Recently, I was speaking with my bank officer, Angelo, and noticed that he had a muscular build that suggested that he lifted weights. I asked if he did, and he replied that he had indeed lifted a lot in college. But then he let out a sigh and said, “Now that I have a bad back I wouldn’t think about lifting anything heavier than my 2-year-old son.”
He went on to tell me about how his back went out, and his wife had to call an ambulance because he couldn’t get off the floor.
Why Are We Plagued With Painful Backs?
This wasn’t the first conversation I’ve had with an individual with a bad back. Whether it’s with a family member, coworker, or a friend, the subject of a bad back frequently arises. That’s not surprising since back problems are at epidemic proportions.
Consider these statistics:
- Approximately 60% to 80% of Americans will get at least mild back pain at some time in their lives.
- In 2007 alone, about 27 million US adults aged 18 or older reported having back pain.
- About 70% of these people – 19.1 million – sought treatment by a doctor.
- More women (10.9 million) received medical treatment for their back pain than did men (8.2 million).
Is There A Solution To Painful Backs?
I sympathized with Angelo and related that I too had problems with my back. I told him that I was diagnosed with a herniated lumbar disc 25 years ago. Until about a year ago, I had severe back spasms that would keep me immobile for days.
But, I told him, that’s all in the past now. At 61-years-old, I have no more spasms and no more pain. In fact, my back is stronger than it’s been in 30 years and soon I’ll be attempting a 300 lb deadlift.
Apparently I aroused his curiosity because he wanted to know what I did to make my back better. “Simple,” I said. “I do heavy barbell deadlifts, squats, and some additional core training.”
“How old are you again?” he asked. “Sixty-one”, I replied. He just shook his head in disbelief and lamented, “Well, I don’t think I’ll be lifting weights any time soon.” He then excused himself to go make some copies.
The Quirkiness Of Low Back Pain
I noticed, however, that Angelo got up from his chair, seemingly without any pain, and returned to his chair and sat down, again without any obvious difficulty. If he was currently having back pain, he didn’t show it. Apparently, his back had gotten a lot better.
Research has shown that after an acute low back pain event, about 90% of individuals recover in a few months. However, here’s the problem. Recurrent back problems are common, varying between 25 to 50% in a year. Unfortunately, for about 10% of the adult population, an acute back pain episode will turn into chronic low back pain.
My Strengthened Back
Since I’ve learned how to properly protect and strengthen my back, my back problems are just a bad memory. Also, my back is getting stronger. Here’s a 300-pound deadlift I did a few months ago. I’m 61 years old and weigh 165 pounds.
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In this post, I’ll give you the 10 point strategy I use to protect and strengthen my back and keep it pain-free.
Perhaps this strategy will help you to continue lifting heavy things well into your senior years or even help you get your back strong again so that you have no need to fear lifting up your young children or even your grandchildren.
First though, let’s take a look at why our backs are failing us.
Why Are Our Backs Failing?
Our spines are a wondrously created biological system. They’re called upon to be stiff enough to bear loads and at the same time flexible enough to allow us to twist and bend. They’re composed of a series of stacked vertebrae that are separated by fibrocartilaginous water filled discs that provide shock absorption.
The discs are composed of two parts: a tough outer membrane (annulus fibrosus) and an inner water segment (nucleus pulposus).
Unfortunately, as we age these vertebral discs begin to degenerate.
Degenerative Disc Disease
The accumulated daily stress from compression and minor injuries will cause our discs to break down. This is known as degenerative disc disease (DDD). Technically, DDD is not a disease but a normal process of aging. Nearly everybody over the age of 40 is experiencing some disc degeneration.
However, not everyone who experiences DDD will have back pain. Some people with awful looking back x-rays never have any pain. But for most of us, a degenerative disc spells trouble.
These problems occur when the annulus fibrosus degenerates to a point where it tears or ruptures. If the tear is serious enough, the contents from the nucleus pulposus may leak out causing the disc to gradually collapse. This may result in decreased shock absorption capacity and/or create pressure on surrounding nerves.
