Muscle for Life with Mike Matthews - 6 of the Best Exercises for Low-Back Pain

Episode Date: December 14, 2020

Modern medicine has a cure for nearly everything. After all, it’s eradicated smallpox, eliminated malaria in most developed countries, and nearly put an end to polio. It’s also created all kinds of pills, potions, and powders to treat ailments ranging from the common cold to cancer. And yet, it still hasn’t come up with a cure for low-back pain. In fact, low-back pain is the leading cause of disability worldwide, and nearly 80% of people will experience it at one time or another. To make matters worse, most cases of low-back pain are chronic or recurring, and symptoms often come and go without rhyme or reason. It affects the young and old, healthy and disabled, active and sedentary. I’m a good example. I’ve been an athlete my entire life, most recently transitioning from collegiate sports to lifting weights to keep myself healthy and motivated. I’ve also dealt with bouts of low-back pain throughout much of my athletic career, starting when I was around 20 years old. I know how frustrating, confusing, and debilitating it can be. Now for the good news. While researchers still have many unanswered questions about low-back pain and no two cases are identical, there are some evidence-based exercises you can use to reduce your chances of developing low-back pain or get rid of it. These exercises don’t just have a sound theoretical basis—they also work in the real world. As a Doctor of Physical Therapy, I see patients every week who are dealing or have dealt with low-back pain, and I know some simple strategies that tend to help. Of course, this article isn’t meant to diagnose or treat anyone, as there are hundreds of potential contributors to low-back pain. That said, I have identified three factors that seem to be common culprits. What’s more, I’ve also experimented with many different stretches, exercises, and other strategies to fix and prevent low-back pain, but the six I describe in this article are the best exercises for low-back pain I’ve found yet. So, if you want to learn what these three causes of low-back pain are, how to know if they’re affecting you, and what you can do to prevent and fix them, keep listening. 4:52 - Define low back pain 6:28 - Exercises to fix a stuck thoracic spine 11:10 - Exercises to fix a shortened quadratus lumborum muscle 18:29 - Exercises to fix glutes not firing properly Mentioned on The Show: Shop Legion Supplements Here: https://legionathletics.com/shop/ Want free workout and meal plans? Download my science-based diet and training templates for men and women: https://legionathletics.com/text-sign-up/

Hi there, and welcome to Muscle for Life. I'm Mike Matthews, your host. Thank you for joining me today. Now, modern medicine is a marvel. It has produced a cure for just about everything. We have eradicated smallpox and eliminated malaria in most developed countries, at least, and we've nearly put an end to polio. We have pills, potions, and powders for treating all kinds of ailments ranging from the common cold to cancer, and yet we still don't have a cure for low back pain. In fact, low back pain is the leading cause of disability worldwide. Nearly 80% of people are going to experience low back pain at one time or another. And to make matters worse, most cases of low back pain are chronic or recurring and

symptoms often come and go without rhyme or reason. Low back pain affects young people, it affects old people, it affects healthy people, disabled people, active people, sedentary people. I'm a good example. I'm 36 years old and I grew up playing sports and always ate well and stayed active. After I got out of sports, I got into weightlifting and I've obviously been doing that for a while now. And about six or seven years ago, following a relatively minor deadlifting injury, nothing too severe, it hurt in my lower back. It turns out it was an SI joint injury. So I felt the pain in my lower back and it was uncomfortable for a couple of weeks. And then I was able to just kind of get back to my normal routine. So nothing

too severe. Following that injury, I had intermittent bouts of enough low back pain that I couldn't squat and I couldn't deadlift for at least a week, if not two or three weeks. And in a couple of cases, it even hurt to walk. Like I'd be walking if I didn't pay attention to how I'm walking and maintaining my posture. There would be a flash of low back pain that was fairly severe. It was very noticeable. I would give it maybe a seven out of 10. In some cases, I would have to immediately stop walking like, oh shit, that feels bad. Now, fortunately, I haven't had anything like that happen in some time now. It has been at least a year, if not two years. And in this podcast, I will talk about why I'll talk about what I did to resolve the issue. But I'm also going to share with you other exercises, other methods of treating low back pain that didn't work for me because they didn't address the underlying problem of why I was experiencing low back pain, but can certainly work for you depending on what's going on. Now, I don't want to over-promise in this podcast because there are hundreds of potential

