Can exercise help combat the risk of back-pain?
Incidences of lower back or hip problems are common health issues in the western world. According to figures from the UK Office for National Statistics almost 31 million days of work were lost in 2013 due to back, neck and muscle problems, costing the UK economy £14bn a year. Back pain is one of the most common causes of absence from work and 80 per cent of the population will suffer with back pain at some point in their lives. Back in 1998 the direct cost to the UK’s NHS for the treatment of lower back pain was around £1.6 billion. This figure would have undoubtedly increased since then following the dramatic rise in obesity, which can cause lordosis of the lumbar spine.
Yet most of these problems would simply not exist if we could hold a squat.
The squat: the secret to rescuing us from back-pain?
No matter the different limb lengths we may have as individuals, all humans are designed to be able to hold the same shapes. These may look slightly different from person to person, depending on limb and torso length, but the shapes serve fundamentally the same purpose. The ‘squat’ is one of these shapes. Unfortunately, in the west we have largely lost our natural ability to squat yet consider that in countries that some might consider less developed, where, for example, toilets are on the ground or sunk into the floor, or where people sleep on the ground, lower back or hip problems are virtually unknown.
The squat and holding the position
Squatting is not all about how much weight you can lift, but whether you can hold your body in a shape you were designed to be able to make. If you can, it means that you have healthy mobility and flexibility of your lower body from your ankles to your lumbar spine. So, if you can’t, make this your priority. And if you find that a particular area of the lower body is tight, then it means you need to spend time stretching and improving its flexibility.
When you can comfortably squat, time yourself to see how long you can hold it and then build on it. Once you can keep the position for multiple minutes, it means you will have regained a shape your body is designed to make.
The ultimate squat fitness goal I set my clients is to be able to hold a squat for 10 minutes, with feet straight, hips lower than the knees, with the knees pointing out to the sides, torso upright and hands relaxed not touching the floor.
For people with joint issues, if you can’t squat, the primary focus should be developing the range of movement in each of the joints from the ankle to the hip. No matter your weight, you can improve flexibility and mobility. Bear in mind this will take time.
Regarding the position of the toes, they may follow the knees, but not in all cases. The optimal position is to maintain straight feet and knees out. This creates the most torque in your musculature and the external rotation of the hip, by placing your knees out, will tilt your pelvis forward and keep your torso upright. This will put less pressure on your lumbar spine.
A 10-15 degrees angle of the toe is okay, but this is not optimal for 2 reasons.
- If the feet are pointed out and the individual lacks both internal and external rotation of hip this can lead to the knee remaining straight and a valgus joint, which has been the cause of numerous ACL tears in the knees of many athletes.
- If the feet are pointed out and the knees are pointed out the individual cannot generate maximum torque in their musculature.
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