The other day I was helping my dog, who is 14, up onto my bed. She had her front legs up there, but I had to hoist her back end up. As soon as I did it, I felt it. Uh oh. The vague twinge in my right low back. I should’ve been more careful. But there it was: my body objecting to the rotation and bending that so often precedes a bout of low back pain. After icing and seeing MY Rolfer, I was fine. But it reminded me of what so many of us neglect when it comes to back pain: prevention!
Back pain is a complex subject. There is so much to say about it—what causes it, how to treat it, whether it involves nerves, bony articulations, tight muscles, etc.—and in the end, answers are often hard to find. According to the National Institute of Health, nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Thirty one million people suffer from some kind of back pain every day. Americans spend at $50 billion on low back pain each year. While some episodes of acute back pain resolve, more or less, without intervention, the acute can become chronic and seriously interfere with the quality of life for many people.
In the therapy I practice as a Rolfer, I am looking for a body-wide balance, an interplay between stability and adaptability–the ability to move when movement is called for. I’m looking to support and enhance the functioning of the natural curves of the spine so movement can move through the body fluidly. Many people have restrictions in areas of their bodies that should move, and too much movement in areas that should have more stability. Particular muscles and joint ligaments provide stability. We have 360 joints in our bodies. Joints are designed to move to varying degrees, some more than others. When muscles and ligaments don’t work properly, either from direct injury or as a result of overuse and/or unskillful movement patterns, the associated joints are prone to hyper-mobility, too much movement, and risk injury. On the other hand, following an injury, there is often restriction of movement at the injured site long past the point of healing, and that joint is no longer able to move freely. Whole-body compensation patterns develop, and become part of the way we move around in the world.
Rolfing can release fixations that prevent freedom of movement, but often times, people need strengthening exercises in addition to Rolfing.
“But I do crunches to strengthen my core!”
What do we mean when we talk about “core”? Depending on who you ask, you’ll get different answers. From a back pain stability perspective, “core” refers to muscles that stabilize the spine and pelvis during exercise/activity. Our multi-jointed bodies were not meant for long periods of sitting or lying around watching television. Our lifestyles have rendered our cores, at least compared to the way our ancestors used theirs, relatively lacking in support. To make up for it, many people do sit-ups, crunches and many other abdominal exercises that focus primarily on the rectus abdominis muscles (“six-pack” muscles) and the internal/external obliques (“love handles”). Yet back pain persists. Why?
The single most important abdominal muscle to train in service of preventing back pain is the Transversus Abdominus. The TA is the deepest muscle that forms the abdominal wall. Its fibers run horizontally around your abdomen like a corset. Its primary function is to compress the ribs and viscera, stabilizing the pelvis and spine. It connects directly into the fascia of the lumbar spine, which is why it’s such an important stabilizing muscle. If this muscle is neglected, it becomes underactive and non supportive. Hence: back pain!
Many core routines and ab exercises inherently activate and strengthen the transverse abdominals in a lesser fashion. Funny enough, isolating the Transversis Abdominus is remarkably easy and can be performed anywhere. Simply suck in your stomach like you are trying to touch your belly-button to your spine. If performed correctly, you should feel an unusual strain on a muscle around your midsection, the worse the strain, the more neglected the muscle. Start off at 5-10 seconds and relax. As the muscle gets stronger, suck in for 30 seconds to a minute at a time. These “vacuum exercises” are easy to do and good for your back and belly. Exercises like planks, side-planks, stabilization and dead bugs are excellent total core strengtheners that should be implemented in everyone’s workout.