contributors to low back pain, but I am going to share with you a few factors that are common culprits as well as several evidence-based exercises and stretches that can be effective for reducing or even eliminating low back pain. Also, if you like what I am doing here on the podcast and elsewhere, definitely check out my sports nutrition company, Legion, which thanks to the support of many people like you is the leading brand of all natural sports supplements in the world. And we're on top because every ingredient and dose in every product is backed by peer-reviewed scientific research. Every formulation is 100% transparent. There are no proprietary blends, for example. And everything is naturally sweetened and flavored. So that means no artificial sweeteners, no artificial food dyes,

which may not be as dangerous as some people would have you believe, but there is good evidence to suggest that having many servings of artificial sweeteners in particular every day for long periods of time may not be the best for your health. So while you don't need pills, powders, and potions to get into great shape, and frankly most of them are virtually useless, there are natural ingredients that can help you lose fat, build muscle, and get healthy faster, and you will find the best of them in Legion's products. To check out everything we have to offer, including protein powders and protein bars, pre-workout, post-workout supplements, fat burners, multivitamins, joint support, and more, head over to www.buylegion.com. And just to show how much I appreciate my podcast peeps, use the coupon code MFL at checkout, and you will save 20% on your entire first order.

So again, if you appreciate my work, and if you want to see more of it, and if you also want all natural evidence-based supplements that work, please do consider supporting Legion so I can keep doing what I love, like producing more podcasts like this. Okay, this may seem unnecessary, but let's just start with a quick definition of the term. What do I mean when I say low back pain? I mean, it could say, you know, low back pain when you have it, but let's be more precise. So low back pain is an acute chronic, which means greater than 12 weeks. It's been going on for not a week or two or three weeks, but several months, or it is a chronic recurring condition. So it comes and goes maybe over the course of at this point, several years, right? And it manifests as pain

between your lowest rib and your glutes. Now, frequently low back pain is coupled with other symptoms such as radiating pain into the glute and also into the leg or legs. There can be trigger points, which are hypersensitive, hyper irritable spots in muscle. There's usually going to be like, it'll feel like there's a knot or there's tightness. And again, it'll be very sensitive when you rub on it or press on it. And sometimes the pain can refer. So you can press in one area and have it be painful and then also feel pain in another area. Now, as I mentioned earlier, there are many different reasons why you can have low back pain. There are many different things that can contribute to it, but there are three factors in particular I want to talk about because they are very common causes

of low back pain. And they are one, your thoracic spine is stuck. Two, your quadratus lumborum muscle is not having a good time. And three, your glutes are not firing. So let's talk about these. Let's talk about the stuck thoracic spine first. So what is the thoracic spine? Well, the thoracic spine is all the vertebrae, roughly from the base of your neck down to the narrowest part of your torso, of your abdomen. And those vertebrae, that range is generally just referred to as the mid back. Now, if that throws you off a little bit because you're wondering, well, I have pain in my low back. So why does my mid back, why does my thoracic spine matter? Well, it turns out the dysfunctions in your mid-back can contribute to low back pain. And how does that work? Well, a healthy thoracic spine should be very mobile. It should be able to

do a lot of bending forward and bending backward and tilting left and right and rotating left and right and so forth. And if you were to just grab a random person off the street or maybe from your local coffee shop, how well do you think they would do going through all of these basic movements? Not very well. I mean, just look at how they sit, for example. Look at what their backs look like when they walk around. Look at their posture. And what you're going to see is a lot of thoracic spines that are very rounded forward in a very hunched over kind of position. And that isn't abnormal technically speaking. The thoracic spine does naturally have a curve to it. It is naturally rounded a little bit forward. But because of how much sitting so many of us do,

