Lower Back Safety!

Lower back safety is an important issue. More to us than to others because a healthy lower back keeps us successful in our sport and lifestyle, but also in every day life if, and I'm sure most of us do, we plan to stay active well into old age.
I had an interesting discussion with a few of my professors the other week. One of them was my anatomy and kinsiology professor, the other was my practices teacher who is also a practicing physical therapist. The subject was lower back safety because we had talked quite a bit about preventive measures and I raised the point of bodybuilding. The fact we can't deny is that despite strengthening and building resistance in the body, we tend to put our lower backs in harms way more than most people. I need but think of a squat or a deadlift to remind you of the strain we subject the lower back to. But especially exercises such as bent-over barbell rows and stiff-leg deadlifts are death traps for lower back injury.

Lower back safety is an important issue. More to us than to others because a healthy lower back keeps us successful in our sport and lifestyle, but also in every day life if, and I'm sure most of us do, we plan to stay active well into old age. Modern society has its own ailments like cancer, AIDS and so on, but perhaps the ones that wreck most havoc on our motility and freedom at later ages are lower back injuries such as hernias and lumbagos. Addressing these problems is never easy. I believe the term "old habits die hard" is most appropriate here. And yet that's what we need to do. Break the old habits that threaten our well being.

Defining the Problem

The trouble with human anatomy is that we were never meant to walk upright. It's an evolutionary curiosity that caused us to stand up, stabilize and fall in love with being above everything. A trait common to humans no doubt. I can show you my circle of friends and a lot of them act like they are above everyone and like it. (That's a joke by the way). Evolution takes care of its own, but over periods of millions of years. So the chance that any of our immediate bloodline will not be born with inherent potential back problems is very unlikely. The fact is that our spine was meant to coordinate front and rear limbs and that know the spine is solely supported by the rear limbs and has to support and hold the entire upper body. That means extra strain when the spine moves: Forward, like bending over to pick something up, or sideways, as if twisting to reach for something. In itself not harmful actions, evolution has at least progressed that far that we can move our body as it is now. The problem with today's society is that we are always lugging heavy weights that need to be moved and that often use the lower back as a hinging point to do that.

Looking at the physiology of the spinal column as a whole we see that vertebrae are the solid part that keeps our body straight. But to move the upper body there has to be a certain mobility, so there are intervertebral joints known as Discus Inter-vertebralis. This disc is basically a small ball, a core, known as the nucleus pulposus. It is located in the middle between two vertebrae and they rotate in opposition to each other over this little ball. Kind of like rolling your hand over a ping-pong ball on a table. This little ball of course can only practice proper functioning and assure full mobility if it is in the dead center. To keep it there we have a protective wall called the annulus fibrosus, which is a a group of 16 to 20 layers called lamels that make up the rest of the disc. Since the vertebrae move over the nucleus, they come in contact with these lamels. They are capable of resisting the pressure, but if extra stress or weight is placed on the vertebrae, their pressure on the lamels is considerably greater as well and that damages and breaks the lamels leaving opening in the protective walls. This causes the nucleus to migrate through thes openings outwards. Not only does this partially or completely ruin the mobility between the two affected vertebrae, the spinal column is also a large part of the autonomic nervous system and neural damage may occur when the nucleus breaks through the protective wall. This condition is known as a Hernia nuclei pulposi (HNP). And I assure you, once you have one, it's no laughing matter. A lot of people, but especially men are at high risk for the condition once past the age of 40. In severe cases surgery is the only option.

How to Prevent Matters or Keep Them From Getting Worse

If I scared anyone - Good. This is a serious matter. This can result from a physical profession, spending too much time in front of a computer screen and so on. But we lift hundreds of pounds using incorrect and harmful techniques every day. The risk of such injury is very real. So we need to address them. I sincerely hope younger or less experienced readers will not shy away from this matter. I know its boring, but it's crucial to your health.

