Description:
Kevin R. Stone, M.D., in San Francisco talks about some
common low back problems that we see, particularly in our rowers
and our cyclists. 4:58 minutes/4.5MB |
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The most important feature of low back pain in our rowers, on the crew,
and our bicyclists appears to be weak abdominal and core strength. So,
while back pain is an enormously broad subject and, by no means do I mean
to cover all of the variations of back pain or the diagnostic implications,
some basics that we focus on are, if an athlete comes in with low back
pain and has no radiation, meaning no numbness or tingling going down their
legs or weakness in their legs that would indicate a nerve injury or a
disc compressing one of the nerves going to the lower extremities, if they
are just having low back pain that is preventing them from enjoying or
doing their sport, then most commonly, when we examine these patients and
these athletes and test their core strength, their abdominal muscles, their
transverse abdominal muscles, their gluteus muscles, the muscles in their
low back, the muscles in their buttocks, and the muscles in the top of
their thighs, we find that, when specific testing is done, they have very
weak core muscles and it is these core muscles that help support the back.
Now,
you might wonder, a rower is using so much musculature to pull the blade
through the water or a cyclist, especially a professional cyclist who is
riding and driving a bicycle up and down mountains, wouldn’t
they have strong musculature in the top of their legs and in their low
back? The answer is no for many of them and the reason is that, if you
look at a cyclist, they sit in that flexed position, where their abdominal
muscles and bellybutton point to the ground and they do not contract their
abdominal muscles when they pedal the bike. If you look at a rower with
modern rowing technique, many of them keep their shoulders ahead of their
hips instead of permitting their shoulders to move past their hips. Therefore
their abdominal muscles stay in flexion and, while they are using strong
leg muscles and strong upper back muscles their abdominal muscles stay
in flexion and stay weak and therefore they pressure completely through
the low back without having any muscular support to support the position
of the back and protect the back, ligaments, and disc from overuse and
injury.
These low back pains are probably frequent in other athletes, other
sports, in workers, and in people who sit in their chairs. Think about
how you’re sitting right now and think about where your bellybutton
is. Now, for just a minute, suck in your bellybutton. Feel what that does
to your abdominal muscles. And, if you’re sitting, if you try rolling
your pelvis forward and then suck your bellybutton or abdominal muscles,
you can feel how you straighten your upper back. Then if you bring your
shoulders a little bit behind your hip joint, you will find you are sitting
quite straight and upright, probably just the way your mother used to tell
you to do. That position is a neutral balance position and, if you can
learn to sit like that, and learn to carry yourself like that, and learn
to play your sports like that, then the incidence of low back pain will
decrease.
There is a long series of creative back exercises that our rehab
team has come up with in order to help people strengthen their abdominal
muscles. We have posted these at www.stoneclinic.com. I strongly encourage
you to look at these exercises and to think about strengthening your core
muscles. If you do so, you will have a lot less lower back pain.
The Stone Clinic in San Francisco concentrates on returning injured people
to their active lives, fitter, faster, and stronger than they were before.
The Stone Clinic includes Dr. Kevin Stone, physician and surgeon, a staff
of physical therapists, and an x-ray and MRI facility. Our specialties
include the treatment of joint injuries and arthritis with leading edge
surgical and rehabilitation techniques. Elite athletes and everyday people
alike come to The Stone Clinic from around the world for the best in orthopaedic
care. The Stone Clinic is located at 3727 Buchanan St., San Francisco,
CA 94123. For more information, please call us at (415) 563-3110. |
