Exercises to help prevent and treat low back pain

Don’t let riding your bike become a pain in the…back! As a board-certified athletic trainer, I’ve helped a lot of athletes with low back pain, and when you look at the statistics that’s not surprising at all. According to the World Health Organization, low back pain is the leading cause of activity limitation and work absence throughout much of the world. The lifetime prevalence of nonspecific low back pain is 60 – 70 percent in industrialized countries.¹

Related:

• Three reasons core stability will take your training to the next level
• Training tips: How your hip flexors could be hurting your back
• Cues to improve your cycling posture

There are many causes of back pain, some of which are complicated and should require direct medical attention especially if you are experiencing sharp, shooting, or radiating pains. However, most cases of low back pain are nonspecific, meaning that they do not involve serious or long-lasting causes or conditions.² This is good news because it means that with some focus and dedicated exercises or adjustments, you can likely diminish your low back pain once and for all.

Bike Fit
It’s really no wonder that cyclists frequently experience low back pain. When laying down on your back your lumbar discs are under approximately 75 kilograms of pressure. When standing, the load increases to 100 kilograms of pressure. When sitting down and leaning forward, which pretty accurately describes a cycling position, you might have a total of 275 kilograms loading your lumbar discs.³ That’s a big load to carry while riding for hours on end!

If you are experiencing low back pain, one of the easiest things you can do is go get a bike fit. Something as simple as adding a few spacers under the stem may give you a more upright position and alleviate some of the pain. Don’t stop there though! The danger of quick fixes is that people often don’t follow through with the root of the problem which is usually biomechanical.

Biomechanical abnormalities
It’s important to remember that the body is a kinetic chain, meaning that everything is interconnected and an imbalance in one part of the body can wreak havoc on another part of your body. In order to address biomechanical imbalances or abnormalities, it’s important to spend time working on both flexibility and core stabilization or strength.

Stretches to strengthen the lower back:

Thomas Stretch
Sitting at the very edge of a table, grab one knee and pull it to your chest, then lean all the way back so that you are laying on the table. The other leg should remain straight out or dangling toward the ground. This exercise helps to stretch your hip flexors which can have a large impact on your back. One of the primary hip flexors (the psoas) actually attaches to the vertebrae of the lower back. Flexible hip flexors will help you keep a more neutral pelvis position and alleviate strain on your back.

Open Book
Lay on your side with your knees stacked on top of each other and your hips and your knees bent to 90 degrees. With your bottom arm extended out from your body and resting on the ground, pull your top arm back so that both shoulder blades touch the ground while the rest of your body remains on its side. This exercise helps to mobilize the thoracic spine which tends to be overlooked.

Cat/Cow
In a quadruped position, arch your back all the way through your neck, then reverse and round your back all the way through your chin being tucked to your chest. This exercise uses light abdominal activation and also works on trunk flexibility.

Exercises for treating low back pain

The core can refer to everything other than your arms and legs and for that reason, the core helps to give stability for almost all athletic movements. The core can help to provide stability and reinforcement for the low back. In fact, there are 29 muscles that help to maneuver the lumbar spine and pelvis.⁴ Since we know that the body is a kinetic chain, we know that weak links can cause a system to break down (“pain”).

It’s important to work the muscles of the core not only for strengthening purposes but also for neuromuscular adaptations. Here are a few specific core exercises that have the potential to really benefit an individual experiencing nonspecific low back pain:

Dead Bug
Lay on your back with your arms and legs straight up in the air and your knees and hips bent to 90 degrees. Slowly lower one arm and its opposite leg while maintaining a flat back and bracing your abdomen. This exercise really targets your rectus abdominis as well as your internal and external obliques.⁴

Pelvic tilts
Begin by laying on the floor on your back with your knees bent to 60 degrees and your feet flat on the floor. Imagine that there is a string attached to your belly button and someone is pulling it down into the floor. Then complete the opposite by letting it pull gently upward to arch your back ever so slightly. These small movements can help align the pelvis, work on abdominal strength, and provide lower trunk stability.

Bird-dog
Begin in the quadruped position and lift opposite arm and opposite leg straight forward and backward, respectively. Hold this position for 5-10 seconds and repeat with the other arm and leg. This exercise specifically activates a large number of core muscles including the gluteus medius, multifidus, and spinal erector muscles.⁴ Focus on keeping a neutral spine and flat back throughout the exercise.

Glute bridges
Lay on your back with your knees bent to 60 degrees and your feet flat on the floor. Lift your glutes off of the floor until your hips are flat. Hold for 5-10 seconds and then return your glutes back to the floor.

Create a New Standard

Many people have experienced low back pain for such a long time that they now consider it to be ‘just a part of life.’ Maybe you’ve even forgotten what pain-free exercise feels like. Don’t give in! Try completing these exercises three or more times per week and see what kinds of rewards you may reap.

Sources

1. “Low Back Pain.” World Health Organization, www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf.
2. Prentice, William E. Principles of Athletic Training: a Competency-Based Approach. McGraw-Hill Higher Education, 2014.
3. Starkey, Chad, and Sara D. Brown. Examination of Orthopedic & Athletic Injuries. F.A. Davis Company, 2015.
4. Higgins, Michael. Therapeutic Exercise: from Theory to Practice. Jaypee Brothers Medical Publishers, 2012.