Wednesday, July 6, 2011

Back Pain

Now that I have drawn a couple of people to my blog, I'm going to have to address their specific concerns. I'm not going to name any names but I possibly sent you a personal email. Lower back pain and immobile hips. So if you haven't, take the time to read the article I wrote for the CFC blog on "Mobility and Stability". This is important to understand the joint by joint approach.

If a joint doesn't have enough mobility, it is going to ask the next structure to do what is not it's responsibility. So for all you lower back pain people, if your hips have mobility issues, it's going to ask your lumbar spine (which supposed to be a stable structure) for mobility. One of the best movements to see this concept is the overhead squat.
So, looking at the diagram above there is no contention that the load must remain over the f. line or mid foot or in the frontal plane. So, in the case of immobility in the hips, the angle of A. decreases and cause shear force on the lumbar spine because of the lengthening of the spine moment arm. If we want to delve further we can look at the opening of angle 90-A (which is 90 degrees minus A) requiring more flexibility form the shoulder joint and taking it out of proper alignment of being supported by the scapula.

Like I said, I like the OHS to describe this concept but it goes much further. If you have lack of mobility in the shoulders what happens when you get weight overhead (as in a press)? You jam your head forward because the coach want to see your ears. You put this ridiculous arch in your lower back. The coach then proceeds to tell you to tighten your abs. You tighten your abs and lose the weight out front because it is no longer in the frontal plane. This is the best pic I can find so you'll have to imagine weight overhead. So what did you do? You have lack of mobility in your shoulder (gleno-humeral joint) so you are throwing your cervical spine forward to get your ears seen, not able to stabilize correctly with your scapula (shoulder blades) because the lack of mobility doesn't allow them to be secured correctly by the rotator cuff and to top it off you are asking for additional movement from your lumbar spine to make everything happen.

What is the answer and what should you do? DON'T PRESS OVER HEAD. Work on your shoulder mobility. It's f*cking up your lower back. That's it. That simple. No overhead work until you can get the required mobility. Sad thing is that because of this ego thing that everyone swears they have checked, we wait until something is broken until we fix it.

Wow! That took much longer than expected. I know there is a ton of information in here. I have just fed you water through a fire hose. Please post questions to comments so everyone can see them. I will try not to answer them at the box or via email so ask them here. Also, if you think that I'm talking about you... I probably am.

WS4SB Day2
820pm
A1 Vertical Jump 10x2 (was supposed to be 8 sets)
B1 Barbell step up 16" box 155#s 3x8 (found a little asymmetry going on, left leg initially stronger)
C2 GH Raises 1x12 2x8 (supposed to be 3x12 but hammies couldn't take it)
D1 Controlled TTB 4x8 (supposed to be 4x10 but over come by gross amounts of weak sauce)

About an hour later, I realized that I haven't eaten all day.

7 comments:

  1. Rudy, I actually think the shoulder mobility issues causing lower back pain makes sense for me. I know that I've been guilty of pushing my head through to achieve a "full rep" at times. And I know with heavy presses I get lower back pain sometimes from sticking my butt back, putting extra weight on my lower back. To work on my shoulder mobility, is there anything specific you would recommend? I'll go through mobilitywod.com videos in the meantime and try to pick out some that will help.

    Another question. I've noticed that I'll get some shoulder pain in weird situations when I'm not really lifting heavy stuff. It's not constant, but sometimes it'll happen when I'm warming up with some presses just with the bar. Another example, I'll be carrying a relatively heavy'ish backpack (laptop inside for instance), and be getting into my car. As I'm going to sit in the driver's seat, I take the backpack off to set it down in the passenger seat. So basically, it would be like I was holding the backpack off to my side with one arm straight out (90 degree angle between my body and arm--hopefully that makes sense). I don't get any pain while doing that, but as soon as I release the backpack, I'll get some pain it my shoulder. It doesn't last that long, though. Kind of a weird example, but it happens more often than not. Any idea what's going on there?

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  2. I'd actually go with manual therapy first. I think you will only get minimal gains of flexibility if you don't have someone break up scar tissue first.

    As for part 2, I don't think your rotator cuff is efficiently doing it's job. I think In extreme situations where the load is heavy or the lever is long it's prepared to brace, but in situations where the load is light or variable it doesn't react appropriately. Like your stabilizers know on or off right now and don't apply force to the upper arm correctly.

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  3. Some people are having issues posting so I'm going to copy and paste from my email.

    Jean:
    In terms of specific questions about your post, in response to your comment that we shouldn’t lift overhead until we have our should stability issues resolved, does that mean that I should not be working on presses in the current strength regimen? What about snatches and OHS in metcons? Should I just be subbing cleans and FS? Or continue testing out the moves at lighter weights than I actually might be able to do until I get the necessary flexibility to execute at higher weights.

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  4. @Jean, If your poor overhead position is from lack of mobility, yes, no overhead work at all. If it was a compensation after max effort/technical failure, then it's a different story.

    Yes, if you don't own the mobility, you shouldn't go there. We tend to make these exceptions for the shoulders but it's like saying I can't get in to the depth of a squat, but I'm going to do weighted squat jumps to get there.

    In the current strength regimen you are better off using the time to work on your mobility. You need mobility and stability before you can develop strength.

    As for metcons, ask the coach. Depending on what the intentions of the workout are, certain subs will be more appropriate than others.

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  5. Rudy,

    You mentioned to me about 10 days ago that I check out this post, and unfortunately I am only getting to it now, after we did press with you today at the 9am class. Besides the situation you describe with the press, are there any other telltale signs of shoulder immobility (and its relation to back pain) that I should be aware of? I don't believe i am having major technique issues with the press or overhead squat -- i struggle more with repeating the same motion over and over again, which I think will come with more time in Crossfit -- and I have not experienced any back aches since I joined Crossfit except for after deadlifting last week: that was more a soreness and tightness that lasted two days and the residual ache dissipated by Tuesday of this week. But, i am new enough to Crossfit that I always worry my technique will lead me down the wrong road, and I'd rather cut out my bad habits now at a lighter weight. It would be good to talk with you about this in person sometime soon, to get a little better idea of what to be watching out for. Thanks for guiding me to this post and to the blog in general, lots of very helpful information in here.

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  6. @Tony, Chat with me next time you are in. I'll be writing somethings on checking your shoulder mobility as it has been a frequent question.

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  7. Rudy,
    Sorry it took me so long but I finally really read your article (I was probably subconsciously avoiding it because I'm public enemy number one on this one). Anyway i'm planning to go in and see Dr. Paul about breaking up some scar tissue in my shoulders. Is there any other info I should relay to him in order to make sure I have a successful trip and start to resolve my shoulder mobility issue?
    Thanks!

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