Specific Causes Of Back Pain Associated With Degenerative Disc Disease (DDD)
Back pain from DDD is usually caused by four scenarios.
All of the above conditions can result in lower back pain. Sometimes pain may also radiate to the hips, buttocks, thighs or legs. If pressure, is placed on an adjacent nerve by the nucleus pulposus of the disc, then sporadic tingling or weakness through the knees, legs, and feet can also occur. See sciatica.
Severe muscle spasms can also result from DDD. These spasms are the result of your body’s attempt to stabilize your spine. If you’ve ever had a back spasm, you know how painful it can be.
A Sedentary Lifestyle Can Worsen Degenerative Disc Disease
Though DDD is a normal process of aging, our less active lifestyles may be worsening the condition. Research (and here) has shown that approximately 25 percent to 35 percent of American adults are inactive. Inactivity is defined as having a job that requires little physical labor, engaging in no regular physical activity program, and being generally inactive around the house or yard.
Further, consider that many of us have office jobs that require sitting for eight to nine hours a day. Now add another hour or two of driving time and that adds up to a lot of sitting.
The result of a sedentary lifestyle compounded by prolonged sitting is disastrous for back health because it leads to a weakening of the muscles of your midsection or core. A weak core contributes to back instability. An unstable back is not something you want when your discs are degenerating.
Disc Herniation Due To Injury
Disc herniation doesn’t always have to be the result of DDD. Injury, especially from sports-related activities, can also cause herniation. I initially injured my back in high school during wrestling practice. Twenty years later, I injured it again on the Back To The Future Ride at Universal Studios. Go figure. But any sudden bending or torsional movements can cause a disc herniation.
Treatment Of Acute Pain With DDD And Disc Herniation
Fortunately, according to research, most annular tears and minor disc herniations will get better over time. Orthopedic surgeons at the University of California, Irvine, estimate that only 5% of us who have back pain will need surgery. However, if your pain is intractable, surgery may be an option. See Dr. Peter Attia’s story.
Healing Chronic Back Pain
If you’re someone who has suffered from chronic back pain, I’m sure you’ve heard the same advice from well-meaning friends that I’ve heard over the last 30 years. It goes something like this. Why don’t you see my chiropractor? Have you tried physical therapy? I have some good stretches you need to try. You need to strengthen your core with sit-ups. Rolling on a big stability ball did the trick for me.
All of these techniques are supposed to cure back pain and prevent problems in the future, right? Well, some of them worked for me over the short term, but not over the long term.
The reason was that they didn’t fully address the number one factor we can control when it comes to DDD. That’s back stability.
As I mentioned before, our spines are to be rigid enough to bear loads and at the same time flexible enough to allow us to do crazy things like dancing, simple things like tying our shoes, or wondrous things like looking up at a beautiful nighttime sky.
In order to do that, your spine has to be stabilized by muscles and other soft tissue. These structures act as a guy wire system to stiffen and stabilize the spine when it is required to bear loads.
If these muscles are weak, the stability of your spine will be severely compromised. That makes it possible for vertebrae to pinch and poke around soft tissue and squeeze discs. That’s disastrous to a back that is already in decline.
In order to increase spine stability, you’ve probably heard that you have to strengthen your core muscles. This is good advice but is usually not sufficient. Let me tell you why.
The Limitation of Bodyweight Core Training
Your core muscles are those found in your midsection and the mid and lower part of your back.
To strengthen those muscles, we’re told to do exercises like planks, crunches, bird dogs, etc. This is excellent advice, and I’ll talk about those exercises shortly. However, these exercises usually target smaller muscles which are not the only muscles that support the spine.
The largest stabilizer muscles of the lower back and the largest amount of abdominal muscle tissue cannot be adequately strengthened by bodyweight-only exercises.