Targeting the Problem: Strengthening the Lower Back

This is the most obvious of all solutions. But it's important to realize this only works up to a point. Strengthening the lower back is in no way a security that will keep you from injury, but it is a prerequisite for it. Without it, you can kiss your lifting days goodbye. And with a little bad luck, 20 years down the road you might kiss your walking days goodbye. This is where it starts. This is not an actual solution, but if you don't take the time to read this and act on what you read, there is no point in reading on. The calf will have drowned. This is where it starts.

Strengthening is mainly geared towards the spinal erectors and gluteus muscles. They straighten the spine and provide the counterbalance for all these harmful actions. Experienced lifters will know Squats and deadlifts are key components here, but the last thing I would advocate is that someone who has never done these lifts or is not particularly versed in the proper execution of them starts doing them out of the blue. Light work like bodyweight hyper-extensions and light weights on the leg press are essential starting out. Using moderate to high reps (15-20) address the muscles with these. With the spinal erectors its important to tense but not over-stress the lower back muscles by holding the contraction for a count but no longer on the hyperextension. For the gluteus working the bottom range of motion on the leg press (stretch to halfway) and emphasizing the ultimate contraction by squeezing the butt are the essential keys to developing stabilizing strength in the gluteus muscles.

At the same time you should attempt to get versed in the more important lifts such as squats and deadlifts. I'll expand on the proper performance of these lifts in the next paragraph. But what you should remember is to start with an empty bar or a very light weight and practice that proper performance a lot. Because the low weight will add no real stress of muscle fatigue it's safe to practice the form 5 or 10 minutes, 3 or 4 times a week after a workout. When you start using weight of course, muscular fatigue and risk of overtraining will keep the practice of these lifts restrained to the days when you work the respective body-parts they train: back and legs. Slowly but certainly make the emphasis of lower back strengthening these two lifts, but warming up before a workout with a few bodyweight hyperextensions can't hurt, even on back day.

Preventing the Problem: Using Correct Form

Daily life puts enough damaging strain on the spine, especially if you work in a profession where you either stay seated for long periods of time or if you have to move heavy objects via manual labor. The last thing you want to do is add more to that stress than you have to when you workout. A pro can be sloppy in his form sometimes. And we emulate pros. But one of the things my discussion with my professors addressed was that pro's don't have these stressful jobs, they do have very good round the clock medical assistance and lastly, they use steroids. Aromatizable steroids significantly reduce the risk of joint problems because a lot of water is retained in joints due to excess estrogens in the body. This provides and extra cushion that reduces the stress of the vertebrae on the inter-vertebral disc. The amateur and the natural need to be a little stricter with their form. Not so much in light of results, that's an archaic myth, but mainly for health reasons.

The first issue we should address in this paragraph are the key lifts for strengthening the lower back, the squat and deadlift. Because these are also key lifts in obtaining maximum body strength and stability and due to their importance as an overall growth stimulus you will eventually lift considerable weight in these lifts. For those most dedicated and experienced, lifts of 500 pounds on the squat and 700 or 800 pounds on the dead are attainable without having geared our training specifically to lifting that amount. Even though a lot of us will not reach those weights we can deduce that whatever we do lift is still considerable. It would be ironic that improper execution of the lifts that can best strengthen the lower back would actually cause the damage. Therefore it is paramount that you learn to execute these lifts properly before you attempt large weights.

