Retrain your brain: say goodbye to lower-back pain with this innovative new approach

Muscle & Fitness/Hers, Sept, 2004 by Tracy Teare

WHEN YOUR LOWER BACK ACHES, conventional wisdom says you've got core strength issues, and it's off to the gym for some trunk and ab strengthening to gird that torso. Trouble is, this approach probably doesn't address the root of the problem, and sometimes may even make matters worse.

A better approach, says Mike Clark, MS, PT, president and CEO of the National Academy of Sports Medicine, is to correct underlying postural problems by retraining the brain. Yes, the brain.

Because a properly functioning body moves in predictable patterns, it follows that when the body has to cheat or compensate to perform a certain movement, it causes a glitch in the system. For example, if you have the range of motion, stability and strength to do a squat, you won't compromise the position of your hips, knees or feet as you bend and straighten. But, if your hip flexors are too tight, the positioning of your glutes is thrown off and you end up compensating by overusing your hamstrings and low-back muscles.

"The body tries to do it the right way first, but the brain gets an error message if it can't recruit the intended muscle," Clark explains. "So the brain sends a different message and recruits a different set of muscles. Then, if you repeat the move, the brain learns to choose that secondary, inefficient pattern, which over time leads to more stress, fatigue and, possibly, injury."

The job, then, is to get your brain back on track--to retrain it to select the most efficient patterns. The first step is to locate your postural flaws. Next comes a three-step process of relaxing, stretching and strengthening. Clark uses a technique known as "self myofascial release," or SMR, to relax the muscles. This involves slowly rolling pressure across a given muscle to release knots and kinks. Just as a knotted rubber band can't stretch to capacity, neither can a kinked muscle. Stretches increase flexibility, unkink the muscle and place it in the best position to communicate with the nervous system. Finally, corrective strengthening moves enable the muscle to better support the affected joints.

We asked Clark to set in motion his approach with a program for correcting a common posture problem that can lead to low back pain.

The Program

To determine if this program is right for you, stand sideways in front of a mirror. Tilt your pelvis forward and back-ward, imagining it is a bucket of water. If your hip bones easily tip forward, as if water would pour out the front of the "bucket" and down the front of your thighs, you have a tendency toward a sway back or anterior tilt. In this case, follow the program at right.

Do the moves daily; it takes about 10 minutes. After four weeks, your posture should have improved, and your brain trained to follow new movement patterns. For the next four weeks, do the routine three times a week. After those eight weeks, you can drop the routine entirely, but repeat the mirror posture check described above once a month to make sure you're staying on track.

Sway back, or anterior pelvic tilt

As the top of your pelvis tilts forward, your spine arcs excessively, putting pressure on your lower back. Over the long term, Clark says this can lead to problems such as back pain and herniated discs. Do one to three sets of each exercise.

SMR for the latissimus dorsi

Purpose: The lat--your back's biggest muscle--links the lower back to the upper arm. Releasing this muscle helps keep the lower back properly aligned.

Exercise: Place a foam roller on the floor and lie on your left side with the roller positioned under your armpit. Stack your hips and shoulders and pull your abs inward to align your body. Place your right hand on your hip, and your right foot on the floor in front of you. Push with your foot to slowly move your body upward to roll over the foam. Whenever you reach a tender point, stop, and hold in place for 20 to 30 seconds. When the roller reaches the bottom of your waist at the base of your hip, turn over, lie on your right side, and repeat to complete the set.

SMR for quadriceps

Purpose: Part of the quads attaches to the pelvis and lower back, and if these muscles are too tight, they pull the hips forward. Releasing and stretching the quads is important for keeping the pelvis in its proper position.

Exercise: Start in a kneeling position with a foam roller placed under-neath you. Stretch into a plank position, balanced on your elbows and toes so that the foam roller is just above your knees. Slowly pull your body forward with your arms to roll the foam up toward your hips. Whenever you hit a spot that feels tender, tight or knotted, stop and hold in place for 20 to 30 seconds. Keep your abs pulled in so your back doesn't arch excessively, and keep weight off your knees. Roll the foam up and down for eight to 12 repetitions.

Static stretch for latissimus dorsi

Purpose: To stretch your upper body, from hands to lats.

Exercise: Kneel in front of a stability ball with your right arm extended on the ball. Contract your abs to round your lower back slightly. Slowly lengthen your arm until you feel a slight tension along your right side, from your shoulder all the way down through your low back. Hold for 30 seconds. Switch sides and repeat to complete the set.