Updated: Dec 21, 2022
Lower back pain is something a large majority of the population will experience. As such, we tend to have many untrue beliefs that get passed down from the general population and unfortunately healthcare professionals as well.
1) Rounding your back is inherently dangerous
I do a weekly reminder on my social media to train your lower back, especially in a rounded position. This usually entails me doing some crazy-looking back extension with a barbell on my back to prove a point, (that we should train our lower back and spine like we would any muscle or joint).
The stronger we get in a rounded position, the more resilient we are in these positions. Always avoiding it and trying to stay "neutral" at all times is not realistic and causes more harm than good.
What we now know is that even when we think our spine is neutral and flat, it's actually moving quite a bit, (no matter how much we try to keep a "flat back"). The spine was meant to be mobile and strong in many positions so trying to be robotic with our spine is counter-productive.
2) Butt wink, and other pelvic postures, cause back pain
Butt wink occurs when our hips tuck under in the bottom of a squat and this was thought to be a cause of back pain. The same was thought of for anterior and posterior pelvic tilt, some common hip postures that nearly every person has to some degree.
Similar to avoiding a rounded back for fear of causing damage, there's just as little merit here when it comes to the hips. Depending on the shape of your hips, how wide and how deep your hip sockets are, your squat technique will be affected.
If you have shorter legs, a longer torso, and shallow hip sockets, you'll most likely be able to squat "ass-to-grass" with a perfectly straight looking spine. Others with longer legs, deeper hip sockets, straight-looking, and shorter torsos may tuck their hips under at the bottom of a squat because that's the only way anatomically that they can reach that range.
And nearly every single person has some sort of pelvic tilt, whether anterior or posterior, and even trying to define a single "perfect" posture doesn't make much sense.
What we see in reality is that people can move just fine in a variety of different postures and the human body has an amazing ability to adapt to whatever pelvic position we are in. It's nothing to stress over.
3) Back and spine imaging is useful for determining the cause of your pain
We are often sent to go get MRIs and X-Rays and other imaging to determine what's going on in the spine and lower back.
But what we're seeing more and more is that these imaging results aren't that helpful.
Roughly 90% of lower back pain is "non-specific", meaning that we can't discern an actual cause for it.
A large number of people walk around with what imaging would define as a "disc bulge", and have no lower back pain. Others have no discernable disc bulge and they still have lower back pain, making it unreliable for diagnosing what's going on.
A similar number of people walk around with what healthcare professionals might define as an "unnatural" spinal curve. Again, there is no perfect posture the spine is meant to be in. Some people have more exaggerated curves in their spine and others have more flat-looking spines. Neither has been determined to be a predictor of pain.
The problem with this is that people go and get imaging results, and are told that there's a problem with their spines and that they are at risk for lower back pathology. This not only creates unnecessary fear but can actually exacerbate feelings of pain.
Be cautious about people giving you any definitive information using spinal imaging.
4) Being overweight causes low back pain
Having excess weight, especially in the abdominal region, was thought to put undue stress on the spine, causing lower back pain.
However again we see a lack of evidence showing this.
What we do see evidence for is how people's spines adapt to the excess weight with an actual increase in bone density and strength in the spine. Think of having to carry around extra weight and what type of adaptation would occur.
We see plenty of overweight people with and without back pain. It's not a strong correlator.
What does correlate however is a lack of movement and strength.
So what we once thought of as a cause of pain (being overweight) was just a symptom of the problem (being sedentary).
It can be frustrating to a lot of people that we can't really nail down most of the time why we have lower back pain in the first place. But the good news is that the treatment is the same regardless.
Train your lower back! Find an entry point that's relatively pain-free (modify and regress movements as needed), and slowly progress and build strength and mobility over time.
To your good health,
If you're dealing with back pain, I've got a free 4-week low back training template to get you started on the path to a stronger spine and lower back.
You can find it here.
If you're looking to get your rehab journey started and get back to doing what you love pain-free, click here to inquire about coaching options.
I help people all over the world regardless of location to build sustainable strength while leaving aches and pains behind.