My Back Feels Weak! by Eric C. Bull, PT, DSc, MPT, MMT, OCS
There are several reasons your back may feel weak and not healthy. After the very first time you had back pain, one of the primary muscles which helps to support your spine, the lumbar multifidus, changes from muscle to fat. There is nothing you can do about this at the first terrible onset of the pain as exercising at a high enough intensity to stop the wasting away only makes your pain worse.
The importance of this discovery was that it explained why, when a person has back pain one time, that person is more likely to have back pain again. The lumbar multifidus muscles that change from muscle to fat reduce on average by nearly 1/3 from the size they were before you had pain. The lumbar multifidus muscles are hard to see on yourself unless you look in the mirror at your low back, so it is not normal to notice that they have wasted away. Even if you stand and look at your low back in a mirror, unless you are very very skinny, it is hard to see these muscles as they are very deep and about the size of a tootsie roll.
In thinking about how these muscles waste away, it can be comparable to injuring your knee. Can you imagine hurting your right knee to the same intensity of pain as how bad your low back feels? Could you then imagine that your right thigh muscle (quadriceps) would start to waste away as compared to your left thigh muscles over the course of a couple weeks? Just from the pain alone your right thigh muscle would start to not look as healthy as the uninjured left one. Now imagine that this goes on for several weeks! You would be able to see the difference easily between your right thigh and left thigh, the injured and uninjured sides. That is exactly what happens in your Low Back!
In reality, the majority of the population do nothing the first time they hurt their low back or knee. So now, you are walking around with one leg or one side of your low back weaker than the other. Going back to the knee comparison for a second, 3 months later let’s say you have no knee pain, but you go to climb a flight of steps, can you imagine that the right knee injury and wasted away muscles on the right side? Can you believe that this is exactly because the right knee did not have the strength of complete that task without re-injury.
Back to your back. Now your low back has the exact same thing happen. You have an injury to your low back which produces pain and specific muscle wasting. The pain goes away over time, but you unknowingly have a weakened low back. You goto do something but your low back does not feel quite right and you are cautious. This is your weak low back trying to communicate to you to do something about it.
The great news is that there is a very specific group of exercises that can be done to exactly target increasing the strength of those weakened low back muscles, and no they don’t show this to you on infomercials. If you have allowed your pain to go on too long. If it is keeping you from being healthy and doing what you want. If you are fearful it is worsening, then make it stronger.