In order for these muscles to get stronger, they must be progressively loaded. This means that once a muscle has adapted to a load (e.g. 200-pound squat) an increased load (205-pound squat) must be employed so that muscles can continue to adapt and grow. Body-weight only exercises can’t accomplish this.
This is not to disparage body-weight only exercise routines. Dr. Ted Naiman has a body-weight weight only exercise plan that is extremely intense.
That brings me to the 10 strategies for protecting my back.
1. Barbell Squats And Deadlifts
Performing heavy deadlifts and squats to strengthen a bad back may sound counter-intuitive. But it’s not. These exercises performed with progressive loading over time strengthen the largest back stabilizer muscles. Deadlifts strengthen the erector spinae, and squats strengthen the abdominals. At the same time, they will also strengthen the smaller muscles responsible for stabilization.
When done correctly (with a flat back), these exercises strengthen and stabilize the back. They mimic normal body movements which will train your body to perform daily movements correctly.
In other words, when you bend down to pick up your child, your body will assume it’s performing a deadlift and stabilize the spine accordingly.
My Start To Deadlifting
When I started deadlifting, I wasn’t experiencing acute back pain. I had slight achiness when I stood up after sitting for prolonged periods, but it would subside after I walked around a bit. That was about it.
At 58 years old, I started deadlifting with 65 pounds and have progressed up to 300 pounds. Never despise the day of small beginnings. You never know where hard work can take you.
In the over 4 years I’ve been lifting, I’ve only missed about five days of training because of my back. More on that later.
I wasn’t able to start squatting right away because of bad shoulders (I couldn’t grab the bar). But I’ve been doing back squats for over 2 years without any significant problems.
2. Proper Technique
Strategy 2 continues to deal with barbell resistance training. If you’re going to do barbell back squats or deadlifts, they must be done with proper technique. Proper technique will reduce your chance of injury and improve your strength.
If you can find a good coach, fantastic. There is online coaching available from the good people at startingstrength.com. If you’re a home gym do-it-yourselfer like me, there are videos online that show how to perform the lifts correctly.
3. Treat every weight as heavy
Sometimes we assume because a weight isn’t near our max, that it isn’t heavy so we can’t get injured on it. That couldn’t be more false. The one time I did tweak my back on a deadlift, it was on a warm-up that was well below my workout weight.
Check out this video from Aaron Lipsey featuring the instruction of world-renowned back expert Dr. Stuart McGill on proper deadlift form.
The takeaway is to prepare for the lift by mentally and physically activating your core.
McGill has helped numerous athletes return to their respective sports after back injuries. In this video series, elite lifter Layne Norton from Biolayne.com, documents how Dr. McGill was instrumental in his rehabilitation from a severe back injury.
A key to that rehab was the incorporation of McGill’s Big Three.
4. McGill’s Big Three
Let’s get into some of the body weight core exercises. While deadlifts and squats made my back stronger, they didn’t solve all my back problems. They did relieve a lot of chronic lumbar pain, but I was still experiencing occasional severe spasms while not lifting. This occurred about twice a year for the first three years I was lifting.
For the last year, however, I haven’t experienced any spasms or injury. I believe this is because I have incorporated Dr. McGill’s big three core exercises into my daily workout.
The Core Strengthening Exercises
McGill recommends these three core exercise for back rehabilitation but they are also used as a preventative measure. These exercises include:
- Bird dogs
- Side planks
McGill demonstrates these exercises in the video below.
The curl up and bird dog workout sets are based on a descending pyramid structure. Six repetitions on each side, 20 seconds of rest, then 4 reps, then 2 reps. Each rep is held for 10 seconds. On bird dogs, this is done for both sides. For curl-ups, I use the same pyramid for each side of the raised leg.
For side planks, I hold it for 45 seconds on each side. You could also alternate 10 seconds per side.
I do these exercises religiously at least once a day.
