A discussion with a patient last week prompted a kick in the ass to get this blog back on track. He wanted to continue exercising at the gym even with his recent onset of low back pain. This is not another post regarding how sit-ups are bad for your back - a quick google search will tell you why - or how you need to stop exercising if you have any sort of injury. I recommend patients continue to train with specific guidelines to prevent the exercise from making the injury more complex.
The patient stated he continued to go to the gym but performed all exercises seated to protect his back. I explained that seated exercises typically increased strain and pressure to the spine. The chart above shows how sitting upright can increase spinal pressure by 50%. Increasing flexion while seated nearly doubles the effect of gravity on the spine. This can often be experienced by patients that have pain moving from a seated position to standing. Typically, a quick flexion extension motion occurs when they “ramp up” the body to stand.
Adding resistance training to a seated position will further increase spinal pressure. Hips, knees, and ankles joints share the load while standing. The supporting musculature of the lower extremities also become more active. Often times a degree of flexion and extension occur throughout a lift. If the lower body is no longer involved, the motion occurs mainly throughout the spine. This motion increases shearing forces on the spine and interspinal discs.
Pain and most injuries typically do not restrict all forms of activity. Some exercises or positions will be restricted due to the increased risk of complicating an injury. Low back or spinal pain can greatly be affected by performing exercises in positions that are not sparing to the body. When in doubt, perform exercises standing vs. seated to limit increased stress to the spine.