The aging athlete and back pain
Aging Personal Trainer
They say that 80 percent of Americans experience severe back pain at least once in their lives and the other 20 percent are liars. Everyone has their opinion as to the causes of back pain, and how you get rid of it — so I’ll give you mine.
Acute injuries haunt athletes for the rest of their careers. Everyone knows that acute injuries become chronic, affecting long-term performance. The NFL posts the players’ injuries for this reason so gamblers can make more informed bets.
NFL players reluctantly spend hours with functional therapists like athletic trainers, physical therapists, massage therapists and personal trainers. Athletes know that they must do this to stay on the field. None of us therapists are cheap, but neither are Bentleys and gaudy jewelry, hence the exorbitant salaries. Seriously, these guys rack up some hefty health-care bills, and it’s not covered by Obamacare. Sound familiar?
What NFL therapists collectively know is if you can keep the soft tissue in check, things work out OK. They also know that if soft tissue is not in check, bad stuff happens. It’s not quite that simple, but the underlying concept is. It’s a race against the clock. In pro football, trainers have six days to repair soft tissue damage maximally. However, the body has its own healing clock that doesn’t always jibe with the NFL schedule. Some of the most talented athletes you’ll never see just can’t recover in time for the next show. The inability to hang with the schedule accounts for a high proportion of the overuse injuries that high school and college athletes experience. There is a fine line between “accidents” and overuse.
I’ll argue that most back pain is easy to fix. The behavior that gets you into back pain is not. There are many variations and individual differences, so of course you should get a professional, objective assessment about your back pain. Before you hear about the fix, dig on some anatomy and physiology.
One of the most common and overlooked causes of chronic back pain that I see in athletes and average Joes is overflexion of the hips, like sitting or riding a bike. Both encourage too much hip flexion. Your primary hip flexors are your psoas [so–as] muscles. Psoas muscles are deep within your abdominal cavity and are difficult to reach. Psoas muscles get tight, or, technically, “short,” and the opposing muscles, the glutes, are too weak to keep up. When the psoas gets chronically short, it pulls on lumbar vertebrae. This leads to disk problems, back pain, digestive problems, hip and leg dysfunction and eventually surgery. If you sit on your butt all day at the office you are accomplishing a few things in addition to earning a living. You are also cutting off circulation to your glutes and shortening your psoas, thus creating a perfect environment for back pain.
Stretching: We all can benefit from some of the techniques that pro trainers use. All the stretching in the world will not fix this problem. Of course, stretching is important. While you are gathering up beer and hot wings, pros spend two-three hours stretching and warming up prior to the game to avoid injury by maximizing joint integrity.
Foam rolling: It’s often quite difficult to foam roll the psoas, but doable. There are ways to “floss” the psoas muscle to stretch it and settle it down, but this is only part of the equation. It will just become aggravated again, and you will try to settle it down again and eventually you will feel like you are in the movie “Groundhog Day.”
Drugs: You could take some “psoas-chill-out pills” and mask the problem, thus avoiding the real issue, but you already know that this is foolish, expensive and often dangerous. But then again, big pharma needs your support. Drugs are a good option to settle down an acute problem, as long as you can get off of them.
Conditioning your core: Core strength is great but glute weakness trumps core strengthening as a method of fixing lower back problems. Since chronically dysfunctional muscles can pull joints out of whack and create the need for surgery, it might make sense to improve the balance of strength of the affected joint or joints. In the case of back pain, strengthening glutes and taking the pressure off hip flexors works very well. As we sit more and more and avoid deep squats, we decondition glutes. Glutes are the primary hip, pelvis and thigh movers, and they need to be strong. The first thing I do with aging athletes with back pain is perfect their squat mechanics. Squats don’t injure knees; injured knees keep you from squatting. We’ll cover knees in the next article.
Please feel free to contact me for help with this problem or to complain about tofu at Midland Fitness 945-4440.
Steve Wells is a personal trainer and co-owner of Midland Fitness. His column appears on Tuesdays.
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