The most common source of pain in sports is the low back. Often, athletes are treated with massage, chiropractic manipulation, stretches, low back exercises that usually focus on improving the mobility and/or strength of the low back. This may fix some instances of low back pain, but what about when none of those applications work? Where do we go from there? Why does the low back continue to hurt?
Low back pain (LBP) can be caused by mobility or a lack of strength but commonly, especially for stubborn LBP, the cause can be motor control. Many athletes have poor motor control of their low back for a variety of reasons; the main reason being that the low back is poorly innervated by motor neurons compared to other parts of the body like feet, hands, and mouth. This makes it very difficult for athletes to understand how their back is moving which causes delays in feedback mechanisms and makes it even more difficult when you add in pain to the equation. Put simply, the low back is hard to control which makes it easy to injure and hard to make changes. So how can we fix this?
One of the best ways to fix LBP is to cue the athlete during low back movements. This will give the athlete more external feedback to help make changes. One of the best ways athletes learn is by solving problems and a practitioner gives an athlete a problem to solve (an exercise) and helps the athlete solve the problem by giving feedback and cues. An exercise that I use which has solved a lot of LBP in athletes is from Functional Range Conditioning (FRC) called a Full Spine CAR (controlled articular rotation). This exercise is similar to a Cat/Camel exercise but is used to look for “movement blocks” where the spine moves as a whole block rather than segmentally. Segmental movement is required to own that low back motor control. Having that segmental movement would give the athlete a reduction in pain, an increase in low back movement awareness, and help mitigate future low back injuries. Dr. Ryan Hamilton, DC is certified FRCms practitioner and uses the FRC method to improve the motor control of his patients and athletes when other therapies have failed. We hope you give it a try!