Safety & Health

An Overview of Exercises to Strengthen the Low Back

Issue 11 and Volume 5.

Low back pain and debilitating injuries have long plagued the fire service. Expensive workers’ compensation claims, short- and long-term disability payouts, and in some cases, medical retirements continually drain fire departments of important working capital. We can probably all agree that it would be nice if that money went toward force enhancement rather than compensation for force depletion.

To avoid putting undue financial hardship on our already overextended departments, and to keep yourself off the “day” roster and on the line, we recommend performing low back and core strengthening exercises. We’ve found that these exercises have improved our low back strength and flexibility, potentially providing protection against injury.

The San Diego Study
In an effort to identify which, if any, physiological differences exist between individuals with back pain and those without, a recent study was conducted utilizing members of the San Diego Fire-Rescue Department (SDFRD). The objective of the study was to identify ways to better prevent injuries to the low back.

Following procedures defined in the Fire Service Joint Labor Management Wellness Fitness Initiative (WFI), the men and women of the SDFRD were surveyed, clinically tested and medically evaluated. They also performed various fitness tests, which included a timed, low-back extension test.

The results indicated that there were no significant variations between the two groups when testing their low back/hip flexion flexibility; however, there were notable variations in all the other tests, including body fat percentage, aerobic capacity, trunk flexion endurance, low-back/lower-extremity lift strength, upper body endurance (push-ups), arm strength (curls) and most notably, back extension endurance.

The Back Extension Test
The back extension endurance test is performed by placing the participant face-down on a bench, with the front upper edge of their pelvis resting on the edge of the bench. Their arms are folded across their chest with their hands resting on opposing shoulders. The person administering the test then kneels at the participant’s ankles and applies pressure in order to keep the participant’s lower body stationary.

The test begins when the participant raises and holds their torso in a horizontal position; it concludes when the participant’s torso drops 10 degrees below the start point. The time between the start and end of the test is recorded. 

The test results differed significantly between the group that reported back pain/injury and the group that did not. More compelling, however, was the fact that 83 percent of the entire test group reporting back pain did not achieve their recommended target times (men: 147 seconds; women: 189 seconds). This revealed that they are even more vulnerable to experiencing future back problems.

Poor isometric back extension endurance has been linked to an increased risk of low back pain episodes, and a higher incidence of disability claims due to chronic back disorders.1,2  The lesson: If you want to decrease the probability that you’ll sustain a low back injury, it’s a good idea to include back extension exercises that involve high repetition, low intensity and extended duration.

How to Develop Low Back Strength
The study suggests that muscle strength—and even more so, endurance—could be key factors in preserving your low back. Three things come to mind for us when focusing on these areas: Core lifts, exercise ball workouts and yoga. We’ve addressed all of these techniques in detail in previous articles, but we’ll give a brief recap of each and let you know where to find more detailed information on the various execises.

Core Lifts
If performed properly, dead lifts, power cleans and squats continue to be three of the most effective strengthening lifts out there. They all develop strength through a functional range of motion via an integrated effort by several muscle groups, and they all foster strength and balance elements, which help develop strength in large muscle groups as well as small, more structural, stabilizing muscles. For
more on core lifts, visit http://www.firefighternation.com/profiles/blogs/more-power-to-ya-2-lifts-that or http://www.firefighternation.com/profiles/blogs/back-it-up-dead-lifts-help.

The Exercise Ball
Working out on an exercise ball is a longstanding means of rehabilitating back injuries. So it only makes sense that performing these exercises prior to injuring your back could help strengthen your back, which could prevent the injury in the first place.

The ball accentuates balance, which makes it the perfect tool for strengthening deep core muscles critical to preserving low back strength. You can vary the impact of the balance requirements by minimizing or fortifying the amount of stabilization you provide through points of contact with the ground or any other means of support.

The exercise ball is so versitile that you can find hundreds of ways to develop muscle strength and endurance by incorporating this very inexpensive piece of equipment into your workout program.

For more on exercise ball workouts, visit http://www.firefighternation.com/profiles/blogs/have-a-ball-work-out-for-less.

Yoga
The benefits of yoga can be underestimated. It has the outward appearance of being quite passive, as the skilled individual can make a session of yoga look like a simple exercise of sequential stretches. But there are many physical benefits of yoga from a low back strengthing perspective: You’ll improve your balance, develop static strength through a broad range of motion, and develop a keen sense of your body and its capabilities within various movement patterns. This will help train your body to move safely through yoga positions while developing needed strength. For some yoga moves perfect for firefighters, visit http://www.firefighternation.com/profiles/blogs/the-mindbody-workout-a.

Conclusion
The low back can be very tricky. If you don’t take care of it and do everything you can to provide for its safety, you may find yourself with a career-ending injury. If that isn’t bad enough, trying to enjoy that medical retirement isn’t easy when sitting, standing, walking and just about everyother activity is riddled with pain.

What’s more, when your back is vulnerable due to weakness, it doesn’t take a lot to injure it. Seemingly benign movements can bring you to your knees. But by developing the needed muscle strength and endurance, in addition to training your body to move safely within typical and not-so-typical movement patterns, you’ll increase your odds of maintaining sound low back health.
    
References

  1. Biering-Sorensen F. Physical measurements as risk indicators for low back trouble over a one-year period. Spine. 1984;9(2):106–119.
  2. Rissanen A, Helivaara M, Alaranta H, et al. Does good trunk extensor performance protect against back-related work disability? J Rehabil Med. 2002;34(2):62–66.

For more information on the San Diego Fire-Rescue Department’s back study, visit http://tinyurl.com/sdfrbackstudy.