and when we're not sitting hunched over at the computer working, maybe we are sitting staring at our phones. And even when we're standing and even walking around, we're looking down at our phones. This hunched over position can become exaggerated and can result in a mid-back, in a thoracic spine that cannot move through full ranges of motion and is stuck to some degree. move through full ranges of motion and is stuck to some degree. And when that is the case, when the mid-back cannot move as freely as it should be able to, that reduced range of motion can contribute to low back pain. And the reason for that is very simple. If the thoracic spine is not functioning the way that it should because of prolonged sitting and this hunched over posture, something is going to have to pick up that slack, right? Well, that is the low back, which doesn't and shouldn't move as freely as the mid-back. That's not how it's supposed to work. So when you have this imbalance between the mobility

of the mid-back and the low back, then you can have an overworked low back that is forced to move more than it should, and that can cause pain. So how do you fix that? And how do you prevent that if you want to be preventative? Well, there are two simple exercises that can help restore thoracic mobility, extension and rotation. It can help unstick your spine, if you will. And the first one is foam rolling into thoracic extension. And you can find videos on how to do this on YouTube, but I'll quickly just describe how you do it. You lie on a foam roller so that it is across your shoulder blades. So it's touching your shoulder blades.

And then you have your head in your hands. You support the weight of your head with your hands. And then you just gently roll up and down your spine, never moving beyond the tops of your shoulder blades or onto your lower back. So you're just rolling up and down your mid back, and then you allow your spine to extend over the foam roller as you roll up and down. And if you're not sure what thoracic extension is, think upward dog. That is going into thoracic extension, where your head is moving back and your spine is bending backward. Flexion would be the opposite. Okay, the next stretch for unsticking the mid-back is a

side-lying thoracic rotation. Again, you can find videos on how to do this online, but quickly what you do is you lie on your right side and you bring your thighs up so they form a in contact with the ground and allowing your torso to rotate as you're moving your arm around your body until your left shoulder blade is on the floor. So now your left arm is on the other side of your body and your left hand is going to be down somewhere close to your butt. And if you are having trouble picturing that in your head, I understand. I'm probably not doing the best job describing the movement, but if you just look at a video online, you'll see it's very simple. Okay, that's it for the thoracic spine issue. Now let's move on and talk about the quadratus lumborum muscle, which

is a muscle in the low back that runs from the top of the hip bone to the vertebrae of the low back and also the lowest rib. This is not a muscle that you have probably thought much about. You don't talk about your QL when you are discussing your back training, for example, but it plays a large role in pelvic stability. It is responsible for what is referred to as lateral flexion, which is just side bending. And if you want to feel this muscle contract, stand up and then raise a foot off of the floor without bending at the hip or knee. Your foot will come up a couple of inches and that's the result of the QL contracting. Now, what does this guy have to do with low back pain? Well, it has a lot to do with it actually. So remember how most of us, myself included, spend most of our days sitting? Well, when we sit in a normal chair, there's a constant force that's pushing up on our pelvis and it's pushing our hip bones up.

And this upward force from the chair is necessary to support our body weight, right? But it also does a good job of shortening the QL muscles. And over time, if they remain in this shortened state for too long every day, it can cause significant pain. Now, what about sitting on the couch? Well, you probably lean on one side or the other, and that causes one of the QL muscles, we have two, right? One on either side of the spine, one to shorten and one to lengthen. And again, if a QL muscle is in that shortened state for too long, pain can result. Now keep in mind, when I'm talking about the shortening of these muscles, don't think I'm referring to the myth that if muscles remain in a shortened state for too long, they become permanently

