One-Sided Back Pain

Written on January 8, 2008 at 9:05 pm, by Eric Cressey

Before we get to the content, I wanted to quickly pass along a few announcements:

1. I just confirmed that I’ll be speaking at a seminar in Montreal, Quebec on October 20-21.  Three other speakers have already been confirmed, and the organizer is waiting on a fourth. Trust me – with these names, you won’t be disappointed!  Keep an eye out for more information in upcoming newsletters.

2. Through Thursday at 7PM, Nate Green’s Standing on the Shoulders of Giants will be on sale for $49 (regularly $97).  I contributed a bonus interview on this collection of interviews with some very knowledgeable industry veterans, and anyone who considers himself an “up and comer” in the business would be wise to purchase a set.  Check it out: Standing on the Shoulders of Giants.

Now, to follow up on my newsletter from earlier this week, here are random thoughts 6-10 from me.

6. Incorporate posterior capsule stretching in overhead throwing athletes.  There is considerable research demonstrating that glenohumeral internal rotation deficit (GIRD) is highly correlated with shoulder injuries in overhead throwing athletes.  Incorporating a very simple sleeper stretch daily can dramatically reduce the risk of shoulder problems in such athletes; if you aren’t including this stretch in your program, you shouldn’t be allowed to train overhead athletes!

7. One-sided back pain is almost always related to a lack of hip external rotation and hip extension range of motion.  If your hip doesn’t externally rotate sufficiently, you’ll compensate by rotating more at your lumbar spine.  If you don’t have terminal hip extension (thanks to glutes that actually fire), you’ll compensate with lumbar hyperextension.  Extension-rotation syndromes are a good 80% of lower back problems.  Work on hip mobility and stabilize the lumbar spine, and you’ll be golden.  Aggressive soft tissue work with the foam roller and lacrosse ball is useful on the TFL/IT band, quads, adductors, piriformis, and gluteus medius.

For others, the rotational deficit will be in internal rotation.  Know how to assess both and you’ll be able to head off problems before they set in.

8. Direct training for the subscapularis is a commonly overlooked training initiative that can yield tremendous results.  This is especially true in the aforementioned overhead throwing athletes who have tightness in the posterior capsule.  This is also a common problem in those who have noteworthy amounts of scar tissue on pectoralis major – and this is often exemplified when someone has an uneven lockout while bench pressing.  When infraspinatus and teres minor are doing a lot of work and getting scarred up as a result, you know that there is a good chance that the subscapularis isn’t doing its job in depressing the humeral head.  Run a lift-off test to check subscap function, and then correlate your findings with scar tissue in the posterior capsule.

My favorite exercise for improving subscap function is the prone internal rotation; you can find a video HERE.  Avoid the common substitution patterns of flexing the wrist, anteriorly tilting the scapula, and extending the elbow.  Think 90/90 in terms of shoulder and elbow angles.

9. Vanilla protein powder is really versatile.  I’m far from a gourmet chef, but I’ve come to the conclusion that if I put Vanilla Metabolic Drive in a blender with some ice and water, I can make pretty much anything taste tolerable.  Yesterday, just for the heck of it, I used spinach, broccoli, and blueberries – and I didn’t even need to pinch my nose to drink it.  I guess you could call that the lazy man’s Greens Plus…

Of course, you could always pick up a copy of Precision Nutrition, which includes the Gourmet Nutrition cookbook, and actually make it taste good.

10. The rhomboids aren’t as innocent as you think.  Typically, the rhomboids are “tossed in” with the lower and middle traps as the “good” scapular retractors.  In reality, with the line of pull of the rhomboids, you basically have a muscle group that in many ways parallels the function of the upper traps – which we know contribute to scapular dysfunction and shoulder, upper back, and neck pain.

I’ve seen a lot of upper body problems resolve with dedicated soft tissue work – both in the form of massage and rolling the upper back with a doubled tennis ball (masking taped together) – on the rhomboids.

We’ll be back next week with more expert tips!  Until then, train hard and have fun!

All the Best,

EC