Preventing Lower Back Pain: Assuming is Okay Written on June 21, 2010 at 7:43 am, by Eric Cressey It's widely known that approximately 80% of the population will suffer from lower back pain at some point during their lives. What isn't widely known, however, is that even those who are asymptomatic are usually walking around with a host of nasty stuff going on with their spines. Don't believe me? A 1994 study in the New England Journal of Medicine found that in a study of MRIs of 98 asymptomatic individuals, 82% of those MRIs came back as positive for a disc bulge, protrusion, or extrusion at one level. And, 38% actually had these issues at more than one level. You can read the free full text HERE. As the others discovered, it doesn't stop with disc issues, either - and that's where a great study from Soler and Calderon comes in. They looked at the incidence of spondylolysis (vertebral fractures) in elite Spanish athletes, and found that 8% of those they examined had them. Only about half of those diagnosed via imaging actually had back pain, though. The incidence was highest in track and field throwers, rowers, gymnasts, and weightlifters - and I'd expect that this figure is actually higher in the U.S., where we have more sports (hockey, baseball, lacrosse) involving violent extension and rotation, more contact sports, and more participation in weight training. What does this mean for us? Well, as Chou et al. reported in The Lancet, "Lumbar imaging for low-back pain without indications of serious underlying conditions does not improve clinical outcomes. Therefore, clinicians should refrain from routine, immediate lumbar imaging in patients with acute or subacute low-back pain and without features suggesting a serious underlying condition." That's not the point of my article today, though; I'll leave that stuff to the physicians to decide and rehabilitation specialists to interpret and treat. As fitness professionals, strength coaches, and even just fitness enthusiasts and athletes, we need to assume that there is are probably a lot of structural abnormalities going on in the spines we encounter - including our own. The programs we write and follow need to be sound and take these issues into account, considering differences in age, gender, sport participation, and injury history. The technique we use needs to position us so that we can avoid causing them to reach threshold. And, we need to appreciate that there is a risk-reward balance to be "struck" with everything we do in training because nobody will ever be "perfectly prepared" for the demands to be placed on their bodies. Rather than lay all my thoughts out here, I'm going to direct you to some previous writing of mine: To Squat or Not to Squat?

Lower Back Savers: Part 1

Lower Back Savers: Part 2

Lower Back Savers: Part 3 I'd also highly recommend Ultimate Back Fitness and Performance by Dr. Stuart McGill.

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