At one time or another, about 80 percent of Americans suffer from some kind of lower back pain, research has shown. Eighty percent — it’s a staggering number. To ensure you’re not in that majority, you need to get out ahead of the problem. The fact is, it’s far easier to prevent an injury than treat one. Here are three tests that will help you pinpoint the weaknesses that lead to back pain.
Back Extension Test
The back extensor muscles attach to and support the spine. If your extensors are weak, it can make standing, maintaining an upright posture, and lifting difficult.
- Lie facedown, and extend arms out in a "T" position with thumbs up, squeezing shoulder blades down and back.
- Draw in belly button (this will prevent you from compensating with your pelvis).
- Keeping chin tucked, lift chest up off the floor and hold as long as you can while maintaining a flat back.
- Ideally, you should be able to hold this position for at least seven seconds. If not, it indicates your back extensors are weak.
The Fix: Build strength by practicing this test until you build up the endurance to maintain the position for more than seven seconds.
Standing Flexion Test
Muscle tightness along your spine can hinder movement and lead to injuries like disc herniation, vertebral fractures, and nerve compression. The standing flexion test is a way to determine if your spine is moving the way it should, and if not, what area you need to focus on.
- Stand up straight with feet shoulder-width apart.
- Bend forward at the waist as far as possible without bending the knees; first round the neck, then mid back, and then lower back.
- The goal is to reach the toes with a uniform curvature of the spine; if your back appears to be flat in a certain area, that means you have tightness and need to increase mobility.
The Fix: Foam Roller Thoracic Extension
- Lie faceup and place a foam roller under your mid-back. Bend knees and plant feet on the ground to support your lower back. Place hands behind head, keeping elbows close together.
- Arch your upper back up and roll the foam roller down your back, then return to your start position. That's one rep. Repeat for 10 reps, moving up or down the spine toward any problem areas.
Mid-Back Rotational Test
This indicates how well you can stabilize your trunk by testing your mid-back extension and rotation. Poor stability during movements can create a spine, joint, or disc injury in your cervical or lumbar spine. There are two versions of this test.
Test One: Traps and Rhomboids
- Kneel, sitting all the way back on your heels.
- Bend your upper body forward and place forearms on ground.
- Place your right hand behind your head, while keeping left forearm and hand on floor centered in front of knees. Rotate your right elbow toward the ceiling. You should ideally be able to get 50 degrees of rotation from the ground to your collarbone. Perform on the opposite side and compare both sides.
- If you have trouble rotating to 50 degrees, you may be tight or weak in your lower traps, middle traps, and rhomboids.
The Fix: Lat Pull-Downs, Kneeling
- Use resistance bands or a cable resistance machine.
- Kneel on a pad, chest upright, shoulders down and back, abs engaged, feet hip width apart behind you.
- Lead with elbows and pull down until your elbows form a 90-degree angle, forearms parallel to the ground.
- Keep arms and elbows close to body throughout exercise.
- Hold for a count and repeat for three sets of 10 reps.
Test Two: Lats and Obliques
- From the same kneeling position, place right hand and forearm behind back, while keeping your left forearm and hand on the floor centered in front of your knees.
- Rotate your right shoulder toward the ceiling. You should be able to get 50 degrees of rotation. Perform on the opposite side and compare.
- If you cannot do this version, it indicates you might also be tight or weak in your lats, intercostals, and obliques.
The Fix: Standing Rows with External Rotation
- Anchor a resistance band at chest height and hold the ends with arms extended, palms up, standing with your feet shoulder width apart.
- Draw belly button in and tuck in tailbone to rotate hips back. Maintain a slight chin tuck.
- Pull the band toward body, squeezing shoulder blades down and back, elbows tucked in at your sides.
- Repeat for three sets of 10 reps.
David Reavy, founder of Chicago-based React Physical Therapy, is the creator of the Reavy Method, a whole-body approach to physical therapy and exercise. Reavy works with numerous pro athletes from the NFL, NBA, MLS, and the WNBA.