smaller or permanently shrunken, permanently stuck in this shortened position. That is not true. But what is true is if a muscle is in a shortened state too often and for too long, it can become accustomed to that shortened state. It can become accustomed to a shorter range of motion than it should be able to move through comfortably. Now, something that is interesting about the pain that can result from QL shortening and QL aggravation is it usually refers downward. So the QL itself might be tender to the touch. It might hurt if you massage it or if you massage gun it, but the pain can also spread to other areas of the low back and even the leg. The most

common spots where the pain is most severe is right where the QL is, the area in the low back between the bottom of the rib and the top of the hip, and particularly down closer to where the top of the hip bone is, as well as the glutes and all over the glutes really. But a couple of the hot spots are the bottom portion, the bottom part of our butt cheeks around the middle point toward the outside point, and then the middle inside portion of our glutes. So closer to the base of our spine. As a quick note, if I have low back pain, which I usually don't have, but I will get a little bit of if I pain afterward. Or if I'm working and not really paying attention to the time and getting up, which I try to get up every 45 minutes or so and just move around a little bit, but sometimes I'll get into something and hours will go by and I haven't moved anything more than maybe my eyeballs and my fingers, then I may feel it a

little bit in my lower back because my left QL just tends to get aggravated if I sit for too long. And that may be because, if I think about it now, I tend to lean a little bit to the left when I sit for whatever reason. And I've probably been doing that my entire life. So my left QL has taken the brunt of that probably for a long time and is quick to protest, is prickly. Okay, so now let's get to solutions. So the first stretch I want to share with you is just called the quadratus lumborum stretch, and it's very simple. What you do is you sit on the ground with your legs spread apart, and then you bend your left knee slightly so you can grab your left foot, and then you use your right hand to touch your head

behind your ear on the right side of your head. And then you lower your head toward your left knee and you just hold that position for 30 to 60 seconds. And then you repeat it with the opposite side of your body. And you can do a few rounds of that every day. And then you can do another quadratus lumborum stretch that puts you in a 90-90 position. That's where you start. So if you look at the 90-90 stretch, you'll see what I mean, but it's simply a stretch where you bend your legs at 90 degrees at the knee and you also have them at 90 degree angles relative to your hips. And you have one leg out in front of you and one leg behind you. And again, if you're having trouble picturing that,

just look up online 90-90 stretch and you'll see what I mean. Now, the 90-90 stretch is a great stretch for the hips. You can turn it into a QL stretch as well by pressing that leg down and back, pressing the top of the pelvis on that side of the body down and back, and then taking your arm on that side of the body. So for example, if your left leg is behind you, then you take your left arm and you bring it straight up and then you reach across toward the right. You want to reach out in front of you off to the right and you should feel the stretch in your QL. In this instance, it would be on the left side of your body, the left QL. Now, if you want to intensify the stretch, instead of doing kind of a side bend

over to the right with a little bit of rotation, really start rotating your body to the right so you can reach even further as if you were trying to put your palm, the palm of your left hand on the floor. Now, one other thing you can do is work the soft tissue by flossing the QL muscle. So let's say the problem is your right side and you're going to floss your right. So what you do is lie on your right side and then place a tennis ball or a lacrosse ball, or maybe the end of a battle rope or the end of a barbell under the area where the QL is located. And then you want to support your body weight with your right elbow and then lift your right knee up to your waist, or at least as high as you can go without pulling yourself out

of position, and then straighten your right leg, pushing it out as straight as you can get it. And you want to repeat that three to four times. And if you're doing it right, you should feel the ball or the battle rope or barbell or whatever you're using digging into the QL. You should feel it working the QL, massaging the QL, basically. If you like what I'm doing here on the podcast and elsewhere, definitely check out my sports nutrition company, Legion, which thanks to the support of many people like you,

