As you can imagine, when you are a chiropractor you see a lot of back pain. I mean a LOT of back pain. Many patients are just looking for a quick fix so that they can get about their busy lives. Once in a while I have one come in who is thinking the right way. This means that they aren’t just looking to feel better but the actually want to be better. Usually I can spot these people because they will ask a question like: “How strong does my back need to be?” Of course they are asking how much muscle strength they need in the back to avoid problems like the one that landed them in my office. I know I shouldn’t take it the wrong way, but sometimes I just think that people don’t really want to see me. 🙂
While “How strong does my back need to be?” is a good question, it isn’t necessarily the right question. The question you should be asking is “What exercises can keep my back pain-free and functioning well?” I thought you’d never ask. If you aren’t really interested in the answer to that question I can save you some time and you can just stop reading here. Otherwise, what follows are some of my thoughts about the answer to that question based on years of clinical experience and research.
How Strong Does My Back Need to Be?
First of all, back “strength” is kind of a misleading concept. When we think of an idea like muscle strength it can conjure up images of a muscle bound bro at the gym asking for a spot and comparing bench press records. There isn’t really a quantifiable answer to how many pounds your back should be able to lift or anything like that. The simple answer is that it needs to be strong enough. I know that isn’t very satisfying to you Type A personalities out there but I will explain further. Imagine you wanted to chop down a tree. You get a chainsaw and gas it up. You pulled the cord and it growls to a noisy start. Then you take the chainsaw and throw it at the tree. Is that tree coming down? Probably not. It’s not that you didn’t have the right tools for the job; it’s that they weren’t used appropriately.
When people have dysfunction of their low back muscles it usually isn’t because they can’t generate enough force with their muscles. Problems usually result from a lack of coordination of these muscles. You probably have the strength right now to have a healthy back. The problem is more likely that you don’t have the endurance and coordination to stay out of trouble.
Is this the part where I start selling you chiropractic adjustments? Not yet, but that’s coming. A chiropractic adjustment, while certainly one of the best treatments available for low back pain, cannot really fix the coordination and endurance problem you have in your low back. What is required is to perform exercises focused on specific muscle groups to train them to do their job. It is not enough to just do them once either. To get the payout you are looking for you need to be consistent with this training. The good news is that you probably won’t get all sweaty doing these exercises.
How Does This Work With a Chiropractic Treatment Plan?
Now… about those adjustments. The chiropractic adjustment helps to restore bio-mechanical integrity to your spine. A common pain generator in the low back is the joint where one vertebra of the back meets its neighbor. Sometimes we call these facet joints. If you really need me to impress you, they are also called zygapophysial joints (I swear I did not make that word up). Manipulating these joints with a chiropractic adjustment has been shown in research to bring pain relief which can even be instant in some cases. Surrounding each of these joints is a capsule made out of connective tissue. These capsules have nerves that run into them. These nerves carry information back to the brain about the position and function of this joint. Some theories suggest that restriction in these joints happens because of a breakdown in this feedback. A chiropractic adjustment stretches the capsule and the effect is kind of like “rebooting” the joint. This is the condition you want your joints to be in when you are training and coordinating important postural muscles in your back.
So, Which Exercises Should I Do Then?
Are you wondering what these exercises could be and how you can know which ones to do? There are several resources for exercises that you can find online. For example, here is a great article on the subject from on of the most respected resources in the field of spinal bio-mechanics, Stuart McGill, PhD. Here is the thing though: a piece of paper or a blog post can’t give you the feedback you need about where your specific weaknesses lie. Working with a chiropractor, physical therapist, athletic trainer or other bio-mechanical specialist can help you overcome back pain. It’s not just about doing some exercises (there is no shortage of exercises), rather it is about doing the right exercises.
When I work with a patient who has low back pain my goal is to get them better as quickly and completely as possible. I base the success of my practice on outcomes for my patients and not the frequency of their visits. So I don’t just throw out exercises all willy-nilly. I evaluate and help you determine which training techniques are best for you. Since, you have read this far I know that you are a person who values a long-term solution over a short-term patch. Now, knowing what you know, what do you plan to do for yourself?