This article is a transcribed edited summary of a video Bob and Brad recorded in May of 2023. For the original video go to https://youtu.be/dYOglvA7Zp8
Mike: Did you know that 80% of adults will experience back pain at some point in their life? And this can have a major effect on how good you feel, limit your everyday activities and you're just not going to be as happy.
Brad: That's right. We've seen this in the clinic year after year, actually, decades. Well, one decade for Mike, Bob, and I, for decades. But the thing about back pain is it does not only affect your back, but it affects your mood. You can get very ornery when your back is uncomfortable, as well as you become less active, which also can lead to weight gain. It's a bad thing; we can help you out.
Mike: We're going to help you by showing you six core exercises that'll help protect your back and let you stay active and even function at a high level like you would like to.
Brad: Believe it or not, a strong core, strong back. All right. Now, the big thing with lower back pain, if you look at the lower back or the lumbar spine, you can see there's nothing around to support it except for muscles.
Brad: If you look at the upper back, you have the rib cage and those structures that offer a lot of support, almost like a back belt.
Brad: So your muscles, your core muscles, the abdominal muscles, your transverse muscles, and the back muscles, all can be worked and strengthened to provide strong support, giving your back what it needs to be active.
Mike: So if these muscles are nice and strong, they'll keep your lordotic curve or your spine in the right position, decreasing the amount of pain. And when these muscles engage, it'll take the pressure off of that painful area.
Brad: Lordotic curve, I like that term. It's the arch in the back. Let's go to work on the next phase. Now, if you happen to have very acute back pain, in other words, they're very tender right now, these exercises will have to wait until it settles down and you want to start working into getting stronger again. For those people who have not had back pain or who've had back pain but it feels better, it's ideal, to strengthen the back to prevent future back pain.
Mike: So the four core muscles we are going to be talking about here, three of them are abdominal muscles and one is a pair of back muscles. The first one you're going to target is the rectus abdominis, which is known as the six-pack. The next is the transverse abdominis, which starts in the front and wraps all the way around to your back. You typically work these when you're doing, say, a plank exercise, that's when you'll feel that transverse abdominis. The third abdominal muscle is the obliques, they are on both sides and they go in a diagonal fashion, they go both ways. They help with side bending, keeping you upright. The last muscle group is the back. We're just going to call them the lumbar paraspinals because this is the area of the low back you want to strengthen up to keep your spine in the correct position.
Brad: Right. I think probably that last set of muscles, that gets missed out on a lot of programs. And the other thing about this program, it's going to strengthen all four of these, and two of the positions are going to be standing, weight-bearing, the way that your body functions when you're pushing, when you're pulling, when you're lifting, you're standing. So you want to train your body to be strong in your back while in those positions. A lot of core exercises skip that altogether, so we've got you covered.
Mike: So for all of these exercises, we want you to start with 10 reps of each of them. Eventually, over time, you can build up your repetitions to either 30 reps total or 50 reps, depending on how active you are and how well you can endure these exercises.
Brad: Right. Don't overdo it, keep it low, and an important part, if you've never done these exercises before, don't do them every day. Start with a Monday, Wednesday, and Friday routine, so the muscles can relax and rebuild for a day. After a couple of weeks or more, if it's feeling strong and you're not getting sore muscles, then you can progress and eventually go to five, maybe six days a week. I never recommend seven days a week, always one day for rest, but that's down the road a little bit. So again, three days a week to start and get those muscles engaged.
Mike: I think we should also add that if any of these increase your back pain, don't do that exercise, it's probably not for you.
Brad: Right. Either not doing it properly or it's just not your exercise. The first exercise we're going to work on is these muscles in the front, the very common exercise with some basic situps, but we're going to show the situps so that it protects your back, very important. So you can do these on your bed if it's a firm bed or on a carpeted floor, works very well. Mike is going to demonstrate here, lying on your back and this hook lying position knees up, you're going to take your hand so that you can position your back properly. His fingers are right under the low back and he's going to push down and squish his fingers a little bit and that puts your back in a good neutral position. While you're doing the exercise, Mike, I want you to keep that pressure on those fingers, okay? So it's simply, I call this double knee to chest, bring the knees up and back down, but while you do it, be very much aware of how you're maintaining pressure on those fingers. And it's very much more difficult and it's very appropriate, it's the best way to do core exercise. How are you doing Mike?
Mike: I'm doing good.
Brad: After you get done with 10 of these, you're good. Now, the other option for this, is if you happen to be, and there probably will not be many people, but if you have a large ball at home for exercises, you can do it this way. The advantage of using the ball is you don't need to put your hands under there. This is the way I do them, and I don't put my hands there. It works very well, it keeps your back protected. And the hard part is getting a hold of the ball. Once you get that down, you're fine. I've found if I wear my shoes, the heels of my shoes grab into the ball and I do it with shorts on, because your skin grips onto the ball. Again, do not purchase a ball for this exercise unless you really want to. It's not necessary, just do it the original way like I told Mike.
