In all of my years training clients in rehabilitation, usually the simplest methods are the most effective, but are also the methods often overlooked by many when searching for answers to their injury. And when it comes to chronic back pain this is often the case. Don't get me wrong there is a lot of things that will need to be addressed and looked at in order to effectively treat the problem for a long term success. But we are so often blinded by symptoms and looking for ways to get out of pain and asking what you can do to "fix me", we forget to ask the better question being, WHY am I in pain? What is the cause of this problem? What are the things I keep doing to aggravate my condition? When you find the answers to these questions you are halfway towards the road of full rehabilitation and never suffering with your problem again. This article is not to diagnose you or put a label on your pain but show you a very simple methods of narrowing down the focus on WHY you have pain in the first place. This then narrows down your choice of corrective strategies to use.

There Is Essentially Two Types Of Back Pain

We tend to make things way to complicated and we spend too much time looking at muscles as opposed to movements. As mentioned in the introduction we are so programmed into thinking of what can I do to fix my problem and look at pain as something to be removed. Pain is merely a warning as to something that is not right in the system, just removing pain does not solve the problem. Actually it tends to make the problem bigger if you have not addressed the source of the problem which is why people with back pain to end up in chronic pain that becomes more severe over time, and even creating other injuries like knee pain and neck pain.

Surgery and anti inflammatory medication are a classic case of turning the alarm off without addressing the cause of the problem. And if you are doubting that exercise is the best form of treatment I encourage you to read some of the amazing stories of people we have worked with that overcame severe injury and pain using methods I am about to show you. Go to this article How These People Overcome Back Pain Using Exercise

Another good article to read is Why Chronic Pain Changes Everything to see the real dangers in back pain fusion surgery and just how pain can create a chain reaction of problems.

Now when I say there is 2 types of back pain, there obviously is many other conditions that you could be diagnosed with. I am referring more to 2 types of movements that cause back pain. We have found you can basically categorize most cases of lower back pain into these 2 categories:

1. Extension related lower back pain
   
2. Flexion related lower back pain
   

Let's take a look at what this exactly means. Take a look at the picture below.

This gives you a look at the various types of postures that people will present with. Bear in mind all of these can create pain, but not not always. I have met some people with terrible posture who had no problems, and met people who seemed to be in great posture in a world of pain! The reason for this is that the body can adapt, and static posture does not dictate how you move. Movement will over ride static posture all the time, either in a good way or a bad way.

Having said that we generally find that people with a lordosis and kyphosis type of posture will often experience extension related back pain injuries such as SIJ dysfunction. Whereas the flat back and sway back type postures tend to experience the flexion related back pain injuries like herniated discs. And scolliosis can fall into both categories.

Now you cannot rely on a postural assessment to determine this, the more reliable way to assess this is by finding answers to these 2 questions.

1. What body positions give my back RELIEF?
   
2. What body positions cause more PAIN?
   

You don't need x-rays, MRI or catscans to find this out, you just need to move in positions that either make your pain worse or better and make a note of what you are doing. And your body will not lie. Remember pain is like an alarm going off telling you something is wrong here and you need to look at this. The relief position is also important for this position is what the body needs more of. Again your body is telling you "I need more of this" to heal myself.

Try these simple tests below.

1. Prone Lying Test - Lie on the floor for 3 minutes on your stomach with your hands under your chin (stop if it gives you pain). Did this position give you pain or relief? Pain = extension related back pain. Relief = flexion related back pain.
   
2. Standing Pelvic Roll Test - Standing straight with a wooden stick on your shoulders as if about to do a barbell squat. Roll your pelvis forwards and backwards. Pain with backwards = extension related back pain. Pain with forwards = flexion related back pain.
   

Watch the video below

Extension Related Back Pain Common Characteristics

• The pain is caused from arching their back to much & compressing the spine and relief from pulling flattening the back out.
  