Too many times I see young kids attempting to do large lifts of 200 or 300 pounds on squats when they really can't even properly handle 100 lbs. This leads to sloppy form and partial range of motion. In turn that creates imbalances that do more harm than good. Full range of motion and proper execution are a must. For the squat that means ass to the grass, sitting on your heels. You need to align the bar on your shoulders in such a position that it does not cause you discomfort and that allows you to keep your spine straight. The back has to remain straight throughout the exercise. That is the first point. The second is that the knees stay pointed straight up at the ceiling at all times. In effect that means your are sitting back on your heels, hinging on your knees. This is a range of motion in multiple special planes, so never attempt a squat on a smith rack. That leads to injury of either the lower back or the knees. When sitting in the stretch position do not think of lifting the weight back up. As I said you are hinging on the knees. That means the weight is not limited to the barbell. It also includes anything above your knees. That's the majority of your body-weight. Instead think in reverse. Think like you want to drive your heels in the floor with explosive force, that will push ALL the weight up as a whole. As mentioned in the previous paragraph start with an empty bar and practice this form and then slowly add weight. I don't care if it takes you 5 years to lift 200 lbs, in the end your weights will progress faster than others and your back will be in much better shape. Not to mention the enormous quads and glutes you'll have. Until you can perform it as it should be performed and you are handling a decent weight, there is no need to go with anything lower than 15 to 20 reps. There is a lot of slow twitch fiber in the quads and hams, and they will probably grow better in that rep range. Only if you are an experienced lifter of many years should you attempt lower reps.

Deadlifts aren't all that easy either. As with the squat you will want to keep the back straight as possible. If you do not do this, you won't be lifting with the quads, hams and spinal erectors, but mostly with your spine and upper back, putting undue strain on the lumbal vertebrae (those of the lower back). Load up a bar (very light at first and set it on the floor. Set your feet right in front of it and keeping the back straight, bend through your knees until you can reach the bar. Ass to the grass once again. Now use a switch grip: one hand facing forward, the other back. That will give you a better grip in most cases although personally I use both straps and gloves for this lift. Because of the position of your feet your knees should be over the bar now. Your back is still straight, I can't stress that enough. Put heels on the floor and now slowly stretch your arms. If the arms are bent you will have the feeling you have to lift the weight with the arms, upper back, shoulders and traps. That's a mistake. The muscles should be out of it. The arms are mere levers. Lift through the legs, gluteus and lower back muscles and pull the weight straight up. When performing it think of it as a push, not a pull, the lower muscles will be doing all the work. As the bar rises, your legs straighten, so don't worry about the knees being in the way. Again practice the form with light weights, multiple times, then increase the weights slowly as you decrease the frequency. Here you only stay with high reps until you have it down, as soon as you start using real weights you should probably do 5 sets of 5 reps before every back workout.

The second issue this paragraph should address is the proper performance and safety when doing other exercises that do not affect these muscles, but put them in harm's way nonetheless. I'm thinking mainly of stiff-leg deadlifts for hamstrings and bent-over barbell rows for the lats. Let's have a look at the rows fist. If you compare it to a dumbbell row you will notice that they have more than one contact point. A normal dumbbell row uses the entire upper body as a contact point for support, the 1-arm dumbbell row stabilizes the body using the leg on the same side and the knee and hand on the other side of the active portion. Multiple contact points are important as they divide the stress over a larger plane and not just a small area like the lumbal vertebrae. Now in a bent-over barbell row we stand bent-over with the upper body as a lever hinging on those very vertebrae, while the other end of the lever is carrying an inhuman amount of weight. That's a definite no-no. Yet bent over barbell rows are a key lift and treasured by many in the development of a thick back. I offer you two solutions. The first is one my old coach Mr.Hudson taught me. Rest a barbell on a bench station, on the actual bench. Put a towel around the barbell of the bench set. Now stand over the bench, bend over and rest your head on the towel around the bar. With the other loaded barbell on the bench now all you have to do is keep the back straight and pull the bar into your abdomen. The head resting on the second bar is an additional contact point that helps spread the load over the entire back. The second solution I was taught by a fellow trainer, a weightlifter. He suggested I set up a high bench. How you do that depends on whats at your disposal. I used a decline ab-board. Attached one end to the top ladder of the station and put a bench under the other station. But if you have a bench with high legs, or a very narrow table, they may provide and alternative. Leave the barbell underneath and lay down on this high bench on your belly. Hold the barbell with two hands and lift to the abdomen. The advantage here is that the entire front of the upper body is a contact point. This not only protects the lower back, it also keeps it straight for you, preventing cheating.

