Some abdominal exercises can cause back injuries

Certain abdominal exercises are often associated with back injuries for many people. If you’re one of them, you’ve probably wondered what’s going on. It’s a question we answer often enough for patients in our Austin-area physical therapy clinic. And sometimes we share that information with other health professionals.

If you’re in the Austin area and already dealing with an injury, click here or the orange buttons above to request a completely free consultation with anexpert physical therapist. We can quickly figure out what’s causing your pain and keeping you out of the gym without it costing you a dime.

In this video, you’ll see a segment from a presentation Dr. Carter gave to a group of personal trainers. He had been asked why some people hurt their backs doing certain abdominal exercises. Here was the answer.


VIDEO TRANSCRIPTION

(Please excuse grammatical errors, as this is simply a transcription of conversational speaking)

You know in a lot of gyms, I see people trying to do abdominal exercises or being asked to do abdominal exercises that their abs are simply not strong enough to do with good form.

The hip flexors love to get involved in abdominal exercises, especially the psoas. And so on an anatomical level, what happens—especially with abdominal exercises like leg lifts… or planks is a good example. The psoas runs from the inside upper hip and attaches to the lumbar spine at all segments. So it’s not just a hip flexor in that it pulls the hip up, but it pulls from the other direction too. So it’s pulling from the lumbar spine. What it does is it’ll pull you kind of down and into an anterior pelvic tilt or a low-back arch. And so what happens is that if they’re repeatedly getting pulled into that position, it’s compressing all the structures in the low back. And then they end up with pain.

If you have abdominals that are strong enough to counteract that—to create that posterior pelvic tilt so you keep a neutral spine—then you’re fine and there will be no back injuries.

But what I’ve seen is that a lot of people are doing exercises without enough abdominal strength.

Gym equipment and exercises that can cause injuries

In our clinic, we have the opportunity to meet many people who’ve come for help with injuries they sustained while working out. So we have a great window into the types of gym equipment and exercises that are problematic for many. After my presentation, one of the personal trainers in the audience asked if there are there any commonly used exercises or equipment I warn people/personal trainers to avoid.

You can hear my answer for yourself in the video below.

 

VIDEO TRANSCRIPTION

(Please excuse grammatical errors, as this is simply a transcription of conversational speaking)

I hope I’m not offending anyone with this, but leg throws. I feel like with leg throws—where they grab your hands and you’re throwing their legs—in some people, it is appropriate and okay. But I think that it’s pretty limited to probably gymnasts and divers.

I was a diver at Texas, and we used to do that a lot. It was fine for us. But I think the population that can do that safely is really, really small.

There’s just so many great ways to strengthen the abs, it’s like, why use things that put people under so much strain? To have that kind of a force going down, your abs have to be so strong to keep from going into that back hard.

So that would be one. And I didn’t see this gym equipment here—don’t think you have it. Do you have the seated machines where you sit and you crunch down on a bar?

I’m sorry to say this, but I would probably sell it for scrap. Because when you… and again, I hope I’m not offending anyone, but I’m glad we’re talking about this because this would be a good thing to spread the word. As compared to lying and standing; when you sit, the pressure—and they’ve measured this in studies—through  the lumbar discs is astronomically higher when you’re sitting.

And you know if you add if you add flexion to that, and then you kind of…. If you guys know much about the disc, the outer part of the disc is tough. It is what keeps the gel inside, but if there are any kind of tears or weakness to it, it’s usually going to be on the back side because of posture and the things that we do. So that gel is kind of pushed to the back.

If you’re sitting with that compression and then adding a weighted flexion into it with all that abdominal pressure, it’s a recipe for disaster if someone already has any kind of bulging disk or something like that. Quite often people have bulging discs with no pain at all. They don’t even know they’re there. Someone’s like thirty-five, pretty fit. You do an MRI, and their back looks terrible. And they’re just like a ticking time bomb when you’re doing that kind of stuff.

There are so many ways you just can put a weight on their chests and have them do it on the ground as a crunch. Also with rotation, you have the compression and then you have a shear force, and that’s a really good way to tear a disc as well. So i would really avoid those two machines and if you see other people using them I would warn them about it and explain why.

If you’re in the Austin area and already dealing with an injury, click here or the orange buttons above to request a completely free consultation with anexpert physical therapist. We can quickly figure out what’s causing your pain and keeping you out of the gym without it costing you a dime.

How P90X can cause back injuries

We help lots of patients to overcome their injuries with a variety of physical therapy techniques. During my presentation for personal trainers, I was asked about P90X. Here’s my reasoning for why some exercise programs can be dangerous.

VIDEO TRANSCRIPTION

(Please excuse grammatical errors, as this is simply a transcription of conversational speaking)

I’m just going to say something that you’re probably not going to want to hear. But I love P90X. That’s not because of any results someone gets or doesn’t get, but simply because it’s created a lot of low-back pain patients for me. It’s made me a lot of money!

I wish I was joking, but I’m not kidding. And I’ve been meaning to send them a thank you card or something, but I haven’t gotten to it.

The problem is that on that program, and in a lot of gyms, I see people trying to do abdominal exercises—or being asked to do abdominal exercises—that their abs are simply not strong enough to actually do with good form. So the hip flexor is allowed to get involved in abdominal exercises, especially the psoas. And so at an anatomical level, what happens—especially with abdominal exercises like leg lifts, or planks is a good example—the psoas runs from the inside kind of upper hip and attaches to the lumbar spine at all segments. So it’s not just a hip flexor in that it pulls the hip up, but it pulls from the other direction too.

So it’s pulling from the lumbar spine. What it does is it’ll pull you kind of down and into an anterior pelvic tilt or a low-back arch.

So what happens is that if they are repeatedly getting pulled into that position, it’s compressing all the structures in the lower back. And then they end up with pain. If you have abdominals that are strong enough to counteract that, to create that posterior pelvic tilt and you keep a neutral spine, then you’re fine. But what I’ve seen is that a lot of people are doing these exercises without that abdominal strength.

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