Home Posts tagged "low back pain" (Page 3)

CP Intern Blog by Conor Nordengren: Up the “Ab Ante”

Today's guest blog comes from current Cressey Performance intern, Conor Nordgren. We’ve all heard those stories about the training regimens of celebrities and how they do 500 crunches first thing in the morning and 500 more right before bed to get that perfect six-pack of abs.  Many of you have probably also seen that infamous video of T.O. performing crunches while conducting an interview with reporters.

While exercises like crunches and sit-ups can bring out those abs and sculpt a nice six-pack, is this the safest method to train the core? Top strength and conditioning coaches like Eric Cressey, Tony Gentilcore, Mike Robertson, Mike Boyle, and Jason Nunn have recently written and talked on the subject and say that it is not. As an intern at Cressey Performance, I’ve been exposed to a ton of programs and not a single one of them has included a crunch or a sit-up. Here’s why: If you’re familiar with Mike Boyle’s joint by joint approach to training, you know that the lumbar spine requires stability as opposed to mobility. Think about the execution of a conventional sit-up: what is your lumbar spine doing? That’s right, it’s flexing. The lumbar spine is not designed for a great deal of movement (whether it is flexion or extension), let alone repetitive movement. Our spine as a whole is not meant for a ton of flexion or extension, either. While you may “feel the burn” in your abs when performing a set of crunches, you are essentially training spinal flexion. World-renowned low-back researcher Dr. Stuart McGill says that we have a finite number of flexion/extension cycles in our back until injury is caused. That number is different for every person, but the bottom line is that by performing exercises like crunches and sit-ups, you’re increasing your risk for injury with every rep! Dr. McGill has actually done experiments where he’s put pig spines in a crunch machine and after a certain number of crunches, or flexes, spinal disks explode. Crunches and sit-ups also promote a kyphotic, or rounded back, posture. Visualize someone in the top position of a crunch or a sit-up. Now, keep that visual of their upper-back, but picture them standing up. Hello Quasimodo!

Would you consider this good posture? Of course you wouldn’t (well, hopefully not). So why would we want to reinforce it? James Porterfield and Carl DeRosa have written that the core musculature is primarily designed to transmit force, not to produce it. While crunches and sit-ups are promoting flexion of the spine, our core should instead be trained in preventing movement. If we train our core to be rigid and prevent movement, the stronger it will be; this translates to more overall force production throughout the whole body which will allow for bigger lifts. Sounds pretty good, huh? Thanks in large part to Mike Robertson, we’ve been introduced to four acceptable movement patterns that should be utilized when training the core. They are anti-rotation, anti-extension, anti-lateral flexion, and hip flexion with a neutral spine. While there are several variations of the following exercises, here are some of my favorites: Anti-rotation: Tall Kneeling Pallof Press – the kneeling version really forces you to use your glutes and your core, since your quads are taken out of the picture (this exercise can also be done on a cable machine). Anti-extension: Ab Wheel Rollouts – progress to band-resisted or off of a box for added difficulty. Anti-lateral flexion: Waiter Carries – can also be done with a kettlebell. Hip Flexion with a Neutral Spine: Prone Jackknifes with a stability ball – you may find this to be one of the more challenging movements, so really focus on keeping that core tight! Some of you may have a hard time imagining your workout without any crunches or sit-ups. You might be skeptical that the above exercises may not get you the results that you desire. Well, Tony “The Situation” Gentilcore performs these movements on a regular basis, and when he voluntarily and superfluously flashes his abs at us interns every day, let me tell you, I could wash my clothes on those things! But seriously, change is hard and not an easy thing to accept. However, the good thing about change is that it can be for the better. I’m not demanding that you immediately stop performing crunches and/or sit-ups; that choice is yours. It’s my hope that you think about how you’re currently training your core and ask yourself if this is the most optimal, functional, and above all else, SAFEST way to do so. This may help to keep you injury-free down the road so you can continue hitting the iron hard. Conor Nordengren can be reached at cnordengren@gmail.com. Sign-up Today for our FREE Newsletter:
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Preventing Lower Back Pain: Assuming is Okay

It's widely known that approximately 80% of the population will suffer from lower back pain at some point during their lives.  What isn't widely known, however, is that even those who are asymptomatic are usually walking around with a host of nasty stuff going on with their spines.  Don't believe me?

A 1994 study in the New England Journal of Medicine found that in a study of MRIs of 98 asymptomatic individuals, 82% of those MRIs came back as positive for a disc bulge, protrusion, or extrusion at one level.  And, 38% actually had these issues at more than one level.  You can read the free full text HERE.

spinemri

As the others discovered, it doesn't stop with disc issues, either - and that's where a great study from Soler and Calderon comes in.  They looked at the incidence of spondylolysis (vertebral fractures) in elite Spanish athletes, and found that 8% of those they examined had them.  Only about half of those diagnosed via imaging actually had back pain, though.  The incidence was highest in track and field throwers, rowers, gymnasts, and weightlifters - and I'd expect that this figure is actually higher in the U.S., where we have more sports (hockey, baseball, lacrosse) involving violent extension and rotation, more contact sports, and more participation in weight training.

