Strengthening For Back Pain-Might You Benefit?

There are a lot of treatments for back pain promoted by a variety of healthcare professionals: spinal adjustments/manipulations, dry needling, kinesiotaping, cupping, massage, injections, etc. Sometimes,  these can help you feel better. Unfortunately, many times, the pain relief is short lasting and you have to keep going back for treatment, or the pain returns when you try to get active again. For longer lasting benefit, there is some research to support the need to get you off the treatment table, and onto doing some things to get your back stronger....

If you were to injury your knee or shoulder, one of the main things that would be recommended to help your recovery would be to strengthen your thigh and hip muscles for the knee and to strengthen your rotator cuff and muscles around your shoulder blade for shoulder pain or injury. For back pain or injury, the idea that strengthening should be part of your rehab is not highly promoted-but, maybe it should be.

In 2021, Nicholas Tataryn and colleagues published an article in the Journal of Sports Medicine entitled: "Posterior-chain Resistance Training Compared to General Exercises and Walking Programmes for the Treatment of Chronic Low Back Pain in the General Population." They found differences in pain levels, function, and strength in the group performing posterior-chain exercises. This tells us that for some people dealing with long-standing low back pain, using resistance training for the muscles on their back sides (the posterior chain) may be beneficial. 

So, what is "posterior-chain" strengthening, and how do we do it? The posterior chain is comprised of the muscles on your back side-your back, butt, and hamstring muscles. There are many ways to strengthen these muscles and where each person starts will depend on the information that I attain from that person. Sometimes, exercises to strengthen the posterior-chain are started while laying down if that is where the person needs to start. Eventually though, we want to progress to standing because that is where we function in life and that is how we can apply resistance to these muscles the best. To the right is a picture of a "hip-hinge" movement. Teaching someone to be able to do this is one of the keys in being able to load the posterior-chain appropriately. 

Once a person can hip hinge, it is time to add some resistance. How much and how to do it totally depends on each individual. Below are a couple of pictures that show different options for strengthening the back side.

, Both of the people in this picture are clients that I worked with (shared with their permission). One of them struggled with recovery from a herniated disc and the other had two lumbar fusion surgeries. Both struggled with ongoing pain for a long time. Neither of them jumped right into these exercises or this amount of weight. But, with education about their problems, encouragement, and perseverance,  they both were able to gradually progress the movements their backs could tolerate and the amount of weight that they could progressively lift. This has transferred to both of them experiencing much less pain while at the same time being able to do many more of the physical activities that they enjoy!

Is strengthening your back going to be beneficial for you? Hard to say because, like many things for back pain, it does not benefit everyone. BUT, if you have been struggling with pain for a long time (either constantly or off and on) and are not getting lasting relief from what you have done so far, getting guidance and started on a resistance training program for your back would be a good option. With the right guidance, you can learn how to get started, what to expect, what is ok to feel and what is not, and how to progress (or regress if needed).  

If you need help getting started, don't hesitate to reach out. 
Thanks for reading, 
​Bob