154 Chapter 7: Training for Mobility 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. When the spine is flexed, the hands are closer together. When the spine is overextended, the hands are farther apart. The two-hand rule is a simple method of assessing the current position of your spine and affording feedback as to what adjustments (if any) need to be made. The belly-whack test is another simple method of assessing posture. In essence, proper posture requires a certain amount of tension (albeit modest) from the abdominal muscles in order to maintain a neutral spine. Being able to take a quick whack to the belly ensures you have enough abdominal tension in order to support good posture. Figure 7.14 depicts the proper set-up and
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