is the leading brand of all natural sports supplements in the world. Now let's talk about the glutes, the low back pain cause number three. Glutes are not firing. And there are many reasons why we want strong glutes and warding off low back pain is one of them. So each of our butt cheeks actually has three different muscles. We have the gluteus maximus, medius, and minimus. And as the names suggest, the gluteus maximus is the big one. It's actually one of the largest and most powerful muscles in the body. And it has two main functions. So hip extension, which is moving the leg backward and behind you, and then hip external rotation. So that's turning your thigh outward away from the

midpoint of your body. Now the gluteus medius and minimus are located on the outside, further out on the side of your hips and are smaller than gluteus maximus. And they are responsible for similar functions. So you have hip abduction, which is AB duction, which is raising your leg to the side out away from you. And then you have hip internal rotation, which is the opposite of external rotation, which is turning your leg inward toward the middle of your body. Now, why does this matter? Well, glute weakness and glute imbalances can play a huge role in low back pain for a few reasons. First, the glutes are involved in a big way in keeping your back upright. And we take this for granted because we live in an upright position. We are used to it, but that is not a natural or default position for our skeleton.

It takes a number of muscles that must continually contract to stabilize our spine and to keep it straight and allow us to be upright. And our glutes are largely responsible for this. They are majorly involved in being able to just stay upright. And if the glutes can't do their job well, that can show up in many different ways. But a couple of common ones is if someone who has this issue is walking and they are swinging from side to side unintentionally, or if somebody is, let's say, standing around at a conference or a concert concert and they're constantly having to shift their weight from one foot to the other, what is likely happening is that their glutes are not strong enough to keep their hips level when they're walking or when they are standing. And then there's weightlifting where weak glutes or glutes that are firing at the wrong times, they're not working the way that they should, can really mess

up your squat, for example. We all know that our knees shouldn't bow inward toward each other when we are squatting, but what many people don't know is that can often be the result of weak glute muscles or muscles, glute muscles that just fire at the wrong time. Similarly, weak glutes or glutes that are misfiring, not functioning the way that they should, not contracting and relaxing the way that they should make hip hinge movements problematic. And that means really any type of deadlift. So you have a conventional deadlift, you have a sumo deadlift, trap bar deadlift, stiff leg deadlift, Romanian deadlift, as well as good mornings and glute ham raises, really any exercise

that involves a hip drive where the spine is staying mostly neutral and the knees are staying slightly flexed. And those hip hinge movements are driven by the glutes because the glutes are the most powerful extensors of the hip. And of course, the hip extension occurs during the ascension phase of the lifts when you're standing up. What often happens though, is people use their back muscles to swing the weights up using their back like a lever, which takes tension off of the glutes. Instead, the glutes should be driving these lifts. They should be lengthening when the weight is lowering to the floor and then flexing

hard when the weight is moving up. And you should feel it in your glutes. You should feel tension in your glutes throughout the entirety of any hip hinge movement. And again, your spine is going to be in that neutral position. A good cue for understanding what this should feel like is to squeeze your glutes, like try to give yourself a wedgie as you are standing up in a hip hinge. And that is how every rep should feel. Your glutes should be very active. They should be consciously involved in the lift. Now, many people who are experiencing back pain because of this glute issue can correct it by just consciously including their glutes in the squat and in the deadlift and any other hip hinge movements that they're doing. Again, by giving themselves a

wedgie, squeezing their butt cheeks together hard as they are standing up toward the top of each rep. Something else that can help though is to train your glutes in multiple planes of motion. Now, what do I mean by that? Well, your body can move in multiple different directions, right? And there are technical terms for these directions. So if we are moving forward or backward, that is referred to as the sagittal plane. So think of like literally walking forward or walking backwards. You're moving in the sagittal plane. Now, as far as the glutes go, the gluteus maximus, interestingly, is the only muscle in the body that has a single sagittal plane function, which is hip extension, moving the leg backward behind you, right? But the rest, the other two

