Sunday, November 22, 2020

My prophylactic back exercise routine (updated 11/22/20)

I wrote the original of this post in the early COVID era. Since then I expanded the basement home gym with a way over-specced power lifting squat rack and a full Olympic spec weight set (what I could find, more than I wanted).  I also ran into some minor back strains, perhaps due to on/off COVID CrossFit and more of the age and arthritis annoyances. Between those two developments I've expanded my pre-lifting warmup. I still do the morning stretches and (on non-lifting days) the evening Roman chair, but if I'm lifting I have a more extensive warmup now:
  • Roman Chair 10 reps
  • Inchworm toe touch to push-up then Up/Down dog 10 reps
  • Hollow rock 15 reps
  • Side planks with dips 30 sec each side -- for fun I'm now doing side star planks.
  • Touch toes with rounded back and slow roll-up, repeat with a 35lb woman's barbell. (I think adding weights to this was a bad idea.)
  • Hanging knee/hip rotation 30 reps (Hang from bar, trace figure 8 with knees while flex or extend hips.) 
  • 30 traditional bent knee setups
  • Roman Chair 10 rep with two 15 lb dumbbells held in 90 degree reverse curl
  • Russian twist 30 reps with 15 lb dumbbell (feet off ground)
  • Deadlift 45lb bar 10-20 reps, usually do some Romanian deadlift and good mornings
  • 30 traditional bent knee setups
  • Side twist stretch with a plastic bar to keep arms aligned
  • Roman Chair 10 reps with two 25 lb dumbbells held in 90 degree reverse curl
  • 30 traditional bent knee setups
  • Russian twist 30 reps with 25 lb dumbbell (feet off ground)
  • Deadlift 75-115+ 8 reps standard and Sumo

Then the workout. 

-- Original 5/24/2020
I realized today I've never shared my prophylactic back exercise routine. I'll post it here as a reference. Some editorial comments below.

For 12 years I've done these stretches every morning before I get out of bed, I got them from Physicians Neck and Back Clinic in Roseville MN (click for full size):

I don't bother with the wall lean stretch in morning (see below) and I combine the standing thigh stretch with a freestanding balance exercise of pivoting forward to stretch hamstring.

In the evening I do 30-40 back extensions on a 45 degree roman chair. I use a StrengthTrainer ST45 for over 10 years, it's done well.

The first 10 are unweighted, the next set I use two 15 lb dumbbell, then a set with two 25, then a 25 and 35 (I need more dumbbells). Between sets I do lateral plank with hip dips for 20 sec each side (this was impossible when I started but now the only problem is some right wrist arthritis but if that's bothering me I do a straight wrist fist plant).

The editorial comments

My experience as a physician who treats people with back pain and as someone who has had some success with the problem is that nobody wants to hear that fitness is (almost!) the only fix. I get it, twenty years ago I also thought of this is an unfixable problem too, but at least since 2009 this has been common knowledge. The surprising bit is how much exercise it takes.

My back isn't bulletproof. I've had several episodes of back pain over the past 12 years. The most worrisome was seven months ago and was probably an L5/S1 disc prolapse. That took 6 weeks to mostly heal with diligent exercise and 10 weeks before I could set new CrossFit personal weight lifting records. I think I have some residual left foot extensor weakness (had to switch from low support CrossFit shoes to real running shoes for runs). On the other hand I play ice hockey, do CrossFit Olympic lifts, and basically expect a lot out of a crummy old back.

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