Learn the hows and whys back pain occurs along with exercises to help strengthen your core.

1. Exercise and Low Back Pain
Pamela Brown, MA, CSCS, CES,
PRCS, ACSM-cPT
www.pamelabrowncoaching.com
trainsmart@pambrownfitness.com

2. Objectives
• What can cause low back pain
• Exercises to eliminate pain
• Any precautions

3. Causes of back pain
• Movement patterns (how you move)
– i.e., carrying, lifting, stooping, etc…
• Postural control
– i.e., letting your spine flatten, arch, or rotate
excessively during movement (lack of lumbar
stability)
– May have strong muscles but lack ability to control
unwanted movements
• Lack of mobility at hips, t-spine, and ankles
– Decreases stability at lower back
• Muscle imbalances
– Tight lower back and hip flexors due to weak glutes
and abdominals

4. Back pain causes, cont
• Excessive anterior pelvic tilt of pelvis during
movement
• SI Joint dysfunction
• Gluteal amnesia: gluteals are not functioning
properly
– Places more stress on the lower back
• Lack of endurance in lower back muscles
– Lack of or poor cardiovascular training or muscle
endurance training

5. More on postural control
• Common postural
flaw: lower crossed
syndrome
• Characterized by
excessive arch in
lower back and
“pregnant”
appearance

6. Over-training rectus ab (6-pack
muscle)
• Crunches teaches you how to become
better at crunches, not movement
– Doesn’t teach you how to stabilize spine
• May result in loss of control over rotation
– Inhibits obliques from doing their job
• Can lead to hunchback-rounded shoulder
appearance
– Increases shoulder injury risk

7. Overall goal
INCREASE CORE STABILITY!!!!
– Stability: stiffness; unable to move
• Increasing stability of the spine and pelvis while
increasing mobility at hips and ankle
– Stability before strength
• Increasing muscle endurance
• Increasing muscle activation/coordination
– Using right muscles at the right time in the right way

8. Exercise Considerations
1. Identify movements that make pain worse and
correct
2. Increase flexibility of tight/overactive muscles
3. Activate weakened/underactive muscles
4. Put back into movement
5. Increase muscular endurance
*using lower crossed syndrome as an example

9. ID patterns
• Handout
• Learn how to maintain neutral spine
• Hip hinge (moving through hips)

10. #2-Stretch tight muscles
• Tight muscles will not let joint move
freely, causing more stress at the joint (the
spine and hips)
• Tight muscles on one side of the joint will
cause the muscles on the other side of joint
to relax
• May need to be released through foam
rolling or massage

11. #3-Activate weakened muscles
• After you increase flexibility of tight
muscles, must “turn on” muscles that have
been relaxed
• Increases joint stability and decreases
stress on joint

12. #4-Use muscles in movement
• Re-training the body how to use newly
stretched and activated muscles in
functional movements

13. Focus of exercise sessions
• Increasing gluteal and abdominal and
endurance
– Increases core strength even though you’re not
training for it

14. Types of core exercises
• Use exercises that emphasize neutral, stable spine either
in isolation or with extremity movement
– Works abs at ideal length and how you use them in daily life
• Suggested to stop use of crunch, sit-up, and leg lift
variations until sufficient stability is achieved
• Exercises that trains abs and surrounding muscles as a
unit
• Functional exercises indirectly trains abs
– You use abs in every move that you make

15. Precautions
• Avoid hyperextension or hyperflexion while
lifting, reaching overhead, carrying things,etc…
• Avoid twisting in flexed or extended positions
• Maintain neutral spine during all exercises and
movements
• Stop exercise if pain is present
• Consult MD or PT if pain is persistent
• Carry loads level with your lower back
• Avoid morning exercise that places your spine in
flexion

16. Exercises
ALL ABOUT MUSCLE ACTIVATION AND TECHNIQUE!!!
• Postural control
– Neutral spine
• Abdominal brace
• Horse Stance
• Dead bug
• Hip flexor stretch
• Inner thigh stretch
• Birddog
• Front plank
• Bridge
• LEARN NEUTRAL SPINE AND PLACE INTO
FUNCTIONAL MOVEMENTS

17. Other considerations
• Cardiovascular exercise: provides oxygen for
muscles which increases muscle endurance;
increases release of natural pain killers
• Nutrition: healthy food, healthy muscles,
ligaments, etc…
• Stress control
• Use more bodyweight/functional movements

18. For more information
• Contact Pamela
– coachpamelabrown@gmail.com
– Visit www.pamelabrowncoaching.com and
schedule a consultation
– Get a Skype movement assessment and/or
program design