The stiff-leg deadlift is harder. Sometimes I feel it's best not to do it as long as other means of training the hams are available. If you feel you must perform this, the only advice I can offer is bend the knees slightly and lean them forward, stick your butt out the other way. This creates a Z-shaped structure that has a stronger base with multiple stress points (lower back, gluteus, knees, heels). Of course don't bend the legs too much, it's still a hamstring exercise. Just don't lean into it with straight legs while using a heavy weight.

These are the most important ones, but I'm sure I'm forgetting other, probably less stressful, incidences, so I'll give you a piece of advise to judge yourself by. There is nothing, and I mean nothing (no exercises, no action, nothing) that warrants bending the back. Always, always keep a straight back. It's a bad habit to not do this that comes more natural than we would like, and to a point it's tolerable, but when lifting weights, in the gym or elsewhere, you cannot afford to take that risk. The same with continually stressful working conditions like working 8 hours sitting down in front of a computer screen. Adjust your chair so you can sit up straight while working. Strap yourself in the chair for all I care. For manual labor jobs this is a problem too, but that is best resolved with recommendations in the paragraph on everyday life.

Auxiliary Muscles: The Abdomen

Those of you familiar with strength and power training will be familiar with this theory. To increase performance in any lift it's important to see things as a whole. And a chain is only as strong as its weakest link. Hence you have to look at the different parts of the whole as well (even-though the whole is more than a sum of its parts). More than one muscle aids in key lifts like a bench press. And when one fails to increase his bench it's not always the result of weak pectorals. It may be a weakness in the triceps, forearms, front or lateral delts or even the rotator cuff. Then you must work on these auxiliary muscles to bring them up to par with the rest in order for the whole of the movement to progress again.

The same with the lower back. It has counteracting muscles in the abdomen and stabilizing muscles as well (the obliques). A lot of the work in saving the strain from the skeletal portion of the lower back (the vertebrae and inter-vertebral discs) is making sure when it isn't taxing the lower back muscles, it has other muscles that prevent it from taking more strain than it has to. Namely the abdomen. Largely responsible for our capability to walk on two feet stems from that area as well. In laying or hanging positions and in lesser measure seated positions the abdominal muscles carry the spine and most of the back. Supporting it and pulling it so the spinal erectors don't need to do all the lifting. Therefor having strong abdominals is an absolute must in protecting the lower back. Just look at people with HNP. They can't work or use the abdominals properly any more either and they will probably never do another sit-up in their life. That's why it's best to train your abs preventively. Because gaining muscle is dependent on calories, and calories make you fat and cover the abs, a lot of people don't put as much work in the abs as they should, so they lose strength. But abs are more than something women like to touch and look at, remember that.

Doing regular abdominal training, 2 or 3 times a week with a minimal of 8 sets is a prerequisite in protecting the lower back and preventing injury later in life. Strong abs and strong lower back muscles form the core of your body. That's perhaps one of the most important things many young lifters need to learn. Muscles don't just need to look good, they are functional and need to do what they were designed to do first of all. Making them look good is secondary.

Everyday Life: Don't be Afraid to be Preventive

Most of us care about the gym most, that's why you are on this website, reading this article I assume. And being preventive in the gym helps us maintain lower back health in everyday life. But it doesn't hurt to be preventive in everyday life as well, sparing the lower back as much as possible. This is especially true in manual labor professions. And for the casual visitor who reads this article looking for a resolution to his lower back problems this is probably even more important. The fact is the way we contort ourselves in respect to our physical structure is downright shameful. People bending way over with straight legs to pick up a set of heavy boxes. A guy twisting and bending to pick up a case of beer only to reach out and bend over as he attempts to toss it in the back of the trunk of his car is almost painful to watch. Not to mention all the demonic inventions that force us to bend over like frontally opening washing machines and driers and the opening to the gas tank in the car.

