“OH, my back!”

Lower back pain is one of the most common injury concerns we see with those who work long hours at a desk.  Even if the person is somewhat active, it’s tough to undo 40+ hours of sitting with 30-60 minutes of planned physical activity a couple times per week. On top of that, when you’re dealing with back pain it’s incredibly tempting to skip your workouts, but nothing could be worse for improving your pain.

Striking a balance

In a previous article, I said the following regarding injury:

“One of the biggest mistakes I see people make is attempting to push through an injury when they should be treating it. “I’ll work through it” is an all too common refrain.  Unfortunately, failure to seek treatment inevitably turns a minor injury into chronic pain.”

Treating an injury can involve many modalities, but it very rarely involves doing nothing.  With back pain, unless we’re dealing with an acute injury or degenerative issue that requires special attention, it’s essential that we seek out movement within reason and limitation.

For example, let’s take the case of “Rob”, a 45-year old male with an office job. His job requires sitting for extended periods of time and he’s begun suffering from back pain as a result. While he likes to be active, Rob has recently started to skip his workouts for fear that his back pain will be made worse.   While he would be wise to avoid activities that exacerbate the issue, avoiding activity is the worst thing for him. At the very least, he would benefit from something as simple as getting up from the desk and walking.  A more structured 30 minute yoga class would certainly unlock his body a bit. Most importantly, strength training that targets the weaker areas of his body would help to correct the postural deficiencies that lie at the heart of his pain.

Attacking the weak spots

Sitting for extended periods of time causes back pain because it creates imbalances in the hips and core. Typically, these imbalances include tight hip flexors, weak glutes and a weak core. Our goal is to open up Rob’s hip flexors, while strengthening his glutes and core. Doing so will remove stress from his lumbar spine, which is being tasked with more than it can handle.

Here’s what we’re going to have Rob do as part of each workout:

90/90 Low back stretch with deep breathing – 2 minutes

Because the spinal erectors are usually tight, we’re going to use this 90/90 lying position. Press your low back firmly into the floor – there should be no space. Once you’ve established this position breathe deeply in through your nose and exhale fully through your mouth. Each full breath should take around 10 seconds (4 seconds in, 6 seconds out).

Ultimately, this exercise will help to stretch the spinal erectors and strengthen the diaphragm and deeper core muscles, a great combo for helping to reduce back pain.  You can do it at the gym, at the office with a chair or at home with your coffee table.

1/2 Kneeling Hip Flexor Stretch – 3x/side

Sitting for long periods tends to create tight, overactive hip flexors.  This stretch will help to open up your hips before you focus on strengthening the glutes, their opposing muscle group.

Band Lateral Walks – 3 x 10 steps/side

This exercise targets the abductors (outer glute muscles). Keep tension on the band at all times (feet no closer than hip-width) and lead with the heel on each step

Single Leg Glute Bridge – 3 x 5 reps/side

Squeeze your glutes and lift your hips by driving through the heel of the working leg, stopping short of back hyper-extension. Return to the floor, relax, contract and repeat.  If you feel this in your hamstrings, be sure to focus on squeezing your glutes tight!!

Plank – 3 x 5 Breaths

Contract your glutes and brace your abs, keeping hips level with the shoulders. Take a big, full breath in through your nose and forcefully exhale as if you were trying to fog a mirror.

Physio Ball Dead Bug – 3 x 5 /side

Keep your back pressed to the floor as you extend your arm and leg (extend only as far as you can without losing contact with the floor).  Focus on deep breathing. You may perform this exercise without the ball if it’s too difficult.

Bird Dog – 3 x 8/side

From all fours, fully extend the opposite arm and leg while keep your hips level. Focus deep breaths with each extension. Move with control and own the top (extended) position.

You’ll notice that there’s a heavy focus on breathing with these exercises, and for good reason. Deep breathing helps to activate the deeper core muscles that stabilize the spine, transfer energy and improve posture. If you like to squat, deadlift and lift heavier weight in general, you’ll find that focusing on your breathing helps to improve the quality of these lifts. Also note that the core exercises are primarily “anti” movements – no crunches or sit-ups. Our goal here is to train for stability and remove stress from the lumbar spine rather than add to it.

We can utilize these exercises as part of our warm-up or they can serve as a stand-alone workout. Regardless, incorporating them into your daily routine will help to reduce the severity of your back pain.

Can standing up help?

Ultimately, we still spend 8-10 hours of the day sitting and we have to mitigate that somehow. More and more people are migrating toward standing desks, and with good reason. Standing opens up your hips, activates your core and helps you to actively maintain your posture. As the linked article points out, you may even see improvements in mood, energy level and productivity. However, standing in place for hours on end isn’t great either – you’ll benefit more from frequent movement.

If a standing desk is not an option, you can set up your office chair so that it’s more ergonomically correct. Doing so may help to reduce back pain and improve overall posture.

Again, whether standing your sitting, limited movement is still the biggest concern. You should create avenues to walk around, move and use your body. Set a schedule reminder to get up every 30 minutes. One client of mine purposefully uses a smaller water cup so that she has to get up for a refill more often.  Get creative and get up!