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Low Back Pain III: Building a Strong and Stable Spine

In the first part of our low back pain series, we discussed this vague term and how we can focus on a solution instead of the large variety of problems that can be causing low back pain. Part II was all about movement.  So, from a strength standpoint, how do we move towards low back health and away from poor function?

Hips and Low Back Pain

Your low back and hips are one functional unit. In most cases we want movement and power to come from the hips and the spine to be stable. If the hips stop moving properly, which is extremely common, your low back will be forced to do more. It is not designed to do this and can break down. The squat is a perfect example of using your hips to generate power while having a stable spine. Squat video

If the pattern of hips generating power from a stable spine breaks down, squats become an issue with day to day things, like getting up and down, getting out of a chair, getting in and out of the car, and bending and lifting. The problem is not just doing squats in the gym.

Here is a very simple, but not usually easy, exercise to help to re-train a squat pattern with very little load on your back.
Hip rocking video

Core Stability

Our post on Core Stability goes a bit deeper, but core stability is actually fairly self-explanatory. You want the spinal part of your core to be stable and your limbs to move around that stable core. This is why sit ups are a poor core stability exercise and can even be detrimental.

Segmental Stability

This is stability in a single joint. It is extremely important just like segmental mobility is. One unstable link will decrease the stability and strength of the entire system.

Overall/Global Stability

This would be spine stability over more than one joint. This is built on segmental stability. A system of strong, mobile links has the foundation to be a strong, healthy system.

Improving Core Stability and Low Back Function

The foundation of training for stability is doing things with a neutral, stable spine. Practice does not make perfect, perfect practice makes perfect. For stability training exercise, how you do it, not what you do, is so much more important.

Sit-ups are out in general, and are absolutely out for an injured back or one with a history of problems. Sit-ups do not accomplish our first goal of developing a stable spine to build upon. Done properly, things like planks, bird dog/quadruped, and squats are all excellent core stability exercises. Properly executed is the key, and it is a good idea to have someone with training and experience show you how to do exercises properly at the start. That way you have a good foundation to build on yourself.

Normal movement is also required for normal stability. A joint that is stuck doesn’t need to work and stabilize like one that is moving normally. This is why movement restoration and stability training go together. It is probably a “What comes first, the chicken or the egg?” type scenario but I typically like to work on improving mobility and stability together. Simple idea, difficult to do well.