Thursday, November 19, 2015

If I told you your back could be strong for a lifetime by just using just one technique..
The not so secret truth about sparing your back using the concept of a  neutral spine. 

It's a universally agreed upon notion..
You have always heard "lift with your legs and not with your back", but what does that really mean?  When it's discussed here in our office, a common excuse not to, is that "my knees are too bad to squat and lift". But as you will find the squat lift is not the only way to protect your back.  There is a common theme in exercise and rehabilitation, it's the ability to move at the hips without moving at the back. This dynamic protects the back and allows the force to be carried where it designed to...The hips.
The basic athletic stance

The dead lift

The Yoga half standing forward bend
Drum-roll please!
This one secret  movement is called the Hip hinge. Iit can and should be used in all phases of life, and is essential in day to day lifting or leaning over a counter. When applied to exercise; it is the basic athletic position that all athletes get ready to play from, from heavy olympic lifting (Crossfit), to the Half standing forward bend in Yoga.  It's an essential piece of mobility that comes from the hips. It allows us to move from where we are designed to move as explained in my previous blog hereand here, and finally here. 
Is the force with you or against you?

Our lower backs can handle some movement, but when you add weight to those movements or repetitions (working out or manual labor) you start to add deleterious forces(shearing vs. compressive) to the spine.  While the spine can handle a large amount of compressive forces, even small amounts of shearing forces can damage discs, facet joints and strain muscles.  Keeping in mind the fact that low back pain is an epidemic in this country it's easy to understand how common poor mechanics are. Professor McGill at the University of Waterloo likens the lumbar spine to a wire hanger, you can only bend it so many times before it breaks.

The spine can support hundreds of pounds of compressive force

Mastering the Hinge
There is usually a certain technique that works for each individual when training the hip hinge.  Some pick it up very quickly, while others struggle.  The following are some really simple approaches for moving the right way, moving in a way that ensures you'll be "living to move"!
The Waiter's bow
Place your index fingers stacked where you feel the top of the pelvis.  While sticking you buttocks out, try and bring your chest to the ground. You will definitely feel a hamstring stretch. A verbal cue we have had success with is reach for the back wall with the bones you sit on. This is a intuitive way to learn how to hinge, remember everyone's capacity to perform this will vary. If you find there is very little movement before the fingers separate, patience will be required. 
The take home message here is, if the fingers separate, that repetition should stop at that point
The Face the wall mini squat
This move is great for training a proper squat, with weight bearing through the heels of the feet, but the hinge is a integral part of the beginning of the squat so using a shorter range does a excellent job of programming this movement with out any external cues.
Hinge with dowel assist
Using a dowel(broomstick or pvc pipe) is another great way to learn to move from the hips while keeping the lower back stable(which is, what it's designed for).  To perform, take the dowel and put it behind you. The contact points are the base of your skull and the middle of your tailbone.  The most important aspect of this activity is to maintain contacts at all points.  It's less important how low you can go, that part will come with posterior chain mobility and time. 

The Hinge in day to day activities. 
The Golfer's lift
Now that we know how to hinge, we can apply it to some daily activities that may cause injuries.  Using a one legged hinge to pick smaller objects is a great idea, the lower back isn't really designed to bend over and over, so any time we can avoid bending we should. You will note the strait spine in this picture. Using support makes it even safer if balance is an issue, the good news is that you will also get a balance component out of lifting off the ground like this. 

Standing Hamstring stretch
We can get a great stretch through the hamstring and calf by hip hinging, this is one of the top recommended posterior chain stretch that I recommend.  Note how flat the back is, this subject leads through the chest to get the desired stretch on the upside leg. This can also be performed with the heel on the floor.
Toes up, heels down

The stiff legged deadlift(around the house)
Lifting mechanics are the same all around, whether it's a 300lb barbell or a laundry basket. The less we wear out our spines the longer they will serve us, and the more active you can be.  Again note the flat (1) back posture compared to the rounded back (2). 

Conclusion; With a little bit of awareness and some time invested, you can spare you and your lower back a lifetime of heartache.  All of these techniques are prerequisites for the best type of exercise...The functional type that makes you stronger, more durable and lean.  If you need help with any of these concepts or exercises, feel free to reach out or stop by!!
 Today we provided principles, so you can adapt your own protocols, don't hesitate to contact us with questions. 

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Dr. Serafim is a Rehabilitation and a Strength and Conditioning Specialist. He lives and works in the Exton PA area and has devoted himself to furthering his understanding of movement related disorders. He teaches continuing education and operates a private practice. More information can be found at and feel free to like us at our facebook page.