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Back Pain
( By Knut Nystad -Team Norway)
Hello,
Thanks for addressing classic positioning last week (below) and the various differences in body types that should be taken into consideration. Half way through last year's ski season I experienced lower back pain from classic skiing and had to switch over to skating, which seemed to somewhat help with the pain. I've been diagnosed with a mild lordosis and am wondering what type of exercises are most beneficial to prevent this from happening again this year? I attend Pilates, but obviously that is not enough. Any suggestions would be great.
Thanks,
C. C.
Dear CC,
I am no doctor, and I always recommend seeking medical help to address back issues. All I can do is to tell you about my personal experiences, and what has worked for me.
This is a long story, but hopefully it will open your eyes to what you have to do in order to not only ski, but live, without pain in your back.
I have struggled with back pains since I was a teenager. For years my lower back hampered my ability to ski, and was one of the main reason why I ended my racing career at an early age (25). It was frustrating to train long hours and participate in races when an aching back became the bottle neck to achieve good results - not legs, arms, lungs or heart.
At the age of 29 I decided to have a back surgery in order to try to reduce my pain - in my mind I had a long life ahead of me, so why not prepare for the long haul and fix the issue before it became a major problem. The decision point for me was my personal desire to maintain a certain quality of life. I wanted to be able to ski, run, hike, bike, golf and stay active for years after my active career.
One day in the late fall I went to the hospital and met up with the doctor that was going to perform the surgery. I chose him because of the status he had earned during his long career as a back surgeon. He could easily have been my grandfather. I was the 7th person that week he operated on. I ended up fusing L3 and L4.
In the years before my surgery I tried to address the issue with PT, chiropractors, acupuncture, medicine, stretching, strength training pain killers etc etc - but I never got much better - the pain always returned, and after many years I found myself almost constantly searching for pain in my back. It was like I had an "internal spot light" focusing on the problem area.
After the surgery I was completely helpless. I realized that for years I had taken the ability to move, with little or no pain, for granted. The doctor told me that the only way to a full recovery was to train, and exactly therefore, he continued, most people failed miserably and ended up experiencing little or no gain from the surgery. I had no choice!
First step on the program was to walk as much as I could. It was a difficult and painful task. To cross the busy roads in my Denver neighborhood felt like a slow hazardous life threatening exercise. I would usually make it half way before the light turned red and cars started flashing their lights, honking and, and yelling. All daily task like going to the bathroom, getting dressed, getting ready for bed etc etc took forever. If I stumbled or coughed it felt like someone ran a sword into my back. I cannot lie - it was a painful process. I realized quickly that if I ever wanted to make a 100% recovery I had to put in the hours.
Every day I walked several hours. Slowly but surely, and as fast as my body allowed, I started to jog, stretch and train specific strength exercises that would gain my back. After one month I could ski. My doctor told me that he had never seen a recovery like mine. It was pleasing and gratifying to hear his nice words, but it also revealed another truth. In my mind, IF I had been just as dedicated to my back exercise program BEFORE my surgery I most likely would have cured my back issue, or at the very least, strongly reduced it. The simple truth was that I had not done enough. I started too late in my career and was not committed enough to fixing MY problem. Too bad it took a surgery and a recovery to come to this conclusion.
You brush your teeth several times a day to be able to smile to the world and avoid any issues. I believe you should have the same attitude toward your back. If you want it to work properly then you have to do something beneficial for your back several times a day. Unfortunately this short conclusion to my long story is the major obstacle blocking the opportunity for most people to get rid of their back pain (unless of course you have a condition that requires a surgery). Taking care of your back is a life style that requires dedication. If you are not ready for this life change or not willing to invest the time it takes, then do not read any further. It would be a complete waste of your time.
I have returning back pains now and then, but I have learned what to do to minimize it, and also how to get back on track. Like most 40+ year olds with kids and a job I have a very hectic schedule, but this is a bad excuse. Truth is I could probably do more for my back, but I do enough to live the active life style I desire. My life sentence is that I have to train, and if I do not then I get punished. It is not enough to train arms, stomach, legs, heart and lungs. It is tempting to train everything you see in the mirror to boost the ego, but I also have to direct focus to the problem area, the part I do not see in the mirror - my back.
