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The World's Premiere Nordic Skiing Publication Volume 21, Issues 1

A Balanced Life
Lower Back Pain?
Don't back away from exercise

Cross-country skiing, whether classical or skating, is a great, low risk way to stay in shape. That's because its smooth movements, which engage muscles in both upper and lower parts of the body, deliver high cardiovascular rewards without the awkward twists and torques of other aerobic sports. It also burns 600 to 900 calories an hour.

Unfortunately, for many skiers there

is one annoying drawback. That is, an aching back.

Exertion, poor technique or spills can give skiers -- and enthusiasts of many other sports --aches and pains in the lumbar region.

Jane Brody, the Personal Health columnist for the New York Times, once devoted an article to the pleasures and benefits of cross-country skiing. In it, she pointed out that "low back pain can be a problem, especially among skiers with weak abdominal muscles."

Lower back pain (LBP) is the bane of fit, unfit and overweight folks, according to an August 2001 article in The Physician and Sportsmedicine. "LBP is second only to the common cold as a cause for primary care office visits, and direct medical costs exceed $25 billion per year," Drs. Jonathan A. Dresner and Stanley A. Herring wrote.

Human anatomy and biomechanics are mostly to blame. The lumbar spine commands flexing, tensing, extending and rotating through three vertical muscle columns, each with its own specialty. Any two movements (i.e. gliding and pushing) at the same time can carry the potential for injury, especially when done repetitively, as most sports require.

The result can be strains, sprains, microscopic tears or muscle fatigue in the lower back, all of which add up to aches and pains that can be acute to chronic, distressing to debilitating.

The good news is that ninety percent of LBP cases clear themselves up within six to 12 weeks, experts say.

So, what to do if you have LBP?

First, go to a doctor to identify the cause. Injury to muscles, ligaments, nerves, disks or the spine may be responsible. Overuse of back muscles or other structural problems, such as a herniated disk also could be involved. Though identifying the cause of back pain can be an inexact science (an MRI won't always identify a cause), a physician's diagnosis and care is important.

The next step is physical therapy -- not bed rest, as so many doctors once prescribed. Recent studies show that stretching and gentle exercise help reduce LBP. Better still, exercise can protect against future occurrences.

Whatever the source of low-back pain, "exercise is likely to be a part of the solution," says an article in the Feb. 2002 edition of the University of California, Berkeley, Wellness Letter. The article adds, "Don't think that you can stop exercising when your back pain goes away. Continuing to exercise will help keep your back healthy."

If there is any relief of pain to be found in bed, doctors nevertheless advise keeping periods of bed rest short.

"Bed rest should be limited to no more than two days for nonspecific LBP," Dresner and Sportsmedicine article. "Prolonged inactivity produces a number of deleterious effects, including decreases in muscle strength, flexibility, cardiovascular fitness, bone density and disk nutrition," with no corresponding improvement to recovery rates.

Thus, once the pain subsides, therapeutic exercises should begin. They restore functioning and promote a safe return to activity. Your doctor or physical therapist will show you which exercises are right for you and suggest how often to do them and in what repetition increments.

The program likely will include exercises to stabilize the spine and condition lumbar muscles. They may include arm and leg reaches from a tabletop position, with knees and hands on the floor, as well as stretches that focus on reducing tightness in the hip flexors, hamstrings and lumbar area. Those activities may include curling both knees toward your chest while keeping your lower back to the ground).

Also, an exercise called the bridge frequently is suggested to strengthen your lower back. To do it, lie on your back with your knees bent and feet flat on the floor. Then, tightening your abdominal and buttocks muscles, slowly lift your hips while keeping the lower back straight, forming a "bridge."

Don't forget to stretch and strengthen your abdominal muscles, which do so much to support the back. For this, doctors recommend pelvic tilt repetitions, in which you pivot your pelvis up by tightening your stomach muscles, pushing your lower back against the floor. Partial sit-ups with both knees bent will keep both LBP and G-U-T away, it is said.

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