• This tends to be more common in females
• Very tight hips and back extensors for this person requiring mobility and stretching of these areas
  
• Glutes & abdominal muscles typically very weak requiring strength exercises
  
• Abdominal exercises and lunges are commonly tough for this client.
• Barbell Squats and exercises requiring extension with load are likely to bring the pain on.

Corrective exercises include lunges, deadlifts, lower abdominal activation, push ups with good spinal alignment and basically all exercises that encourage some posterior tilt of the pelvis with either abdominal activation or glute activation. The squat is the key however. As this is the movement likely to cause pain, it is also the long term solution. If you can find a way to change this movement pattern to a position where it no longer causes pain, then you are almost guaranteed of preventing any future injury.

The video below provides you with a detailed look at this and some exercises to correct this problem.

Good articles to read for this person include

• How To Loosen Tight Hips That Cause Back Pain
  
• How To Strengthen Your Glutes
  

Flexion Related Back Pain Common Characteristics

• The pain is caused from bending poorly and relief from lying on their stomach
  
• This is the disc bulge warning sign.
• This person must be very careful with the bending action. Tying shoe laces, gardening or picking a golf ball up are all potential pain inducing movements. In the gym Deadlifts, bent over rows etc are also risky exercises.
• Tight hamstrings, glutes and abdominal muscles are typical for this person requiring stretching and mobility exercises.
  
• Sitting too much and poor bending movements are often the cause
• Weak areas include the back extensors and the hips requiring strength exercises.
  

Corrective exercises for this person are squats, back extensions and exercises that encourage anterior tilt of the pelvis. The deadlift is the key as this is the movement likely to cause more pain, but is the long term solution. Just like the previous problem if you can find a way to turn this into a movement that is free of dysfunction and pain you are well on the way to getting rid of the source of the problem.

Good article to read for this person is - Bulging Disc Exercises For Long Term Relief

The only movement I have left out is twisting and rotational movement. This has been associated with back pain, and will greatly affect scolliosis type postures. If used wisely it can help both types of pain here as often a person with back pain becomes stiff and rigid and finds athletic movements extremely difficult to do. You will find great deal of information about rotation in this article Is Twisting & Rotation Exercise Bad For Your Back?

Back Pain Secrets Program

There is obviously a lot more you need to do and many different ways to go about putting together a specific program for your body. There is no two back pain injuries exactly the same, they share may common traits but there is always something unique to each person that must be factored in. You will find all the detailed assessments, specific exercises, stretches and mobility drills for both kinds of posture in our Back Pain Secrets Program you can get by clicking here or on the image below. Over 90 minutes of video and a 85 page book with a 6 month program guide to follow we cover everything you need to know.

Conclusion

To know exactly where to start, you need to find out what movement creates your pain, and what movement takes away your pain. That's it! Pretty simple stuff I know. Once you know the answer to these two things you can move to step 2 and begin progressing with more specific exercises and stretches to you program, and one giant step closer to finding a solution to your back problem. If there is one thing you take home after reading this I hope it is, you have to find the source of the problem and not just address the symptoms.

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 200 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily.

If you do need specific help with your exercise program please feel free to reach out to me for help and we can set you up with your individualised program.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 15 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

• Functional Anatomy of the Pelvis and the Sacroiliac Joint - By John Gibbons
• The Vital Glutes - By John Gibbons
• Movement - By Gray Cook
• Corrective Exercise Solutions - by Evan Osar
• Back Pain Mechanic - by Dr Stuart McGill
• Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
• Low Back Disorders - by Dr Stuart McGill
• Ultimate Back Fitness & Performance - by Dr Stuart McGill
• Core Stability - by Peak Performance
• Athletic Body in Balance - by Gray Cook
• Anatomy Trains - by Thomas Meyers
• Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
• Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
• How To Eat, Move & Be Healthy by Paul Chek
• Scientific Core Conditioning Correspondence Course - By Paul Chek
• Advanced Program Design - By Paul Chek
• Twist Conditioning Sports Strength - By Peter Twist
• Twist Conditioning Sports Movement - By Peter Twist