The Top Lordosis Exercise
Lordosis refers to the inward curve of the spine, focusing on the neck and the lower back, which have natural “lordotic” curves. Most of the time, particularly in back pain sufferers, this curve becomes exaggerated, creating an excessive lordosis. Correcting this featured postural dysfunction can be challenging to even the best therapists, but if you have the right exercise, it can be a much simpler task.
One of the most important aspects of excessive lumbar lordosis is to remember where it is coming from. There are two major players here. The pelvis is frequently involved, which will be in excessive anterior pelvic tilt, or the neck, which will usually be doing the same thing as the lower back. Since anterior pelvic tilt is the primary cause, it is wise to start there.
Anterior pelvic tilt is caused by muscular imbalance between two main muscle groups. The muscles that create anterior tilt include the psoas, quads, adductors, and lumbar extensors. The muscles that create posterior pelvic tilt include the glutes, hamstrings, obliques, and rectus abdominus.
The ideal exercise will assist in lengthening the muscles that anteriorly tilt the pelvis, and strengthen the muscles that perform posterior pelvic tilt.
This exercise is found in the Supine Hip Extension.
The primary focus of this exercise is contraction of your butt muscles, along with a light contraction in the lower abdominal region, to assist in posterior pelvic tilt.
Here is a sample:
Supine Hip Extension
Lay on your back with your feet about 12 inches from your butt
Keep your feet flat on the floor and emphasize lifting through your heels
Squeeze your glutes and perform a SLIGHT posterior pelvic tilt (to lightly flatten your lower back)
As you continue to increase the tension in your glutes, lift your hips up toward the sky
ONLY go as high as you can get a full glute squeeze. Going too far up usually results in the movement “flowing into your lower back”
Hold for a count of 10 seconds, then return back to the starting position.
Repeat for 10 repetitions.
Getting good at this movement will go a LONG way towards reducing excessive lumbar lordosis!
–Sam Visnic
Welcome back!
Ice vs. Heat, whats better for lower back pain?
The age old question, ice or heat?
Each of these therapeutic modalities has good benefits, but here are my rules for each:
Ice:
Ice is really good for acute injuries or inflammation. Ice serves to constrict blood vessels, therefore cut off inflammation. For example, if you just sprained an ankle, or twisted a knee, and it is in the initial stages of inflammation. In terms of using ice for your lower back, the only time I have seen it work well is for strains. So, for example if you lift too much and you feel like your back is starting to tighten up, and gets an achy, burning type of sensation, not really pain, but just tightness.
Heat:
Heat is my favorite choice for chronic pain. Once you are out of the inflammatory phase, most back pain is caused by a lack of blood flow, generally referred to as “ischemia”. Application of heat pads, or packs, causes dilation of blood vessels. This is an ideal therapeutic intervention for aching lower back pain It is also an excellent modality to use just prior to corrective stretching or exercises. muscles.
How often should you do back exercises?
When considering how often you should perform exercises when you have back pain, there are a number of things to consider:
1. Should you even be doing exercises at all?? How much pain are you in?
When evaluating pain, I use a visual analog scale (VAS). For example, on a 1 to 10, with 1 being “not much pain at all, and a 10 being “worst pain I have ever felt”. Exercises are generally appropriate when you are a 6 or lower. Anything above, rest, relaxation, and even massage therapy is acceptable.
2. What kind of exercise program are we talking about?
Exercises based on your unique muscle imbalances are usually targeted at your weaknesses, as in my DVD program “End Your Back Pain Now!”, and rarely involve the actual muscles that hurt, those can be done more frequently. Doing exercises that directly target painful exercises are not a good idea unless you are being supervised by an expert.
3. What intensity level are the exercises being performed at? (Probably the MOST important factor!!)
I see a range of back pain sufferers in my clinic, from average joe and jane, to weekend warriors, to elite athletes. It may surprise you to know that when high level athletes see me for back pain, I give them deadlifts, pullups, and other full body movements to get rid of their pain. Why? They are usually much more coordinated that the average person, and are used to higher levels of physical exertion. Using this approach helps them get better faster.
The more intense the exercises are, the less often they should be performed. For example, if an advanced athlete needs to deadlift, I usually only allow them to do so 1x every 5-6 days. However, if the weight is very light, I have been known to allow 3x per week, but only for a short period of time.
The lower the intensity of the exercise, such as a Swiss ball reverse back extension (a butt exercise), may be done daily, if no significant soreness results from doing it, and pain levels are monitored.
