Tuesday, September 3, 2024

Managing Lower Back Pain: Insights from an Athletic Perspective

In this post, we’ll explore the specific muscles involved in chronic lower back pain, discuss how inspiratory muscle training can make a difference, and review the findings of a recent study that sheds light on these connections.

The article explained in this post is titled, “Inspiratory Muscle Training in Rehabilitation of Low Back Pain: A Randomized Controlled Trial”. This article shares results for combating Chronic Low Back Pain (CLBP) using Overhead Squat Exercises and Inspiratory Muscle Training. The tests the scientists used were static and dynamic overhead squat assessments. All the participants of this study performed these assessments before and after the 8-week Inspiratory Muscle Training protocol.

Limitations

This study  does have several limitations in the design of the experiment. These limitations may make the results of this study only applicable to the following specific group of people: athletic men and women between the ages of 18 – 25. “Athletic” here refers to - weightlifting and powerlifting athletes with Chronic Lower Back Pain (CLBP) who had exercised for at least 3 years, 3 times per week, 75 minutes per session. Another limitation was the sample size of the study. There were 47 people (23 male, 24 female) in the study split into two groups, an experimental and a control group.

Muscles Involved

When it comes to CLBP, several muscles are involved and can be potential causes of aggravation. It is known that CLBP is caused by an obvious weakness in the core and trunk muscles. This can lead to impaired breathing, increased pain, muscular imbalance, and spinal instability. These symptoms can significantly impact your daily life by making movement and breathing more difficult, increasing your risk of injury, and reducing your overall quality of life. While they aren’t typically life-threatening, they can lead to chronic discomfort and limit your ability to stay active if not properly addressed.

The transverse abdominis muscle in particular is more active during respiration than the other muscles such as the rectus abdominis and internal and external obliques. In this study, the focus was on changes in the erector spinae, multifidus, transverse abdominis, and rectus abdominis muscles due to the training protocol.

Inspiratory Muscle Training

Inspiratory Muscle Training (IMT) typically involves the use of a specialized breathing device that, in some models, comes with different resistance settings as one strengthens their respiratory muscles. These muscles include the diaphragm and the intercostal muscles. The relationship between the diaphragm and the core muscles in this article isn’t immediately obvious.

When you inhale deeply, the diaphragm contracts and moves downward. This creates a cavity in your thoracic region and pushes the abdominal organs outward. This pressure acts as a brace for the spine during deep breathing. CLBP weakness or dysfunction in the diaphragm can lead to compensatory patterns where muscles, specifically in the lower back, overwork to stabilize the spine. Strengthening the intercostal muscles also contributes to better posture and reduces compensatory strain on the lower back.

In the next section I will break down the results of this experiment under this training protocol. If the general assumptions of the impacts of IMT lean more towards truth, then we should see improvements in a participant’s muscular balance, core muscle coordination, reduced stress on the lower back, and potential pain relief.

Results

The study found that the outcome of IMT was an increase in core muscle activity in both the static and dynamic overhead squat test. They found a statistically significant decrease in muscle activation in the erector spinae and rectus abdominis muscle. And a statistically significant increase in muscle activation in the multifidus and transverse abdominis muscles.

To break that down a bit more, after the 8-week training protocol, activation of the multifidus and transverse abdominis muscles helped the body rely less on the erector spinae and rectus abdominis.

My Analysis

Keep in mind that this article has quite a few limitations. The sample size is relatively small. The ages of the participants are in the young adult range. The participants also didn’t have any known health deficits and had trained for at least 3 years. This is a very specific study, that most people may not be able to relate to. But the science and potentially positive effects of a protocol like this can be beneficial to people who might be interested in trying it.

The right breathing technique should be utilized. That’s a known element that has become increasingly popularized in recent years. You don’t have to be a cardiovascular nut to breathe properly.

Full use of the core is also an important element in overall body fitness. You should try incorporating some crunches or core related exercises in your workout plans. It may not reverse lower back pain, but it will at least improve trunk stability, posture, and general everyday activities like bending, twisting and standing up.

What About You?

Have you ever struggled with chronic low back pain? How has it impacted your daily life? Do you think incorporating inspiratory muscle training could make a difference in your own recovery or fitness routine? Have you tried inspiratory muscle training and how has it affected you? I’d love to hear your thoughts and experiences in the comments below.

 

For those interested in exploring the study in more depth, I encourage you to read the full article. You can find it in the reference below.

 

Ahmadnezhad, L., Yalfani, A., & Gholami Borujeni, B. (2020). Inspiratory muscle training in rehabilitation of low back pain: A randomized controlled trial. Journal of Sport Rehabilitation, 29(8), 1151–1158. https://doi.org/10.1123/jsr.2019-0231

 

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