When it comes to injury and back injury prevention, there are quite a few misconceptions that we are going to clear up. Now we all know resistance based training is the most beneficial for strengthening our bones and preventing diseases like Osteoporosis, but many of us fear to lift heavy weight.
I’m not saying pick up the heaviest weight you can find on your first session in the gym, but you need to be lifting a weight level that places stress on the bones, in order for them to adapt and grow.
So how can you keep an appropriate level of strength without hurting your back?
Well, that is what we are going to find out.
Firstly, not all pain is bad. Pain alerts us to a problem that we might not have otherwise recognised.
The two main ‘active’ injuries or ways you can hurt yourself in the gym are when you are tired or fatigued, and when you are not paying attention or become distracted.
When it comes to back injury, it is often not the weight itself, but the fatigue that accumulates. For most of us, our backs are often not the strongest part of us, which means they will fatigue quicker. To overcome this you need to gradually increase the capacity of your back.
This is done with heavy weights (yes, you want to lift approx 50% of your body weight) but keeping the reps low and resting between sets. Start with a lighter weight and gradually increase at approx 10% each week. You don’t want to be lifting 2.5kg weights your whole life.
That being said, always listen for cues that your body is giving you and do not rush any movements.
Another common way people injure their backs is when they are under stress, otherwise known as passive injuries. We are under stress when our muscles are holding under constant tension. If we suddenly move in a position your back is not accustomed to, that’s when the injury occurs. The rigidity of the back position means it’s hard for it to have the flexibility to move and bend.
If you build up the capacity of your back with heavy resistance based training, not only will you be able to relax the muscles under load, everyday activities will become much less strenuous.
Maintaining a strong and healthy back means a combination of stretching and strengthening on regular basis. It is also important to training with a balance of training between the prime movers and stabilisers.
Types of UPPER back injuries
The thoracic spine, also referred to as the upper back is designed for stability (see our previous article on injury prevention using the joint by joint approach). Compared to the lower back, or lumbar spine, the thoracic spine is quite resistant to injury.
Typical injuries in the upper back occur not from a specific exercise itself, but most commonly from a long-term posture that is not optimal, or injury at an adjoining area in the body that is working to overpower its sturdiness.
The thoracic spine starts at the base of the neck and has 12 bones (T1-T12), travelling down the back and torso. Following the joint by a joint approach, you will notice that unlike the lumbar spine, the thoracic spine is built for stability and is relatively immobile to protect the rib cage.
Pain in the upper back is typically a result of:
- Muscular Irritation – The shoulder girdle attaches to the back of the rib cage and one of the most common upper back injuries is often connected to the rotator cuff muscles (supraspinatus, infraspinatus, subscapularis)
- Joint Dysfunction – either from a sudden injury or degeneration as a result of the ageing process
- Posture – when we are physical, mentally or emotionally stressed, we tend to hold tension in our upper back and traps. Ever heard the expression, you’re looking a bit down? That is because our mental health presents with physical symptoms too!
So how can you prevent upper back injury?
Well, injuries can’t end, there are things that you can do to reduce your risk. For example, you can reduce your risk of joint dysfunction by ensuring you keep your bones healthy through diet and resistance training, and also that your technique is correct and monitored by a professional so no sudden injury can occur.
Another precaution you can take is to ensure your shoulder girdle is healthy and you are taking care of the rotator cuff muscles. This means performing specific exercises at the beginning and end of each training sessions to ensure the range of motion is kept open and strength and stability of the shoulder girdle are maintained.
Types of LOWER back injuries
Lower back pain is one of the most common injuries, affecting about 80% of the population.
Non-specific Low Back Pain (NSLBP)
This type of low back pain is by too tight (immobile) or too loose (hypermobile)structures in the body. Some structures in the lower back where pain commonly occurs are:
- The vertebra
- The facet joints (linking vertebra together)
- Intervertebral discs
- Ligaments, nerves and muscles
Activities we perform in daily life can cause these structures to become overloaded and fatigued over time. This wear and tear causes microtrauma and cause a joint to “lock up” which prevents movement through the normal range of motion-leading to pain!
It is common with trauma or age for the disc tissue to weaken, particularly with repetitive motions where we are bending and twisting our trunk. This can result in the disc bulging out and putting pressure on the surrounding nerves which causes pain. There is a common misconception that the discs “slip in and out”. While there may be some fluid that leaks out, this is not the case.
So how can you prevent lower back injury?
The best thing you can do to prevent injury to the lower back is to do regular PREHAB exercise. Doing PREHAB exercise regularly ensures strength and stability in the lumbar spine. When selecting exercises you want to choose movements that challenge the ability to support and stabilise the torso. You also want to learn how to maintain core stiffness throughout the movement with an exercise such as plank stir the pot on an exercise ball.
Another good prehab exercise is the deadlift. Now, I know that might seem a bit counterintuitive if you have a back injury, but it is actually one of the best exercises to prevent future back pain WHEN PERFORMED CORRECTLY.
This is key, the technique, when it comes to the deadlift, make sure you have the assistance of a health professional to monitor your technique. Not only does it work the entire posterior chain of the body, it teaches you to how to hinge from the hips and maintain the control. Progressively increasing the load you lift will also help to increase full body strength and the tissue capacity.
The other exercise is a squat, think about it? When you get up from a chair, when you go to the toilet, you have to squat!. Learning to perform a squat well and perform it with the load will not only assist you with daily activities, but a strong back is less likely to get an injury. You can develop a very resilient spine when continually performing loaded back squats and increasing the load gradually.
Things to remember…
- Correct technique is crucial – make sure you get all your movements assessed by and health and fitness professional
- The load is important – heavy, but gradually and incrementally increased load is the most important. This not only protects our back but also our bones
- Do not rush any movement! – most injuries occur when we are either going too fast, not using the correct technique, are distracted or fatigued. Be mindful of all of these elements when performing a weighted exercise
- Precautions that can be taken to prevent injury – diet, regular resistance training, prehab exercises designed to build the capacity of the tissues.