Brad: Let's go to number two. We're going to work those oblique muscles that kind of come in at an angle like this. That's why they're called obliques. Again, lie on your side, you can do this again on the bed or the floor. You're going to put your arms like this so your palms are on your shoulders or close to it, knees up, and the goal is if you just think about taking your left elbow, bring it towards your right knee at the same time. So the elbow is moving forward, and the knee's coming together. You do not have to touch, but if you can, that's fine. Go ahead. And Mike's going to just show this slowly. And this should be done relatively slowly. You don't want to go through it fast. You're going to engage those oblique muscles which are critical for that rotation stability.
Mike: Again, make sure your lower back is pushing into the mat when you're doing this, you do not want to round your shoulders up when reaching because it's going to put more pressure on your spine, increasing your back pain.
Brad: Right. The other little point is, don't flex your neck forward, try and keep your head in the position as it is when you're lying down. We call that the neutral position protective spine. All right, the next one we're going to talk about is going to strengthen these muscles in the back that do get forgotten sometimes. So we're going to show it in two different manners. If you're a beginner at this, you go to a countertop, we're using the bed as a countertop. It'll probably be a little higher, which is good being in a position like Mike is. And to start with, we're going to break this down from the very beginning. Just take one arm and bring it out in front of you, and then down, and then alternate it.
Brad: Now, that seems like it may not be doing much, you're thinking that's just shoulders, but it's not, that's engaging the muscles all the way down to the belt at a lower level. Now, if that's too easy, stop that and alternate leg lifting. Notice his knees are straight, you must do this with your knees straight. You're getting some hip muscles in there, but that low back is going to town right now and you will feel that.
Brad: If you do 10 of those on each leg and it feels pretty easy, then we go to the whole goal and the optimal strengthening for your back. This is quite a bit harder, it's going to work your balance. So you're going to go up with one arm and the opposite leg lift. And that engages the full-back at an angle. Feel quite a bit harder, Mike?
Mike: Yeah. To kind of make it more challenging, bring your feet further out if you feel safe doing that. You can also get good activation this way, it just makes it a little more challenging, but the advanced or normal version of this exercise, we will show next on the mat.
Brad: Are you getting tired?
Mike: A little.
Brad: I'm not a bit. I feel pretty good, my back's feeling stronger.
Mike: Good for you.
Brad: Let's go. Okay, now this next one, we call it the pointer dog. This is advanced, you may not get to this point and that's okay, it depends on the level you feel you want a challenge. You're probably not going to do this one on the bed; on a carpeted floor is much better because it's wobbly, and it works your balance a lot. Now, when Mike is doing this, one arm goes out and the opposite leg goes out. Try and keep everything on the same plane. In other words, you can see everything is even.
Brad: Now, one thing that Mike is doing that you need to focus on is he's contracting his abdominal muscles, trying to maintain that core so the back does not overarch. Do you feel that Mike?
Mike: Yes.
Brad: Do you want to talk about that just a little bit? Because that is important in this exercise.
Mike: Even though you're moving your arms and your legs, your focus should still be on your core muscles themselves, because that's going to keep your spine in the correct posture. It's working your transverse abdominis a little bit and the rectus abdominis, those front muscles of the abdominal wall there. But you just want to make sure you're engaging it, I'm almost trying to give myself a beer belly pushing to engage those muscles as I am moving my feet and my arms out.
Brad: Excellent. Again, this is advanced. You may not get to it and that's just fine. You're going to get a strong core with the other option. Okay, number four, this one's going to work; side motions in that core. You're going to lie down like Mike is here. This, you can do on the bed. If it's too soft a bed, again, the floor will work better. Go ahead Mike, tell them what you're doing.
Mike: So you're going to start with your knees touching and not your feet, the feet are a little more advanced. So what you're going to do is put your elbow into the mat on this side and you're going to lift your core towards the ceiling. Make sure to go straight up, don't rotate too much forward or back. If you can't even do this, you could take your other arm and push and help use that core muscles to push up. We're going to do repetitions here, so try to do 10 reps if that's possible. If this is problematic or hard, maybe just do a few reps to start. You can also possibly hold these like a plank if you find that a little easier; it's just an option, you don't have to do it.
Mike: Just start with 10 repetitions. Now, if you want to make it a little more advanced, just straighten your legs. You're going to put the pressure through your feet and lift your whole body off the ground here. So you're going to lift up and then back down. You don't need to go way up, you're just kind of going to a neutral straight-line position.
Brad: I do want to emphasize this is probably the most difficult of all these exercises. If you have a history of back problems or if this creates any pain, it's not comfortable in that back, just omit this one. I just think for some people, it's going to be helpful. For people who are not as strong or have a history of back pain, just skip this one, and go to the next one.
Mike: And make sure to do both sides.
