A Case for Using your Back Muscles Again

It is not uncommon for people with lower back pain to be afraid of using their lower back muscles. If you have had a back injury or dealt with back pain, it can be quite unpleasant to use your back muscles initially.

So naturally you learn, or your Physical Therapist or doctor told you to protect your back and use other muscles to support it. Bend with your knees, use your glutes, strengthen your core, work on your “posterior chain” etc.

So you completely avoid ever using your back and learn strategies that complete bypass stressing the area. And this can work for a time in helping your pain subside because you are minimizing stress to the area.

I am not opposed to that at all as a short term strategy.

The problem begins when it turns into a long term strategy.

We all know that if you don’t use it, you lose it: Your back strength, the mobility to bend, the coordination of the muscles, the muscle memory, and the overall capacity of your back to simply be able to do work.

And this might be one of the most common patterns I see clinically in people with chronic lower back pain. Somewhere along the way they learned a protective strategy that helped initially, it became a long term strategy, and years later that engrained pattern has only made the problem worse.

Enter, intentional back strengthening and mobility work.

Of course everyone’s story and case is different. But this principle is pretty consistent. Strengthening your lower back and restoring full range of motion to have a bigger sandbox to play in can be an absolute game changer.

There is a test called the Beiring-Sorenson test that tests the endurance of your spinal erector muscles. In multiple studies measuring this, they found that the performance on this test was a strong predictor of future lower back pain within 1 year.

Demoulin et al showed that maintaining the Biering–Sorenson position for less than 176 seconds, predicts low back pain within the next year and greater than 198 seconds predicts absence of low back pain. (PMID: 16461206)

Furthermore, atrophy of the spinal extensor muscles has been shown at higher incidince in people with chronic lower back pain (PMID 40361257)

To be clear, lower back pain is almost never this black and white. Pain, especially chronic pain can be very complex and is almost always multi-factorial.

Pain Factors

Nonetheless, restoring back strength and mobility can be a big part of that picture for many, and I am gonig to share 5 reasons why.

1. Increased Capacity: Back strength literally simply makes you more capable. You can do more, and your back can handle more stress before it gets angry at you.
2. Larger Sandbox. If your back is stiff, you only have so much room to play before it starts yelling at you. If you open that sandbox up, it gives you more movement options, and most of the time, a less cranky back.
3. Increased Confidence in your self. Building back strength and mobility increases your confidence in your back, and overall self-efficacy. Fear of movement and of back pain and the negative effects that has is a very well documented factor in chronic lower back pain (PMID 28704621). And in my opinion the best way to overcome those fears, is by confronting it. This does NOT mean blindly pushing through pain. But it does mean starting where your body can handle it, and slowly but surely building from there.
4. Desensitize your nervous system. Through graded exposure to movements that have been chronically painful, your nervous system gradually learns to downregulate those threat responses and quiet the alarms. Remember, pain does not always = damage.
5. Self Empowerment. Building back strength and mobility empowers you, because it is something that 100% within your own control to work on and improve, and watch the results play out in your life. Massage, and manual, therapy, dry needling, and spinal manipulation all have their place in calming the nervous system and reflexive muscle tension. But IMO, strength and mobility work is the GOAT (greatest of all time) because you are literally giving your nervous system evidence that you are strong and capable on your own.

So where should you start?

Well obviously, that spot is going to look a little different for everyone. But as I mentioned earlier, the key is to find wher is your tolerable entry point. We don’t want to avoid confrontation forever, but we also don’t want to super aggressively confront out of the gate and shock your body. You need to ease into it. It is a process and it takes time, typically on the order of 3-6 months for most people.

So don’t expect overnight results. (believe me I would sell whatever was doing that if that were a thing) But also remember, good things take time, and creating a lasting change take time. Commit to the process and your back will thank you big time over the long haul.

Here are some examples of movements I use with people to start this process (and all of these can be modified in countless ways to dial them a little easier, or a little harder).

Spinal Flexion Mobility

Back Strength Exercises

Spinal Rotation Exercise

And if you are looking for a more personalized approach to your back rehab, that is what we do. Reach our for a Free Discovery Call so we can chat and learn more about your story to see if we can help.