In this series of blogs, we have laid the foundations for looking after our backs with Spine Hygiene, starting the day off in a Spine Sparing fashion and paying attention to how we move in our daily activities. We then upped our game a bit by starting to Breath instead of just moving air. Then we added some abdominal wall (our ‘flexible ribs’) bracing skills. We looked further at walking and why this is so good for our backs. This cluster of knowledge and skills will take most of us to where we want to be with our backs, but for a good many of us we need more capacity (and for most of us that means endurance rather than strength) in our trunk than walking will give us – and that means doing more specific exercises.
Will I need to do further exercises?
This depends on your existing capacity. If you can easily provide enough Abdominal Brace to suit the most challenging activity that you do, and you can still do it at the end of the day then possibly not.
If you feel that you are not as strong or robust as you would like to be, then very likely you need more Abdominal Brace capacity. If you are feeling some low back discomfort then you will likely benefit from the support and stiffness that exercises bring.
What sort of exercises are we talking about?
Research tells us that the muscles in your abdominal wall – those that form an almost complete corset around our middle – are there primarily to connect our rib cage to our pelvis and thereby to create a stiff torso from shoulders down to hips. The abdominal wall works like a corset or a set of guy-ropes holding a flag pole, and it does this by RESISTING MOVEMENT, NOT CREATING MOVEMENT. These muscles are constructed and packaged such that they really work best when they are simply holding strong at a set length. Additionally, we have a really good understanding of how the discs in our back get injured and it turns out that what our discs cannot tolerate over any period of time is repetitive bending forwards or twisting under some sort of applied load.
For both these well-documented reasons IT DOESN’T MAKE SENSE TO TRAIN THE ABDOMINAL WALL BY BENDING THE SPINE. To do so is to ask the muscles to do something that they are not suited to, and actively damages the discs in your back. THE PERFECT WAY TO CHEW UP YOUR DISCS IS BY DOING TRADITIONAL SIT UPS OR CRUNCHES. This is non-negotiable, and no longer up for debate in the medical, rehabilitation or other literature.
Your vaccination against Poorly-chosen Exercises:
Any strength or endurance exercise that asks you to flex your spine forwards, backwards or side to side is probably ill-considered, and any exercise that asks you to keep your spine straight while something tries to make it flex is probably OK.
Stretching and mobility work is different – we are talking about strengthening work here.
A 5-minute primer from Professor Stuart McGill – don’t let the moustache put you off!
Some trunk capacity exercises
Dead Bug exercise from the University of Bristol:
Kitchen counter pushups – great for the trunk and shoulder girdles:
Professor McGill talks us through his Big-3 spine-sparing trunk capacity exercises. The common theme is no spine movement!
How often will I need to do them?
This is the wrong question, really. A better question is ‘How should I feel when I have done my exercises?’ If we get it right, you won’t care how often you need to do the exercises, because they will fit seamlessly into your day and won’t become a chore.
When we think about exercises to help protect or to rehabilitate our backs, we tend to think about sit ups, planks and other fairly intense and specific sweat-inducing work, and we think that we should be doing this sort of stuff, but … well … we never quite get around to it somehow. In truth, I suspect that we try this stuff once, and then somehow everything else on the to-do list suddenly becomes a bit more pressing. We absolutely will get back to our exercises, but right now that ironing really needs to happen first. And then we are a day late mowing the grass, and then we just need to have a quick look at our email …. Am I right?
If this is your experience, then you, your therapist or your trainer are pitching the exercises too hard!
YOU NEED TO FINISH EVERY EXERCISE SESSION LOOKING FORWARD TO DOING IT AGAIN.
If you get up off the floor, or off your bike, out of the pool or take off your shoes dreading the next session, then for most of us, we’ve blown it! Athletes can and will finish sessions having gone to some pretty dark places, and they will do it again tomorrow because they are highly invested in their performance or their wellbeing, but for the rest of us, developing some sort of consistency and exercise habit is everything. I would far rather you did your exercises at a lower – seemingly trivial even – level but with consistency and anticipation for the next session, rather than allowing your exercises to become an unsustainable chore. Once you have some consistent practice happening, we can add some intensity or quality later, but (and I’m saying it again to make the point)
“YOU NEED TO FINISH EVERY EXERCISE SESSION LOOKING FORWARD TO DOING IT AGAIN. “
So what kills consistency? Faff, effort and administrative demand. If you are a tea or coffee drinker, I guarantee that you can consistently make drinks throughout the day with a minimum of effort because the tea bags, cup, kettle and bin are all right there to hand. If you had to change your clothes, get the kettle out of the loft and shop for tea bags and milk ever time you wanted a cup, you might make tea once and then very reasonably give up. How about we approach exercises the same way? No change of clothes needed. No clearing of floor space needed. Everything to hand. No reason to just put it off until the ironing is done. How about ‘snacking’ on exercises through the day, rather than setting up for big set-meal sessions? If you don’t already have a regular exercise habit, perhaps Snacking is the way to go. If you already have an exercise schedule, just add your trunk exercises onto your existing consistent practice, but make sure to take the Vaccination Against Poorly-Chosen Exercises first!
How many repetitions should I do?
Enough to feel satisfied that you have done something useful and few enough that you are still looking forwards to next time! Perhaps 60% of what you think you should be able to do?
Remember: YOU NEED TO FINISH EVERY EXERCISE SESSION LOOKING FORWARD TO DOING IT AGAIN.
So – get stuck in to everything that we have discussed over the last few blog posts and remember that I am always available for to discuss any aspect of your wellbeing. Hit the “Book an Appointment” button and I look forward to talking exercise.