Exercises that cause back pain. It’s easy to find a lot of misguided advice on the subject. Let’s look at how we’ve arrived here. There has long been a focus upon the spinal disc among spine care providers of all stripes. There are good reasons for this. Back and neck pain conditions that involve disc compromise can lead to considerable morbidity, and all care providers are trained to rule out worse-case scenarios first. A spinal disc also renders well on imaging. Western medicine has become modeled on reproduceable findings. Images that show a disc fit the bill. As a Chiropractor, I have a unique perspective that sets me apart from most other providers. I have the opportunity to guide patients through both the diagnostic and treatment processes, and I spend a lot of time with my hands on my patients. After many years of practice, I can confidently say that the disc is not the most likely cause of low back pain. Of the many possible causes of spinal pain, the one problem most likely to escape detection is muscle pain. No practical diagnostic technology finds myofascial pain. Myofascial pain is best identified manually- by hand. And manual findings are very poorly reproduceable. So, with a more realistic picture of how to navigate spinal pain issues while exercising, lets look at some instances.

Let’s cut to the chase. Sit-ups are bad for a bad back. They are wonderful for keeping a good back good. The sit-up has been demonized by the “experts” for some time now. It is an easy target. Much of the thinking that has led to the conclusion that sit-ups are bad for your back stem from a flawed, but well promoted, study by a Canadian researcher involving dead pig spines (not kidding). He couldn’t have done it by himself. The spine pain management community has long lacked any real grasp of the cause of pain. Anyone with an answer- especially one that would show up on a test- was warmly welcomed. Years later it is still embraced with little to no clinical or in-vivo correlation.

So, sit-ups are bad for a bad back but will keep a good back good. How do you know which one you are? As a Chiropractor, I have a reasonably linear frame-of-reference in this matter. This discussion applies to the golf swing as well. If you view the spine as a sequence of links it becomes straight forward to expect that if each of the links is participating in the movement and no one link is asked to bear the load of other dysfunctional links, then you have a spine that should respond well to being kept functional by spine-engaging movements like a sit-up, crunches or a golf swing. The joints most likely to become dysfunctional in this picture are the sacroiliacs and the lumbosacral junction. Fixations here will impose unreasonable demands on the rest of the spine and could cause trouble. No one in health care does a better job at keeping the sacroiliacs functional than the Chiropractor. Find one that actually adjusts.

For the most part, cycling stands to be a relatively spine- friendly endeavor. It’s low impact, but it does tend to impose qualified issues of weight bearing in many of its forms. The most spine friendly form of cycling happens on a recumbent bike ( I know, it’ not sexy). Things like good spinal mechanics are like a barn door. They work better if the horse isn’t already gone. Most of us don’t embrace such things until we’re forced to, and then we are left chasing the horse that was once our wellness. The classic cycling position of leaning forward and hanging out over handlebars imposes insult upon the musculature of the neck, upper and lower back. If you’re having issues, make the change.

There are a number of training programs that are modelled upon boot-camp type exercises and many people find it to be fun. I find two main sources of risk in such activities. One is that they commonly use what are otherwise very good compound movements such as cleans or squats and then impose the clock upon them. The body arrives at failure performing compound movements one or two muscle groups at a time- not all at once. As individual muscles fail, the technique performing such movements is compromised- possibly begging trouble. People that take movements like squats seriously would never mix aerobic exhaustion with a set that was going anywhere near failure. Secondly, most of the movements encountered in boot camp routines impose upon the body resistances in the vertical plain; picking up weight from the ground or lifting it over head. A preponderance of vertical plain movements load-up spinal and shoulder muscles and increase the likelihood of an over-training injury.

A much better alternative to toe touches as an exercise would be hyperextensions (without the hyper) We have details in the video above if you turn the sound on. The movement requires a Roman Chair.

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