glute muscles are either in the transverse or coronal planes. And the transverse plane is rotary, so rotating left and right. And the coronal plane is moving sideways left and right. Now, most weightlifters only work their glutes in one plane, the sagittal plane, through hip extension. They do hip hinge exercises, they do squat exercises, and maybe they do a glute exercise like a hip thrust or a glute bridge. And that's not necessarily a mistake. For some people, that is enough to have strong glutes that work the way that they're supposed to, but in some people, that is not enough. In some people, neglecting the other two planes can actually result in weak glutes or glutes that are not strong enough to prevent low back pain or lazy glutes, so to speak, that

are not calibrated well enough to work the way that they're supposed to. And the solution here, you guessed it, is to work your glutes in multiple planes just to establish that mind-muscle connection and to improve their strength and their function. And two great exercises for this are the frog bridge. You can find, of course, a video of this online, but you do it by lying on your back on the ground with your knees up and your feet a few inches in front of your butt and turn inward, touching one another. And then you extend your arms straight in front of your face toward the ceiling. You flex your abs a little bit until you feel the small of your back touch the floor, and then you lift your hips toward the ceiling. And you really need to focus on contracting your glutes. And then you lower your hips back to the floor in a slow,

controlled manner. And you do 10 or 15 reps of that. You can do a couple of sets in a session. Another great exercise for correcting glute dysfunction is called the clamshell. And for this one, you lie on one side of your body. I'll describe, let's say your right side first. You would do both sides, of course, but let's say you're lying on your right side and then you bring your knees up a little bit, slightly toward your torso, one leg on top of the other. So they're at about a 45 degree angle, bent at your knees. And then keeping your feet together, you lift your left knee toward the ceiling by contracting your glutes. Again, you want to focus on working your glutes. And then you bring your left knee back to your right knee

and you repeat that 10 or 15 times, flip over, repeat it on your left side. And that would be one set. You can do a few sets of that in a session. And these exercises are not supposed to be difficult. If you are serious about your weightlifting, this is nothing compared to a deadlift or a squat or a hip thrust, you are not going to work up a sweat and they are not going to help you build a bigger butt. But what they will do is improve your glute strength for each of your glute muscles and will improve your glute muscles ability to activate properly. And that can benefit your weightlifting, of course, but it also can just benefit your everyday living. Because again,

strong and functional glutes are crucial for hip stability. And if they are not strong enough, or if they are not working properly, that can lead to low back pain. All right. Well, that is it for this podcast. Thanks again for joining me today. If you are having problems with low back pain, I hope the advice that I've shared with you here and the exercises and the stretches I've shared with you help you resolve it because I have felt your pain. I understand how frustrating and how aggravating it can be. And also coming this week is an interview that I did with the one and only Eric Helms, one of my favorite recurring guests here on the show, where he

talks about the science of auto-regulation in your weightlifting. And then another installment of Best of Muscle for Life is coming as well as another Q&A where I'm going to talk about running and muscle gain, kids and dieting, and the pros and cons of Kratom. All right, well, that's it for this episode. I hope you enjoyed it and found it interesting and helpful. And if you did and you don't mind doing me a favor, please do leave a quick review on iTunes or wherever you're listening to me from in whichever app you're listening to me in. Because that not only convinces people that they should check out the show, it also increases search visibility. And thus it helps more people find their way to me and learn how to get fitter, leaner, stronger, healthier, and happier as well. And of course, if you want to be notified when the next episode

goes live, then simply subscribe to the podcast and you won't miss out on any new stuff. And if you didn't like something about the show, please do shoot me an email at mike at muscleforlife.com, just muscle, F-O-R, life.com, and share your thoughts on how I can do this better. I read everything myself and I'm always looking for constructive feedback, even if it is criticism. I'm open to it. And of course, you can email me if you have positive feedback as well, or if you have questions really relating to anything that you think I could help you with, definitely send me an email. That is the best way to get a hold of me, mikeatmuscleforlife.com. And that's it. Thanks again for listening to this episode,

and I hope to hear from you soon.