When designing training programs for clients, it’s tremendously important to understand how an individual’s spine is positioned and moves to determine appropriate training strategies. Even more so when dealing with clients who have a previous history of back pain or injury to the spine. I want to take you through some methods we use at BPT to examine and determine training tactics.
Resting posture and how it can affect movement
The first thing we do in our assessments is establishing what the client/athlete presents as “resting posture”. When we can identify how people position themselves to begin the movement, we can identify potential dysfunction in basic patterns such as squatting, hinging, pushing, pulling, and bracing. Dr. Stuart McGill talks about the neutral position of the spine as “home base”, referring to its least stressed position. A neutral spine should show three natural curves starting from the top; cervical lordosis, thoracic kyphosis; and lumbar lordosis. If the spine is out of position, there could be added stress to the vertebral bodies and discs during movement.
Identify the passive and active range of motion to determine risk factors
Our next objective to identify if the client/athlete presents an adequate passive and active range of motion through several orthopedic tests. When clients do not present minimal ranges of passive and active range of motion through the hips, it will result in excess stress to the spine. For example, when dealing with clients/athletes that participate in rotational sports such as golf, hockey, softball, or baseball that deal with tremendous amounts of rotational demands, it’s important to perform tests to examine the lead hip range of motion. In 2004, a study from Vijay B Vad was published by the American Journal of Sports Medicine, which had found that there was a direct correlation to range-of-motion deficits in the lead hip and lumbar spine extension that resulted in low back pain.
Stabilize the spine and getting the glutes going
In order to protect the spine, we must train the torso to absorb/resist spinal movement. Repeated flexion, extension, and rotation will cause wear and tear to the spine and if not trained to handle the demands of such stress, injury risk will be much higher. We focus our “core” training to resist motion rather than to produce motion, and our training programs reinforce the ability to “anti” flex, rotate, extend, and laterally flex. In addition to stabilizing the spine, our goal in our warm-ups is to get the glutes to be the main hip extenders and rotators as that’s what they are designed to do. When the lumbar extensors and low back muscles are taking over for the glutes, that’s a sure-fire way to result in a cranky low back.
On his Elite Baseball Development Podcast, Eric Cressey mentions “developing the callus, not the blister.” Too often I see videos of young athletes lifting with poor technique and trying to impress others with high training loads and not enough attention to the quality of movement. The tremendous amount of compress stress that is placed on the spine from heavy deadlifts or back squats performed with spinal flexion is a recipe for disaster regarding long-term spine health. Not to mention, if the athlete or client performs a rotational sport, focusing solely on big bilateral lifts does not translate to rotational power as you would think. Now I’m not saying to never lift heavy bilaterally, but you have to build up experience and resiliency with the big lifts. I would also recommend cycling in plenty of single-leg work into training programs to allow for a break from the bilateral stresses.
These are just a few of many considerations when it comes to assessing spine health and how it plays a huge role in program design. If you wish to learn more, feel free to email questions or comments to firstname.lastname@example.org as I would love to hear some feedback on the topic!