Did you wake up this morning only to find that your low back pain was already the centre of your attention? Or maybe you’ve been dealing with low-grade back pain for years and want to know what you can do to take back control. With so many potential treatment options out there, it can be overwhelming to know where to start when it comes to alleviating your low back pain.
While there are lots of things that could potentially provide relief for your low back pain, improving the endurance of your back muscles seems to be one of the best choices. But don’t just take my word for it. Let’s dive into what the research has to say about the matter.
What the research says
According to a research study in 2010 on spinal muscles:
– poor muscular isometric (being able to stay still) endurance, “of the back extensor muscles seems to have a strong association with the risk of low back pain.”
What is muscular endurance?
(Hint: it is NOT cardiovascular ability)
So now that we know training, muscular endurance is beneficial for reducing low back pain, you might be wondering exactly what muscular endurance is…..
Muscular endurance is the ability of your muscle to keep working over an extended period of time.
People often associate muscular endurance with tasks like running or endurance sports, which is more about cardiovascular endurance. This blog will focus on our muscles. For example, if you didn’t have adequate muscular endurance in your forearms, tasks like gripping your pencil while writing a letter or carrying in the groceries would be nearly impossible.
The two ways in which a muscle can have endurance are:
– dynamic strengthening exercises: think squatting and lunging
– stabilisation exercises
The rest of this blog will focus on the stabilising form of muscular endurance. As in 2013, it was shown that stabilisation improves function (the ability to move and function), more than traditional strengthening exercises. My job as a medical professional is to help people to do whatever I can do to get people back on their feet again. All too often low back pain stops people from being able to functionally do their day-to-day activities. We take our ability to do those small, repetitive everyday tasks and chores for granted. As we normally perform without even thinking about them.
4 reasons muscular endurance, reduces low back pain
If you’re like me, you want to fully understand exactly how things work. So let’s explore the mechanisms behind why muscular endurance, reduces low back pain.
1. Muscular endurance improves stability at the low back
If you do not have sufficient stability at your low back, this means that as you move or pick up something heavy the vertebrae tend to shear against one another more than they would like to. This can result in sharp pain. And if there is too much movement of the vertebrae, the research indicates that they could hit a nerve and cause you to feel tingling or numbness in your legs.
And research indicates that “fatigue of the trunk muscles, increases the risks of neuromuscular deficits, causing uncoordinated movements (i.e., poor motor coordination), increasing the instability of the spine and thus, contributing to overload and injury in passive structures such as ligaments and joints.”
So when you improve the muscular endurance in your low back, you help to activate deep muscles in your back called the multifidus. These muscles help to support each individual vertebrae and reduce the amount of strain at the structures of your back to help you move how you want with little or no pain.
2. Muscular endurance helps you respond better to unexpected loads
If your back muscles tire easily with day-to-day activities, simple, unexpected loads like picking up the laundry or going to pick up your child could result in pain. And research indicates that “decreased muscular endurance of the back is associated with increased muscular fatiguability.” By training the endurance of your back muscles, you increase the threshold at which they start to experience fatigue.
This holds especially true if you participate in sports as well. If your back muscles don’t have sufficient endurance, then when you go to serve the volleyball during the fifth set your back may not be able to effectively handle the quick force that serving demands on the body.
Being better able to handle unexpected loads, may be one reason why muscle endurance exercises in our low back have been shown to “pre-habilitate”, in other words it reduces the risk of developing a lower back injury (Hadala, 2014)
3. Muscular endurance improves your postural control
Why does your posture, even matter when it comes to your low back pain? If you stay slumped over in an office chair all day, this can place both the soft tissues and joints in your lower back in a position that causes a dull ache. And on the other hand, if your back stays in an extended position when standing all day and you can’t find a more neutral position, the joints in your back might be put under too much pressure. Our joints don’t like being compressed for long periods of time.
A study in 2011 found that “impaired back muscle function, as a result of muscle fatigue or pain, may lead to an inability to adapt postural control strategies”. Thus, improving your back muscle endurance helps hold your spine upright in a happy neutral position. When you can sustain good posture for an extended period, this takes the stress off both your muscles and joints and you experience less pain. I guess mom was on to something after all when she kept nagging me about my posture.
4: Speeds up the healing process
And if you have recently developed low back pain, research indicates that “endurance exercise is considered to expedite the recovery period process for patients with an acute episode of low back pain.” One recent 2021 research paper found that improving muscular endurance of your back muscles is more effective “than general exercise on pain and level of disability” in individuals with low back pain.
So what do you do to help your own low back pain?
Now that you are an expert as to why muscular endurance is going to help reduce your lower back pain, you probably want to know how in the world you’re supposed to go about improving your muscular endurance.
A key part of any rehab plan:
Endurance exercise should only form a part of anyone’s weekly exercise regime. Endurance is one form of exercise. According to Katy bowman in her blog nutritious movement reminds us that humans like to have a diversity of nutrients, not just in what we eat, but also in how we move.
If you feel you lack muscular endurance and want to speed up your recovery time and help to prevent future episodes of back pain. Join a Pilates class. Unlike circuit training (strength and cardio-focused, or yoga (flexibility, focused), Pilates improves endurance of your back muscles, so that they can do a better job of stabilising you. Pilates was originally called contrology. With modern pilates exercises still being more stability based, instead of focusing on increasing maximal strength. Pilates aims at improving spinal control through training deep core and back muscles, as opposed to strength or cardiovascular performance. Pilates can be tailored to meet your individual needs. So it doesn’t matter what your current level of fitness is. This ensures you don’t end up making this worse.
Summary:
When it comes to reducing your low back pain, the evidence is clear. Start building the muscular endurance in your low back muscles today and your body will thank you. With a little time and consistency, you can start waking up without even noticing your lower back and start living life on your terms.
References:
– Chok, B., Lee, R., Latimer,J. Tan, S. 1999. Endurance Training of the Trunk Extensor Muscles in People With Subacute Low Back Pain, Physical Therapy, 79(11) ,1032–1042, https://doi.org/10.1093/ptj/
– Hadala, 2014, The effectiveness of lumbar extensor training: local stabilization or dynamic strengthening exercises. A review of literature, Hadała, 2014
– Johanson, E., Brumagne, S., Janssens, L. 2011. The effect of acute back muscle fatigue on postural control strategy in people with and without recurrent low back pain. European Spine Journal, 20, 2152–2159, https://doi.org/10.1007/
– Mbada, C., Ayanniyi, O. 2010. Relations between Back Muscles’ Endurance Capacity and Risk of Low Back Pain, TAF Prevenetitive Medicine Bulletin, 9 (5), 421-426, Microsoft Word – khb_009_05-421.doc (researchgate.net)
– Moon, 2013, Effect of lumbar stabilization and dynamic lumbar strengthening exercises in patients with chronic low back pain
– Nowotny, A., Calderon, M., de Souza, P. 2018. Lumbar stabilisation exercises versus back endurance-resistance exercise training in athletes with chronic low back pain: protocol of a randomised controlled trial
BMJ Open Sport & Exercise Medicine, 4, 452. doi: 10.1136/bmjsem-2018-000452
– Tataryn, N., Simas, V., Catterall, T. 2021. Posterior-Chain Resistance Training Compared to General Exercise and Walking Programmes for the Treatment of Chronic Low Back Pain in the General Population: A Systematic Review and Meta-Analysis. Sports Med. 7(17). https://doi.org/10.1186/