When people come to me with back pain they often talk about strengthening their back. The thing is a ‘weak’ back is rarely the cause of lower back pain. After all, there are plenty of strong people who have bad backs and plenty of weaker people who don’t.

But if that is not the answer to back pain, what is?

As with many things, it’s more complicated than you might think.

Lower back muscles: what is strength?

The strength of the lower back muscles is the force or tension that a muscle, or more correctly a muscle group, can exert against a resistance in one maximal effort. By maximal effort we mean using the greatest amount of strength they can use at that one time. But when we’re talking about back pain that happens over a period of time, there has to be more to it than a problem with that one-time strength.

To try to understand it we have to look at the function of the muscles.

What is back pain?

Put simply, back pain is pain that originates from the lower back. Sounds simple, d...

Do you struggle to get down far enough when you squat? Do you feel restricted when you’re deadlifting, doing particular movements in the gym or simply as you’re moving around in everyday life?

It could be that you have tight hips.

How can you tell if you have tight hips?

If you are suffering with tight hips, the first thing you’ll notice is muscle restriction. You may feel that your muscles are unable to move or flex as much as you want or need them to. You can tell this by simply sitting on a bench and actively rotating one of your hips externally.

1. Turn your hip out to 45 degrees.
2. Take that a step further, so by lifting your foot the bottom of your leg runs parallel to the floor. In order to do this you should use your hands to lift your foot into position. This is called a passive movement.

You should be able to lift your foot higher with the aid of your hand than you can by trying to do the movement actively. If you can’t, that indicates your hip is tight. I.e. the muscle...

I may have said in the past that the biggest mistake people make when treating lower back pain is using exercise. However I’m about to contradict myself. There is a time and a place for exercise in lower back rehabilitation and it’s all about creating a stronger biological scaffold to help support the spine during the rigours of everyday life.

Understanding pain triggers before introducing exercise

All manner of daily activities can cause stiffness and pain in the back. So our first step is to work out what it is that is triggering your pain from an everyday perspective? Can you sit at your desk and be pain free? Can you go to the shops and lift your shopping bags up pain free?  We need to work out how to manage the movements that are causing a problem.

Once we’ve got to the bottom of these we can start to understand how we build exercises that help rather than causing further issue. The aim is to reduce pain and build endurance. In the video tutorial above I share some images with ...

I often talk about the importance of building strong and healthy muscles to protect the lower back and avoid pain and injury. But just which muscles am I talking about here and how exactly do they do their job?

Which are the key lower back muscles?

In the tutorial above I focus on two muscles – or groups of muscles – longissimus and iliocostalis, part of the erector spinae muscles, which go all the way from the tail bone up to the back of the neck.

Longissimus – this originates down on the sacrum, iliac crest and the spinus and transverse processes of the lumbar spine. These are the bony projections that stick out diagonally from the back of the vertebrae. The longissimus travels all the way up into the thoracic spine and inserts onto the ribs.

Iliocostalis – this starts down in the same area, from the sacrum, iliac crest and also the thoracolumbar fascia, like longissimus it inserts up into the thoracic spine and out onto the ribs.

As I want to concentrate on the lower back in t...

When it comes to rehabilitating the lower back, there’s a huge amount of information out there. Some of it is valuable, some should be used with caution, and some is just plain wrong. The problem is, that if you try something that’s not recommended for you, it might be that it just doesn’t work, or you could actually exacerbate the problem and make it worse.

That’s why I wanted to do a tutorial that busts some of those commonly held myths about treating low back pain.

MYTH 1: You have to strengthen the muscles of the torso

You might think this one is a slight technicality, but to me it’s important how we define ‘strengthen’ in this context.

If you’re struggling with lower back pain, the last thing you want to do is go to the gym and overwork or fatigue those back muscles by trying to build up the amount of weight you’re able to lift, push or pull. Instead you need to build up the endurance of those core muscles so they work to protect your back.

Let’s take a step back.

There are ...