What does this mean for us?  Well, as Chou et al. reported in The Lancet, "Lumbar imaging for low-back pain without indications of serious underlying conditions does not improve clinical outcomes. Therefore, clinicians should refrain from routine, immediate lumbar imaging in patients with acute or subacute low-back pain and without features suggesting a serious underlying condition."  That's not the point of my article today, though; I'll leave that stuff to the physicians to decide and rehabilitation specialists to interpret and treat.

As fitness professionals, strength coaches, and even just fitness enthusiasts and athletes, we need to assume that there is are probably a lot of structural abnormalities going on in the spines we encounter - including our own.  The programs we write and follow need to be sound and take these issues into account, considering differences in age, gender, sport participation, and injury history.  The technique we use needs to position us so that we can avoid causing them to reach threshold.  And, we need to appreciate that there is a risk-reward balance to be "struck" with everything we do in training because nobody will ever be "perfectly prepared" for the demands to be placed on their bodies.

Rather than lay all my thoughts out here, I'm going to direct you to some previous writing of mine:

To Squat or Not to Squat?
Lower Back Savers: Part 1
Lower Back Savers: Part 2
Lower Back Savers: Part 3

I'd also highly recommend Ultimate Back Fitness and Performance by Dr. Stuart McGill.

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The Best of 2009: Stuff that was Fun to Write

Thus far this week, we've covered the top articles, product reviews, videos, and guest submissions of the year.  Today, I just wanted to cover the stuff that was fun for me to write (or film) - and it isn't just exclusive to EricCressey.com. Birthday Blogging: 28 Years, 28 Favorites - I just remember that this thing rolled off my fingertips as I wrote it on my 28th birthday. What Folks are Saying about the Cressey Performance Majestic Fleece - I just remember that we had to film this about 47 times because none of us could stop laughing.

The Opportunity Cost of Your Time - I don't know why this one was fun to write, but it was.  I suppose it might have something to do with the fact that I started out at business school, and then moved over to the exercise science world to complete my undergraduate degree.

The Truth About Unstable Surface Training - This was actually introduced at the end of 2008 (and written in sections between 2005 and 2008), but deserves mention in light of its first full year of availability.  I'm most proud of this work because it took a ton of time to compile both the literature and our original research, which was the first of its kind.  Nobody had looked at how a long-term training lower-body unstable surface training intervention would affect healthy, trained athletes' performance.  This book presents not only those results, but a series of practical application recommendations that are of value to any strength coach, personal trainer, or other fitness professional.

Lower Back Savers Part 1, Part 2, and Part 3 - Featured at T-Muscle, these were really fun to write because I had a chance to be dorky and practical at the same time, blending research with what we've anecdotally seen in those with lower back issues.  Honestly, I still have enough content to write a part 4, and that may come around in the next few months.
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Strength Exercise of the Week: Pallof Press

(even though our camera/editing guy spelled it incorrectly)

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Two Anterior Core Progressions

Here's a quick continuation of last week's newsletter, which featured some introductory anterior core training exercises and the rationale for them.  You'll need a TRX set-up to do these; it's an awesome investment, if you haven't picked one up already.  They make it very easy to take your training anywhere you go.

For more information on my overall approach to core training and where these exercises fit in, I encourage you to check out Part 3 of my Lower Back Savers series.

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Assess and Correct Now Available!

Today's a really exciting day for Mike Robertson, Bill Hartman, and I - and hopefully for you, too! You see, after months of planning, filming, and editing, our new product, Assess and Correct, is now available at www.AssessAndCorrect.com.  And, for the first week ONLY, we're making the product available for $30 off what will be the normal retail price.

Layout 1 Assess and Correct is the first resource that empowers you with not only a series of self-assessments to identify your own flexibility and stability limitations, but also exercise progressions to correct those inefficiencies.  In the process, you'll take your athletic performance to all new levels and prevent injuries from creeping up on you - whether you're a high-level athlete or someone who sits at a desk too much. With 27 self-assessments and 78 corresponding exercises, you'll cover virtually everything you need to feel and perform well. And, you'll have plenty of variety to use for many years to come!  And, while the DVDs alone are really comprehensive, the bonuses we've added to this really sweeten the deal.  Included in this package are:

  • DVD #1: Your Comprehensive Guide to Self-Assessment
  • DVD #2: Your Individualized Corrective Exercise Progressions
  • Bonus #1: The Assess and Correct Assessment E-Manual, which is a guide to which you can refer to in conjunction with DVD #1.
  • Bonus #2: The Assess and Correct E-Manual, which includes written cues and photos for each recommended drill in DVD #2 so that you'll have a resource you can take to the gym with you.
  • Bonus #3: "The Great Eight Static Stretches" E-Manual, which shows you eight additional flexibility drills that we use on a regular basis in addition to the drills featured in the DVDs.
  • Bonus #4: The "Optimal Self Myofascial Release" E-Manual, which shows you the soft tissue methods and techniques we use with our clients and athletes.
  • Bonus #5: "Warm-ups for Every Body" E-Manual, which is a collection of two sample warm-up templates for 19 different sports/scenarios.
Again, this introductory offer will end next Sunday, November 1 at midnight EST.  For now, though, I'd encourage you to head over to www.AssessAndCorrect.com to check out some of the sample videos from the DVDs - including the introduction in which we discuss our rationale for creating the product.
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