The first thing any physical therapist will teach you in regards to how to treat your lower back is how to properly pick up something off the floor. It's simple as hell, but it's hard to apply because old habits die hard. But please, for your own sake make a conscious attempt to lift heavy objects this way. Keep the back straight and bend through your knees. Use stretched arms to grab the object and lift through your heels. Keep the object as close as possible to your own body which negates the need for a lever. Keeping the object far away increases the weight and the strain. You accentuate the problem then instead of preventing it. The best thing to compare it to is the technique for deadlifts. It's basically the same technique. Which goes to show that even non-bodybuilders can benefit greatly from learning our lifting techniques.

The second thing you should be aware of is the theory of stabilization. Widening your base for support and seeking support on multiple planes of movement decreases the stress on a single point and spreads out the load over a larger area. To give you a few examples When doing laundry and you need to move down to pick it up and put it in a frontal opening spread your legs farther than normal and then bend through your legs to do it. If it is a lot of work, this will strain the muscles. For those with less physical condition it may even be better to just sit down on the floor to do these things.

Another example is gassing up. You need to bend over slightly as you put gas in the tank. While doing this it is best to put one foot on your tire, seeking not only a wider support, but higher (different planes, better use of stability) support. This spares the lower back. For a last example lets go back to the guy lugging beer. As you attempt to put a heavy object in the trunk keep the object close to the body, lift one knees on the trunk for stability and greater support and then lower the object into the trunk as close to you as possible. Always load heavy objects closest and lighter objects farther.


On the Use of Belts

Some people have asked me to address this issue, some specifically in regards to lower back safety, others more in general. It's always an issue I find very hard to address. I always say that I think everyone should have a lifting belt. But I'm afraid at the same time that people will interpret it like I'm saying you should use a belt all the time. When in fact I hardly ever really advocate the use of the belt.

Though I didn't originally include this paragraph in the article, it's odd that Mr. DeLuca of Bodybuilding.com brought it up because it was part of the discussion I mentioned when starting this article. As previously stated, some exercises just put you in harms way, like it or not. We weren't meant to do them, but they are just so deadly effective at targeting certain muscles that it is unthinkable not to do them. Like the two we discussed, the stiff-leg deadlift and the bent-over barbell row. For those exercises, and especially the SLD, you should ALWAYS use a belt, no matter what weight or what amount of reps you are using. They compromise the lower back to such a great extent that no precaution is too great. The only other exercises the belt should be used are, and I know you are guessing this, the deadlift and the squat. For this reason alone everyone should own a belt because these two key lifts should be in any weight lifting program you undertake due to their crucial nature in building the foundation of the body. However, I would caution not to use them all the time. When learning the proper execution as discussed earlier, avoid the use of the belt. It's important that you teach the body the proper form without assistance so it can comport itself in the correct fashion, then add in the belt to aid to that. But the key is still correct performance. Only when you get up to the really heavy weights should you opt for a belt. I'm a strong believer in the dependency effect, and if you use a belt for every little move, every set of squats, even the warm-ups, you will soon think that you need the belt to achieve the results you get. It's not so much that the belt makes you stronger, or carries the load as some people believe. That's just an old myth. But the fact is that when taking the belt off the concentric pressure is reduced and the mobility and instability of the lower back is increased, which immediately gives you the feeling of less power and also disrupts the stabilizing muscles in the area meaning an injury is never far away. Not to mention the mental aspect of losing the belt as a tool to help you lift the weight.

In these important lifts use the belt for the last sets and the heaviest sets. So it's best to pyramid the weight up and only use the belt in situations you know you haven't fully mastered yet. But in the interest of a balanced physique and proper safety precautions, don't get dependent on the belt.

Conclusion

That's the conclusion of the article. Congratulations for making it this far. It may be far from the most interesting article I ever wrote, but it is probably the most important one I wrote to date. I know many people who started this article will never finish it. And that's sad, especially considering the repercussions it will have for them later in life. It took me a while to realize the importance of having respect for your body and your health. But then we never see we can't be too healthy until we've been really ill. If you made it, that's the most important part, but if you can persuade others to follow in your preventive foot steps you will have helped make this world a better place by saving at least one other person from one of the most common western world diseases: HNP.