Wondering about the process we’ll follow if you sign up for the How to Overcome Lower Back Pain consultation and the online course? Here I’ll go through the process in detail and explain how it worked for one recent client, Beth (not her real name.)

An overview

1. Questionnaires are filled out so I can get an idea of what’s been going on.
2. Consultation over Zoom or similar to allow me to find out more.
3. Advice and recommendations to help overcome your lower back pain.
4. Online support for 2 weeks to answer any questions or clarify understanding.
5. Results and discussion about next steps if required.

Let’s take a look in more detail.

The initial questionnaires

Click through here, enter your email address and you’ll be sent an email with the initial and consultation questionnaires.  I’ll be in touch by email, within 24-hours, to book in your 45-minute online consultation.

The consultation questionnaire provides the information I need to know about your lower back pain, so I’ve got a...

When it comes to exercises for lower back pain, there are plenty to choose from, but how do you know which ones are right for you?

Some exercises can help lower back pain and some can hinder it, it all depends on your situation, but arming yourself with information about how each exercise works anatomically is a great place to start in working out which will be most effective.

Why are some exercises better than others for low back pain

Different exercises will require your body to undertake distinct movements, each bringing different muscles into play and exerting force on your spine and other joints. This can be in the form of compression, over extension or ineffective working of the muscles. To get the most out of any exercise you perform, your goal should be to maximise muscular activity while reducing the risk of further injury.

In this tutorial we’ve chosen to compare the Bird Dog and the Back Extensions, two commonly selected exercises for lower back strength and rehabilitati...

The floppy push-up, or McKenzie press-up, as you might have heard it called, is an exercise that is often prescribed as a way to help overcome low back pain. There are good anatomical reasons why that is the case, however, there are also limitations that it’s important to understand before you decide whether this is the right approach for you.

 What is the McKenzie floppy push-up?

To perform a floppy push-up, first lay down on your front. With your hips touching the floor, gradually push up onto your hands, bringing your head and chest upwards away from the floor. You’ll notice you’re creating an exaggerated curve in the lower spine and it’s this that physiotherapist Robin McKenzie, advocate of this approach, claimed could have a positive impact on lower back pain.

And he was right, to a point.

To explain, we need to turn to anatomy.

The anatomy of a disc bulge

The floppy push-up is said to help reduce the pain caused by disc bulges and herniation, so to understand this we need ...

McGill’s ‘Big 3’

Thanks to years studying the spine, Dr McGill has identified three specific exercises that work together to effectively rehabilitate the back and build core stability. Known throughout the industry as ‘the Big 3’, these are some of the first exercises reached for by people and professionals alike when trying to overcome lower back pain.

In this tutorial, however, I want to explain why I think there’s more to it than that.

What do I know?

I’m not trying to be controversial, or to negate the work Dr McGill has done. I use it with people with lower back pain all the time, so I have a good understanding and appreciation of it. But we do have to understand the context in which we’re doing the exercises and make sure we don’t build them up to be something that they’re not.

I’ve read all four of Dr McGill’s books, I’ve completed his level one foundation course, his level two course on assessing lower back pain and his level 4 performance course. And I’ve interviewed him ...

Have you ever thought about how hard your spine has to work? It allows you to stand and bend. It enables you to walk and move around. In fact, it’s integral to almost every movement you do. And if you suffer with any degree of pain in your spine, you’ll know it can be really quite debilitating, impacting on large parts of everyday life.

Unfortunately, as we age, our spine starts to degenerate and weaken, leading to ‘wear and tear’ of its various parts. In today’s tutorial I want to talk about one such issue that can crop up, the bulging or herniated disc, as well as exercises I advise (and don’t advise!) you to do to aid recovery.

What are spinal discs?

Your spine is made up of 33 vertebrae which are split into five different categories, or types, depending on where they sit and how they behave. The lowest nine, around the tailbone or sacrum, are fused together, however the remainder, from the lumbar region upwards are separated by spinal discs. These discs have a hard, fibrous wall...