145 A Christian Guide to Body Stewardship, Diet and Exercise In addition to activities susceptible to poor posture, certain strength training exercises can, in some cases, also serve as an agitator for low back pain. This is especially true with exercises that directly load the spine (e.g., squat), require a bent body position (e.g., row) or use a twisting motion (e.g., Russian twist). In fact, any exercise that involves a significant amount of compression, shear or torsion force on the spine can increase the risk of damaging the intervertebral discs thereby resulting in low back pain. These risks are compounded when using heavy weight and/or the exercise is performed incorrectly. Figure 7.13 depicts the three major forces that can cause intervertebral disc damage. Figure 7.13. 3 Forces Capable of Causing Intervertebral Disc Damage While it may be appropriate to discontinue the use of some exercises (e.g., Russian twists), it is likely not necessary or recommended for other exercises (e.g., squat, row). Instead, use a slight modification with a similar but different strength training exercise and/or use lighter loads in order to reduce the risk of injury and prevent low back aggravation. For example, if an individual with chronic low back pain wants to incorporate the squat into their training regime, they could employ either the front squat, goblet squat or Bulgarian split squat instead of the back squat. All three of these exercises require lighter loads, which in turn reduces the magnitude of compression forces on the spine. Additionally, individuals wanting to incorporate the deadlift could elevate the bar several inches off the floor by using blocks or a trap bar. In both cases, proper execution requires a more vertical body position thereby reducing the magnitude of shear forces on the spine. Finally, individuals wanting to incorporate power exercises could employ hang cleans instead of power cleans in order to avoid the higher risk phases of movement. Techniques for Assessing Posture Posture plays a major role in both the prevention and cause of low back pain. Because of this role, it may be a good idea to periodically assess posture and make any necessary corrections. Two of the more common tools to assess posture include the two-hand rule and belly-whack test (Starrett, 2015). To perform the two-hand rule, place one thumb on the xiphoid process (sternum) and the other thumb on the iliac crest (top of the pelvis) with the fingers spread and palms facing down and parallel with the floor. When the spine is in a neutral position, both hands are parallel.
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