Although lower back pain is a very common aliment, the spine is actually a remarkably robust structure. The majority of low back pain episodes are mechanical in nature, meaning that either the muscles, ligaments, or joints are irritated leading to pain. Occasionally the sciatic nerve is involved, either because of a disc herniation or piriformis muscle spasm, leading to pain and numbness down the back of the leg. If this is the case, head over to our post specifically on sciatica since the post will focus on mechanical low back pain.
The treatment of mechanical low back pain involves: (1) mobilizing the hips, (2) stabilizing the core, and (3) mobilizing the mid-back. The rest of this post will discuss why these areas of the body are targeted and which exercises can help Ultimate players overcome lower back pain.
Mobilization of the hips
The hips are a ball and socket joint, which means that they were designed to move. With all of the sudden changes in direction and quick pivoting movements in ultimate frisbee, it is important to have good mobility in the hips to avoid putting additional stress on the low back. If the hips are too stiff to accommodate the quick movements in ultimate, the body will compensate by moving at either the lower back of the knee (neither of which are well designed for these rotational movements). Here are three exercises used to mobilize the hips:
Self-myofascial therapy on the glutes
To perform: start by sitting on the foam roller at a 45º angle. Cross the leg of the glute you want to foam roll and slowly roll from your belt line to the top of the hamstring for 30-45 seconds.
Tactical frog (Internal hip rotation)
To perform: begin in a quadruped position on the floor. Rock your body forward and rotate your foot away from your body. Then rock your body back towards your feet and repeat on the other leg.
90/90 mobility (External and Internal Hip Rotation)
To perform: begin on the floor with your hips and knees bent to approximately 90º. Slowly lift the knee of your back leg and rotate to the other side (opening up the hips). Then slowly move your other leg so that you end in a mirror position of the starting position.
Stabilization of the core
It shouldn't be a surprise that strengthening the core muscles is included in the treatment of mechanical low back pain. The basic core exercises (planks, side planks, glute bridges, etc...) are useful in strengthening the core muscles, however, the demands on the core in ultimate frisbee are a little different than in other sports.
In ultimate frisbee, the core muscles need to be able to stabilize the low back at the end ranges of movement. The three pallof press variations below strengthen the core muscles when the body is not in a neutral position.
Basic core exercises (planks, side planks, glute bridges, etc)
Ultimate frisbee specific exercises
Pallof press at end range
To perform: anchor an exercise band behind you then rotate your body keeping your feet planted. Press your arms out directly to your side. Repeat for 10-15 reps and then switch sides. You can also reverse the anchor so that it is in front of you to work the core muscles in a different position.
Pallof press with shoulder flexion
To perform: repeat the same set up as the pallof press exercise above but instead of pressing directly out to your side, you will move your arms in a vertical path up and down. Try to isolate all of the movement to the shoulders, the rest of your body should remain still.
Pallof press with lateral lunge
To perform: anchor an exercise band to your side. Lunge to your side, keeping your chest upright. Press your arms out in front of you and repeat for 10-15 reps, then switch sides. You can also add in the shoulder flexion movements to this exercise to increase the difficulty.
Mobilization of the mid-back
Similar to the reason why we mobilized the hips, it is important to have a mobile mid-back to allow twisting and turning without place too much torque on the lower back. When the mid-back is stiff and locked up, the lower back compensates to allow for twisting and rotating which places additional load on the back.
Mid-Back Foam Roll
To perform: start by lying on the foam roller with your arms crossed across your chest (you can also place your hands behind your head for support if you neck gets tired). Slowly roll from the bottom of your ribcage to the top of your midback for 30-45 seconds.
Windmill on Foam Roller
To perform: start lying on your side with your knee placed on a foam roller. Slowly reach your top hand overhead and around, letting your top shoulder rotate towards the ground. Do not let foam roller roll with you, as this will mean that your low back and pelvis are rotating with you.
In summary, mechanical low back pain is treated by mobilizing the hips, stabilizing the core, and mobilizing the mid-back. Most episodes of mechanical low back pain resolve in 4-6 weeks, but there are many factors that influence this timeframe. If you are having difficulty deciding which exercises you should be doing or have a case that is not resolving, a qualified healthcare professional can help figure out what the best approach is for your specific case.