I
have suffered from periodic bouts
of disabling lower back pain since
my early 20s. I know all too well from
personal experience the feeling of being
unable to straighten up or move without
great pain.
Unfortunately, most everyone suffers
from lower back pain at some time in
their lives, especially as they get older.
There are five vertebrae that comprise
the lumbar spine. The 5th lumbar
vertebra rests on the sacrum, and at
the end of the sacrum is the coccyx.
These bones are held in place by an
interposed network of ligaments,
muscles, cartilage and soft tissue. These
structures hold the vertebrae together,
add stability and allow motion. Between
each vertebral body is a joint formed
by the intervertebral disc. The disc is a
fibrocartilagenous structure that helps
to dissipate mechanical stress and it
resembles a piece of gristle. Severe or
repeated injury or insult can cause the
annular fibers within the disc to herniate
(protrude) or rupture (tear) and cause
intense pain to the adjacent spinal nerves
and surrounding soft tissue.
Mechanical lower back pain is
classified as either intrinsic (postural
and muscular) or extrinsic (pathologic).
Extrinsic causes of lower back pain would
include tumors, infections, osteoarthritis,
scoliosis, and gynecological, prostatic or
renal problems. Extrinsic causes of lower
back pain can usually be diagnosed with
a thorough history and a comprehensive
physical examination. Extrinsic causes
of lower back pain are caused by poor
posture, lack of muscle tone, a weak
core, and instability of the vertebrae or
trauma.
In the past, treatment for a serious
mechanical lower back injury consisted
of traction, bed rest and medication. This
regimen is generally ineffective, and may
have aggravated the situation by allowing
further muscle atrophy due to the
inactivity. In addition, this lack of activity
can have devastating emotional and
psychological consequences on an athlete.
The approach that most doctors now
take is to actively rehabilitate the injured
area. This is done with mild exercise,
stretching, and muscle strengthening
to prevent further injury. The vast
majority of lower back and disc injuries
respond well to conservative care, with
only a small number requiring surgical
intervention.
Unfortunately, pickleball does little to
increase the strength of the abdominal
or core muscles. These abdominal and
core muscles play a key role in aiding
the stability of the lower back and pelvic
region. Adequate strength and endurance
in the core and lower back is vital to
reducing pelvic tilt. Stretching the lower
extremities, especially the hamstrings,
also helps to reduce the pelvic tilt.
FLEXIBILITY AND CORE STRENGTH
Significant contributing factors
to lower back discomfort are a weak
core, tight pelvic, hamstring, calf and
lower back muscles. Stretching and
strengthening these areas will lengthen
and relax the hamstrings, reduce pelvic
tilt and strengthen abdominal, pelvic
and supporting lumbar paraspinal
musculature.
left foot. Lock the knee and contract the
quadriceps muscle group (front of the
thigh). “Climb up” the rope with your
hands and hold for 2 seconds. Return the
left leg to the floor. After 12-15 reps, do
the other leg.
Hip, Gluteal and Lower Back
stretch: Lie on your back and fully
extend the right leg. Bend the left knee
and tighten the abdominal muscles. Grab
the left leg with the right hand and the
thigh with the left hand. Lift the left knee
toward the right shoulder and ground as
far as possible and hold for 2 seconds.
Return to the original position and repeat
12-15 times, then do the other leg.
Lower Back and Pelvic Stretch:
Lie on your back and bring both thighs
up so they are at a 90 degree angle
(perpendicular) to the floor. Place your
arms at your sides and twist to the right
and the left so that the down leg contacts
the floor. Do this 25 times to each side.
Hamstring Stretch: Lie on your
back with the right leg bent. Wrap the
rope around the arch or middle of the
Continued »
DECEMBER 2016 |
MAGAZINE
63