Pretty much the same goes for light pelvic tilting, and other exercises that target postural muscle fibers. However, as mentioned, caution must be taken to ensure that fatiguing the targeted muscle group does not “destabilize” the lower back or sacro-iliac joints, and cause pain.
Why Use a Swiss Ball For Back Pain?
How To Improve Lower Back Stability
The term “stability training” has been thrown around quite a bit in the last couple of years, as the fitness community has gone core training crazy. The problem is, however, most of the gimmicks being used for this so called stability training are simply entertaining at best, and unfortunately do not produce the kind of results that they are believed to.
The Issue of Stability:
Lower back stability, as well as stabilization of all joints in your body, is dependent first of all on optimal muscle balance. When muscle imbalances are present, meaning one muscle is stronger than its antagonist, the joint involved becomes distressed as it fights to maintain its homeostasis.
For example in the lower back, two muscles that have a relationship include the abdominal muscles, and the back extensors. The abdominals have the job of flexing the spine, which flattens the lower back, while the extensors extend the spine, creating an arch in the lower spine. More often than not, the spine has an excessive arch due to the prevalence of anterior pelvic tilt, particularly in the back pain population. This leaves the abdominal muscles in a “lengthened” state, and usually test weak.
In this situation, the lack of balance between the muscles that flatten and extend the spine creates a potential state of “instability” in the spine. It is a relative state, in that you may be stable picking up the newspaper in the morning, but when it comes to more intense efforts, such as playing a pickup game of basketball, or tennis, the instability becomes much more of an issue.
Correcting this stability issue involves identifying the weak muscles, which in this case would be the abdominals, and identifying the tight muscles, which again in this case may include the lower back muscles, and providing appropriate corrective procedures such as exercise and stretching.
The actual selection of exercises to do this would include the ones that work best to strengthen that muscle. If the abs are weak, then performing variations of the plank and/or crunch, will serve to strengthen them, and thus reduce the imbalance relative to the lower back muscles.
Corrective procedures must follow some form of flow, and make sense. Something more therapists need to be aware of, before starting to jump on the “core stability bandwagon”.
–Sam Visnic
How To Fix Your Back When It Goes “Out”…
Its a situation that has happened to most of us at one time or another. You bent over to pick something up, to tie your shoes, or turn in JUST the wrong way…and…
BAM! You feel that sensation. Like someone just stabbed you in the lower back. Then in that instant, you know that when you try to move again, its not going to be good.
Here are some tips on what to do to fix your back:
1. Try to get yourself into a pain free position, or at least the position that causes you the LEAST amount of pain. Usually this means laying flat on your back with 2 pillows or so under your knees.
2. Once you get there, don’t move for about 5 minutes. While you are there, relax yourself. Shut your brain off, just breathe, and imagine all the muscles in your body relaxing, particularly your back.
3. Once you are ready to move, gently tighten your abs (if it doesn’t hurt), and roll to your side. You can then proceed to push yourself to an upright position, while holding your spine in a neutral position. (meaning do NOT let it side bend).
4. Once you are in the seated position, rest there for as much time as it takes you to relax yourself again, then use your legs to “scoot” yourself until your feet hit the floor.
Now, once standing you can determine if you need to get back to laying down, or if you are ready to go about your business.
–Sam Visnic
When Static Back Pain Exercises Cause Pain
Static exercises (where there is no movement, rather a specific position is being “held”) are commonly given at the beginning of any good back pain rehabilitation program, however, there is a time and a place for everything.
One of the times to not overuse static exercises is when your back pain is coming from ischemia. Ischemia essentially occurs when muscles are short, tight, lack proper blood flow, and are tender to light pressure.
When a muscle is not getting good blood flow, static exercises can cause “hit and miss” results. Meaning that sometimes when the exercises are performed, you may feel better, while at other times, the SAME exercises can make you feel worse!
In this situation, movement exercises are more appropriate.
Sam Visnic–
How NOT to get up when you have a disc bulge!
I was working with a new back pain patient today…
And I always watch how they move around before I start doing any “formal” assessments. The reason why I do this is because most of these daily operations are unconscious, meaning the back pain sufferer isn’t aware that they are doing them.
So, anyway, as he was laying on the floor, showing me some exercises that his physical therapists (yes, “s”, meaning quite a few) have given him, (which did I mention, FAILED to give him relief), I noticed that when I asked him to stand up, he tried to perform essentially a full sit up to the seated position.
So what?
