A large proportion of the people I’ve been coaching over the past few weeks have been dealing with back pain, so my Stuart McGill text books have been getting some serious use! The vast majority have been referred to me by the physicians and therefore will have gone through clinical tests and MRIs and I will receive a heads up of what has been found e.g. L4/L5 disc bulging or muscle fat infiltration. To have this kind of information before working with someone with a bad back is invaluable and massively helps me get an idea of where to look for any issue.
I can then get to work and evaluate the way each persons moves and look for a culprit for the pain. I have my progressions for what I want each person to be able achieve alongside supplementary work where necessary e.g. mobility work. They will then work through their training plans and come back for additional work to do. It seems to be working pretty well so far, I’ve learned some lessons though.
If I give someone work to do, let’s say 20 mins per day, they do the exercises perfectly. Brilliant. Let’s also say they sleep 8 hours. That leaves 15 hours 40 mins where they’re sitting, standing, moving and lifting. You can have the best exercise progressions in the world but if their day to day posture is junk that back pain isn’t going to shift. I now place much more emphasis in the first couple of sessions reinforcing this in order to set those postural foundations.
As S&C coaches we’ll talk about good habits in our athletes. Diet, sleep and recovery are all important but posture is vital. It’s a big ask of the 3/4/5 hours work in the gym per week to work against 100+ hours of protracted shoulders or anterior pelvic tilt.