5. Daily Walking
One of the ways to keep your spine healthy is by engaging in a program of walking. According to McGill, proper walking prevents the pelvis from tilting to one side, thus keeping your spine in alignment. Also the process of walking deloads the spine. (McGill, Back Mechanic. pg. 114).
Here are important tips for a good walking program for back health.
- Walk with your chest out and your head up
- Maintain a brisk pace (I usually maintain a 3.5 mph pace). A slow pace is not good for back health.
- Walk 3/day for 10 minutes or 2/d for 15 minutes.
- Let your arms swing from your shoulders.
I started walking 10 years ago as a therapy for chronic fatigue syndrome. When I started, I could barely make it around the block. Now I walk between 1.5 to 2 miles at least 6 days a week.
For those of you who like scientific studies check out this one showing the efficacy of walking for back pain.
6. The Cobra Pose
As I mentioned earlier, I did have a lumbar disc herniation. While I never had severe sciatic pain, I often had recurrences of tingling and other paresthesias in my foot. To solve this, I used a yoga exercise called the cobra pose.
It’s essentially a back extension exercise that is supposed to push the disc back into its proper space.
I first found out about it from these physical therapists in the video below. They’re a riot.
I do this exercise 3 times a day. I hold the pose for 30 seconds and do 3 sets.
7. Kneeling Hip Flexor Stretch
When you lift your knee while standing, the muscles responsible for doing this are your hip flexors. The major hip flexors are the iliacus and the psoas. Often they are grouped together and called the iliopsoas.
The psoas muscle starts at the vertebrae T12, L1-4 (and possibly the discs), runs down to the pelvis where it joins the iliacus, and then to the femur. One of its major functions is to provide stability to the spine.
Often, from constant sitting or other reasons, this muscle can become tight. The effect of this is to cause your pelvis to tilt forward. This causes instability in your spine and an abnormal pressure on the lumbar discs.
Below is an excellent tutorial on how to stretch the hip flexors. I do it 3 times a day. 30 secs on each side for 3 sets.
8. Back Bridges
Back bridges are another stretch that I do as part of my core routine. Dr. McGill tells us why they are an important exercise.
“Chronic back pain tends to cause people to use their hamstring muscles, instead of their glutes to extend the hip. This changes patterns that increase spine load when squatting. Performing the back bridge, squeezing the gluteal muscles, and eliminating hamstrings, helps to establish gluteal dominance during hip extension.”
When we arise from a squatting or stooping position, we want the glutes to be the dominant muscle extending our hip. If the hamstrings predominate, then more pressure than necessary will be put on the spine.
Here’s a video on how to do back bridges.
9. Be Back Conscious During The Day
If you have a bad back or an aging back, one precaution you must take is to be back conscious during the day. You’ve heard the saying, “lift with your legs, not your back.”
Well, you can’t totally eliminate the use of your back when lifting. So that means you have to be especially careful when lifting anything or even when bending.
If you have to lift something, remember to stiffen your core first. Brace yourself with your arms if possible.
When getting out of the car, use the handle to help yourself out. When lifting, brace yourself and make sure your back is stabilized.
Here’s a lesson I learned the hard way. If you’re going to sneeze while standing, stiffen your core first.
This is pretty common sense advice, but it’s so easy to forget.
10. I Take Collagen Every Day
There is some evidence that a possible cause of degenerative disc disease is a reduction of collagen in the disc. Further, as we age, our natural collagen synthesis decreases.
Also, because I lift heavy weights, I know I’m causing significant tissue damage.
So in order to make sure my body is getting enough collagen, I take collagen peptides as a supplement.
The evidence that collagen supplements actually helps your spine is scant, but it may certainly help in keeping other bone, tendons, and ligaments healthy. It seems to work for me.
Okay, that’s what I do to protect and strengthen my back. Hopefully, some of these strategies may help you. God bless and have a great week.
The information in this post is not intended as a substitute for professional medical help or advice. These are the things I do to help my back. Everyone is different and not everything works for the same person. A physician should always be consulted for any health problem.
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