Well, in this case, this patient has had spinal surgery, and a disc fusion, which means that flexion of the spine is a big “no-no”. That and due to the fact he was in pain, his abdominal muscles were not activating very well. Getting up from a lying position in this manner should DEFINITELY be avoided.
I taught him, as I recommend to ALL back pain sufferers, to turn on their side, and push themselves up to a seated position in order to get up.
Your back will thank you a TON for this! I promise!
–Sam Visnic
Why Do So Many More Back Pain Sufferers Have Anterior Pelvic Tilt Than Posterior Pelvic Tilt?
Without a doubt, there is MUCH more anterior pelvic tilt amongst back pain sufferers than posterior pelvic tilt.
Why you may ask?
Well, because your body operates in such a way where it has groups of muscles that operate together when certain factors are present. Say, for example, when you go into “fight or flight”, your chest sinks as your upper abs tighten, the back of your neck and upper shoulders tighten, all with the purpose of protecting vital organs.
In the pelvis, the muscles that shorten and increase tone when you are under stress include:
1. The Psoas
2. The Quadriceps
3. The Adductors (groin muscles)
All 3 of these muscles contribute to anterior pelvic tilt! Now, interestingly enough, a smaller percentage of the population goes the OPPOSITE direction when they get stressed! They actually go into posterior pelvic tilt.
So, what is the difference between the two? What makes someone go into anterior versus posterior pelvic tilt, particularly when stressed? In my experience, postural imbalances are HIGHLY correlated with psychology, and particular characteristics within that realm.
But…thats another blog post!
–Sam Visnic
The Best Back Pain Relief Exercise
One of the very best back pain relief exercises involves one the most commonly underdeveloped muscle groups.
Which muscle group would that be?
Your GLUTES!
That’s right…those huge lumps of muscle that most of us sit on all day long. You know, I was thinking, maybe thats why there is SO MUCH back pain out there…
Our butt muscles are starting a civil war with our backs because we sit on them all day!
lol…maybe not! 
Anyway, squeezing your butt muscles together may very well be the best back pain relief exercise available. This helps alleviate back pain mostly because the majority of the population has an excessive anterior pelvic tilt. If you remember correctly from my previous posts, this postural imbalance involves the pelvis tipping too far forward, and involves too much tension in the psoas and quadricep muscles. Alternately, the abs, hamstrings, and glutes are thereby “weakened”.
So, if your back is bothering you when standing, put a little squeeze in your glutes (don’t worry, no one will notice unless they are staring at your ass!), and that may bring you some relief!
By the way, you don’t need to squeez the life out of them to get relief, just about a 25% squeeze will do the trick!
–Sam Visnic
-
"Having someone like Sam to refer my patients to who is as comprehensive, brilliant and caring as he is makes my job so much easier!! I feel assured that my patients are in good hands and are going to get the results they so desperately want. I highly recommend Sam to anyone who is looking to resolve their back pain easily and effectively!”
-Dr. Holly Lucille N.D., R.N. -
“I've used Sam on more than one occasion to help me with back pain issues. As a full time web designer I often spent too many hours sitting behind the pc which led to chronic back pain. I started working with Sam a few years ago and his knowledge and insight helped me to alleviate my back pain issues and even improve my posture. Whenever I start to have back pain issues I just re-implement the tools and techniques he showed to me and in no time my back pain goes away. He really is the back pain specialist!”
-Jimmy Powell
Owner, Stellar Media Group -
“Sam is an excellent mind/body fitness coach & trainer. When it comes to eliminating complex back problems, Sam's your man. He is passionate about his work and dedicated to healing his clients. I highly recommend his services.”
-Michelle Armstrong
Author, "Manage Your Mind, Master Your Life" -
“In my experience it is rare to find a health practitioner who consistently cures the underlying issues, and successfully drives to total wellness. Sam has become our trusted family 'health support system' because he is one of those rare people. He has successfully helped my mother in law, sister, wife, daughter, and myself cure what western medicine has been unable to. We highly recommend Sam ... plus he's a cool guy !”
-Tim Parsey
Microsoft Partner, Dir UX -
“I was so impressed when working with Sam, from his detailed and thorough evaluation, to the great workouts and home exercises prescribed. I've referred a number of people to Sam and in the past we've used his DVD for gifts to patients for home care. I strongly recommend Sam's services and hope to be working with him personally at some time in the near future.
-Dr. Matt Costantino
HealthSource Chiropractic and Progressive Rehab