Brad: Yes, absolutely. Otherwise, you'll walk crooked or in circles. We'll have none of that. All right, for the next two exercises, the last two, there is one thing you do need to have, some resistance bands. This is critical, these are those weight-bearing, upright standing exercises that make a big difference so that you can function while lifting and pulling things, and you'll understand that as soon as we demonstrate. Then once you get your bands, it's nice to get the ones with the handles. Usually, bands come in a set of four or five, the lightest color is the least resistance, yellow typically, and red is one of the lighter ones, and then you just need a place to anchor the bands. Mike is going to talk about that a little.
Mike: You can use a railing that you have in your house. You can use maybe a bedpost, something that's sturdy and not going to move when you pull it. You don't want to use a chair because it's probably going to fall over. Just make sure it's nice and sturdy and just wrap the band around it so it won't move.
Brad: You can actually open a door up, and we've done this with many patients over the years, and you just put it around the door knob with a door open and that'll be very safe as well. We are going to use wall anchors that work very well, they're on the wall and they're available for you if you want, but whatever works for you. Let's go ahead with the exercises. All right, to start this, we have it at chest level. You do not have to have it here, if your bedpost or your rails are lower, that's just fine. So anchor it. You can probably use two bands and double this, or you could just do one band. Mike's feeling strong today so he's going to double it up, that's the nice thing about bands, you vary the resistance by how close you are to that anchoring point. So this is easy and the farther you step away, the more resistance you get. The resistance level is infinite and that's a big advantage to using bands. Go ahead, Mike.
Mike: So, start with a yellow band like Brad said before, if that's easy, you can progress in bands, but you want to get it nice and taut. What I'm going to do is stand in a straddle position, they say, so it's kind of like a low squat position, pretend like you're riding a horse or something. You don't have to bounce though. So, bring your arms out, you could do this a couple of different ways. You can either just bring it towards your chest and push it straight out, that's a little bit easier version to try first.
Mike: Do slow controlled reps and this is working your entire core, so all four of those muscle groups talked about at the beginning are working to stabilize. If they weren't right now, I'd be pulling over. Now, if you want a little more advanced, Brad likes to call this stir the pot. So it's like you're stirring a pot.
Brad: I think Bob started it.
Mike: Oh, Bob started it. So you just make a circle motion like you're stirring a pot. You can do this either way, I guess you can go like you're evily stirring a witches' kettle or you could just do circles. This is a lot harder and takes time. Go slow and controlled, it makes it work a lot harder.
Brad: This is one of those exercises that looks easy, but as you can tell Mike is kind of grunting and groaning here a little bit, this really works the core.
Brad: Imagine if you're pulling a lawnmower, pushing a lawnmower, or opening a heavy door, this is the way that you're going to simulate it the best. This one as well as the next standing exercise. How are you feeling, Mike?
Mike: Good. You want to make sure to do both directions with this, because this will work your lateral side a little more if you're going one direction versus the other.
Brad: Yep. Okay, and the last one is going to work the obliques and the transverse abdominis, which is critical for activities like shoveling snow, if you're raking leaves, when you're making the bed in you're pulling off all those blankets at the same time. Perfect crossover with this exercise. Mike, go ahead, let's talk about it.
Mike: So again, you're going to use the tension of the band to dictate how hard the exercise becomes for you. So you're going to start in a straight arm position like the last one, but this one, you're going to keep your arms there and you're going to rotate your trunk. Now, you don't want to do it the wrong way, meaning my pelvis would stay forward and just my back twists.
Mike: This doesn't feel as good, it's a lot harder, it can compromise your back, make it more painful. You want to rotate at the hips as you're doing this, so arm straight, twisting my pelvis to the side as I'm going like this.
Brad: I think this is one thing that Bob has said to his patients over the years. Imagine you have a brace that wraps around your whole trunk so it stays still. And really going to motion at the hips and back, there and back. Now, if you're just starting this, you may only want to go a little like half that distance that Mike is going. And you're going to find that that'll give you plenty of resistance. If it's not enough, step away from the wall, another six inches, it will be enough.
Mike: If it's too hard, you can also do the single band, like we mentioned in the previous exercise. So again, straight arm, you probably can't see it from your angle. Slightly bent knees and you're going to rotate at the hips, keeping the back as straight as you can.
Brad: So do it without rotating your hips. This represents hip motion. Right there, you can see nothing's happening, now rotate the hips. And if I keep this in line with the pelvis there, you can see much more motion, keeping the stress off of the back and making those muscles do the work. Muscles work well, the spine is there for structure, not for the work. What do you say to that, Mike? Was that fun?
Mike: Yes, it was great fun.
Brad: Actually, get that core strong. Again, three times a week is a good way to start with this. Progress to more if it feels like you need more of a challenge. So strong backs, strong mind, strong body.
Mike: Strong like bull.
Brad: There you go. All right, enjoy the day.
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