Here’s one of my favorite series of exercises for low back pain.
We are going to be talking about using a medicine ball, which seems a little bit odd when you’re talking about people with low back pain, but it is actually one of my very favorite ways to improve back pain through neurology.
Whenever we talk about low back pain, one of the things we discuss over and over and over from a brain based perspective is that there are three types of movement that our brains constantly having to deal with.
One is reactive. I’m moving through the world. Something happens, it perturbs me. I have to be able to correct for that so I don’t get injured. Secondly is voluntary. And this is what all rehab and exercise basically looks like where I’m telling people to, Hey, do this movement and our brain makes a picture of it and we try to enact that movement. And then we have number three, which is the movement that happens before that, before the voluntary. And that is called anticipatory postural control.
Whenever we think about any kind of movement, our brain begins initiating tensions in our body to protect us and keep us upright before we begin any motion. Unless we’re hit from the side by our crazed pit bull or whatever like mine, when I’m not paying attention, our brain says, Hey, I want you to bend down and pick up that medicine ball. Before I begin doing so, it will begin to adjust muscle tensions throughout the body in order to keep me safe. And that’s all based on how well my brain is able to predict what I’m about to do.
Now, when we look at that neurologically, these anticipatory postural controls are primarily driven through a part of our brain called the supplementary motor area. And the supplementary motor area does lots and lots of cool stuff, but it helps coordinate bilateral activity in the body. And it helps initiate precise anticipatory postural control before we move.
Now, whenever it comes to fixing low back pain, which is what I’m talking about in this context, we have to not only deal with the reactive and the voluntary, but we really have to spend time focusing on improving the anticipatory control. So the question then becomes, how do we do that?
Now, before I answer that, if you are a movement professional, a doctor, a therapist, a coach of any kind that deals with movement from Pilates to yoga to martial arts, to, you know, I don’t know, track and field or fencing or tennis or whatever, or you are a personal trainer, you work in any kind of movement field and you’re interested in bridging what you’re awesome at with applied neuroscience, go to the pinned comment, click the link to email us or set up a call because we’d love to talk with you.
So now let’s talk about how to improve anticipatory postural control, particularly on your own. Let’s say you have low back pain and people are coming to you for low back pain, but no one’s been able to fix your low back pain. Well, what do you do about it? You improve your APAs. And one of the best ways to do that is to use a medicine ball. It’s a little small eight pound medicine ball. And the medicine balls are interesting because there is cool series of research articles that show that using a medicine ball and doing a couple of hundred throws with it actually can have a pretty profound impact on the amount of back pain that people experience, especially going into the next day, as long as we moderate the amount of weight that’s being used and their general physical condition. But the reason that a medicine ball can be so profoundly useful is this.
If I say, Hey, I’m going to have the ball in my hand, and now I’m going to do a, let’s say rotational throw to the side. Before I make that rotation happen, it forces my brain to do what? to regulate what’s going to happen with my posture. This is much heavier than my arms. So the amount of effort that goes into preparing for the movement is magnified whenever I add a weight to my hand. So if you’re going to use a medicine ball, I recommend that you start light, go two, three, four, five pounds, depending on your physical condition. If you’re a giant, you can go heavier. But if you have low back pain, remember we’re trying to make your brain feel less threatened. So don’t go crazy. The basic process here is pretty simple. I like to have people, again, you can do it against the wall. I’m not going to do it to the camera, but you start off with a two hand chest pass. All right, now why two hands? Whenever we talk about this part of the brain, the supplementary motor area, remember it deals with bilateral motor activity. So I like to use both hands and all these throws.
So if you have a small medicine ball, you may need some a little bit bigger. It doesn’t matter. But you start off with just the basic chest pass, throw it against the wall, let it drop, or if it’s a bouncy one, catch it. So you want to do maybe 20 to 30 reps of the chest pass. And I like to have people do that left leg forward, right leg forward and no legs forward, right? Just in a basic stance. Then I want you to do rotational throws. Again, you can start in neutral throw to your left throw to your right. Again, two hands, then go into a left lunge and to a right lunge. Again, aiming for 20 to 30 reps. We’re actually trying to accumulate around 200, 250 repetitions as we go through.
Now, once we’ve done the chest pass, we’ve done the rotation, then we’re going to chop wood, right? So we’re now going to be doing slams where I am taking the ball up to my right, slamming it down to my left, up to left, slamming it to the right. And you try to just let your body go through those motions. And it is perfectly okay to actually release the ball, throw it into the ground. In all of these, it is really, really effective. Whenever we’re making the motion happen, there also is an APA that happens whenever the ball rebounds and we have to catch it. So you have one that’s a little bit more bouncy. Certainly go ahead and try and catch it. But depending on your level of athleticism, that may take a little bit of practice.
So right now, what I really want you to focus on are just these three movements, the forward chest pass, right and left rotational, and then our woodchop patterns. You can obviously get into overhead throws into extension, depending on your specific kind of phenotype of chronic low back pain that may be really necessary. But the idea here is that we’re adding the weight. The reason we’ve added the weight is to make the challenge higher so that my supplementary motor area must become more active. When it becomes more active, voila, my anticipatory postural adjustments happen more appropriately, more accurately, which then improves my voluntary movement, which ultimately lowers threat and allows you to have less pain because your brain knows exactly what your low back is going to do when it is loaded.
That’s a very, very kind of surface level explanation of how this works neurologically, but it’s extremely powerful. So if you have low back pain, if your clients have low back pain, don’t forget about the lowly medicine ball that has been replaced over time by so many cool machines. It’s incredibly powerful, incredibly useful for low back pain. So get one, make sure that you’re using it, just be safe with it.
So again, finally, if as a reminder, if you are a movement professional of any kind, doctor, therapist, coach, you deal with movement, you deal with pain. You would like to blend what you’re doing with applied neuroscience. Go to the pin comment, click the link to email us or set up a call because we’d love to chat with you.
