Arm And Leg Lifts

Lie on your stomach and find the neutral position. You can put a folded towel under your stomach to help maintain your alignment. Tighten your abdominal muscles and lift a straight left arm and right leg a few inches off the floor. Make sure that your back does not arch. Raise your arms and legs only as high as you are able to while maintaining the neutral position. Repeat with the opposite arm and leg. Do 20 repetitions.

5.        Quadruped Arm And Leg Lifts

Get on your hands and knees. Arch your back up toward the ceiling. Let it sag down so that it dips toward the floor, and then come back up halfway. This is your neutral position. Tighten your abdominal muscles. Raise your straight left arm and right leg while maintaining your spine in the neutral position. Hold this position for a moment and then put your arm and leg down. Repeat with the opposite arm and leg. Do 10 to 20 repetitions.

6.        Functional Squats

Stand upright and place your feet shoulder width apart. Find your neutral position and squat down while maintaining it. Your buttocks will move backward, your chest will move forward, and your center of gravity will drop straight down. Your weight should be balanced in the middle of your feet, not on the balls or heels. To avoid knee pain, do not bend your knees more than 90 degrees. Do 10 to 20 repetitions.

7.        Leg Lowering

Lie on your back and bend your knees while keeping your feet flat on the floor. Use your abdominal muscles to keep your back in the neutral position, and slowly extend one leg at a time. Then slowly lower that led to the floor while keeping your abdominal muscles tight. Keep the other leg bent, and make sure that your back does not arch. Do 10 to 20 repetitions.

Raymond Lee Geok Seng is one of the foremost experts in the health and fitness industry and is a writer specializing in body health, muscle development and dieting. He has spent countless of time and efforts conducting research and share his insightful and powerful secrets to benefit men and women all over the world. He is currently the author of the latest edition of "Neck Exercises and Workouts." Visit http://www.bodyfixes.com for more information.

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Video: https://www.youtube.com/user/ThePhysioDetective.