So what exercises should you do? For your specific problem visit an expert. This is what I do.
Part of my problem is the curvature of the spine - too much sway in the lower and upper back. The reason is partly due to that I am relatively too strong in my front muscles compared to my back muscles. My tendons emphasize the problem by being too short in the front, and too long in the back. The result is that I get a forward pelvic tilt causing stress on spine and tense muscles.
Long story short. I have to find exercises that address the following issues.
- Strengthen my hamstring
- Strengthen all muscles in my back
- Increase mobility of my back and spine
- Stretching the front, in other words thighs and psoas.
You do not need a fancy gym to complete this. You also do not need to spend hours every day, but if you can do 10 minutes in the morning and 10 minutes in the evening every day, over time you should be on the happy road to recovery. Remember it is better to do short sessions every day than long sessions now and then. Short sessions have the additional benefit that they build habit.
Some helpful "tools" before we begin.
Swiss ball (Helps me with point 1, 2)
http://swissball.com/
Red Cord (Helps me with point 1, 2 and 4)
redcord.com/Portal.aspx?m=546
RAD Roller (Helps me with point 3)
radroller.com/
Exercises Suggestions:
Here is a bunch of exercises that I use. I do not do them all at once, but I mix them up to not get bored. They are easy to do outside the gym and do not require much assistance or guidance. There are a lot more exercises that you can do if you have free weights, but then I suggest you get help from a personal trainer to ensure that you lift correctly.
Swiss ball
theragear.com/exercise/ball_bridge.php
This exercise can be completed as a full range motion, OR you can just push and hold the hips as high as you can for a given time sequence. In order to challenge yourself try to make the shoulder area touching the ground as small as possible. Another tip is to try to keep the heels and the toes as close as possible - this makes it a bit more difficult to balance, and hence your back muscles will keep on firing to keep you stable. When you become better try to hold a weight in your hand. Keep both hands above your head - drop the hand with the weight slowly out to the side and raise it again - then switch hands - this will make the exercise a little tougher.
theragear.com/exercise/lying_leg_curl.php
This exercise is a good in combination with the above exercise.
theragear.com/exercise/bgglt-dpsp_exercise_ball_toning_bar.php
Try also to stay as long as possible in the high position. Key is to only have the heels of your feet in contact with the ground. You can also do the same as above with weights in your hands.
theragear.com/exercise/one-lbgds_exercise_ball_toning_bar.php
Another version of the previous exercise
theragear.com/exercise/prarmcir_exercise_ball_power_weight.php
For more exercises visit the Swissball home page.
Red Cord - this is truly a full blown weight room in two ropes. Most exercises described above can also be completed with RedCord. Be creative!!
Here is the link to exercises.
redcord.us/ArticleFull_2011.aspx?m=1305&amid=13069
It is only your imagination that limits the possibilities - be creative and do not be afraid to explore how the ropes can work YOUR problem areas.
RAD Roller
I use the soft one to increase mobility in my spine and to loosen up tight muscles. Here is a link radroller.com/pages/how-to-use
The exercise I use is very simple. First I lay down on the floor. I place it so that the two "rollers" touch on each side of the spine, and then just roll slowly and controlled over it. If I need support I just put my hands underneath my lower back.
Other Exercises.
Push ups - very good - forces you to keep your body in a "bridge" position working core muscles, while working arms and back.
Some links to more exercises and links to stimulate your imagination ;)
whyiexercise.com/back-strengthening-exercises.html
whyiexercise.com/exercises-for-low-back-pain.html
mylifestages.org/health/back/lower_back_pain.page
If you need more information and ideas then Google will quickly become your friend.
Again - this works, and has worked, for me, but it might not be correct for you. A qualified expert should guide you every step of the way. Best of luck - and to wrap things up with some final words - in the long run there is no better answer to achieve success than daily focus and hard work - that is why it remains a secret for most people.
Best of Luck
Knut Nystad
Team Norway Coach
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