Why Context Matters with Exercise and Low Back Pain

I had a comment the other day from a YouTube subscriber asking me the following question: 

“Can I perform this (Bird-Dog exercise) with a bulging disc?”

My response:

“Depends. If it doesn’t cause you pain — it may be okay. But it’s important to perform the appropriate variation (progression/regression) and proper technique!”

You see, this subscriber (Subscriber X) asked me a question about performing the bird-dog exercise with a bulging disc. But there are many factors to consider. And I can’t give an absolute answer.

The first consideration would be where the bulging disc located. Is it Cervical, Thoracic, Lumbar? If the bulging disc is in the cervical region, it’s going to have a much different impact than if it’s in the lumbar region. Considering my YouTube channel is about low back pain – I think we can assume that Subscriber X’s bulging disc is in the lumbar.

A second consideration would be if the bulging disc is causing pain or not? I don’t know the answer to this since Subscriber X didn’t mention it, but about 2/3rds of the population may have an asymptomatic lumbar/sacral disc bulge (1). If Subscriber X is asymptomatic, then they’re perhaps fine to perform the bird-dog exercise if they maintain proper technique.

But.

If proper technique is not maintained, then this may create a problem — and this leads me into my third consideration.

Technique.

Let’s say Subscriber X is symptomatic from a bulging disc (assuming low back), and the bird-dog triggers their pain.

Now.

We can rush to the conclusion that the bird-dog is an inappropriate exercise for Subscriber X. But it’s not that simple, because if Subscriber X’s technique (e.g., excessive lumbar extension) is poor when performing the bird-dog — then this may be the reason for their symptoms to trigger. If we’re to clean up their technique  — their symptoms may not trigger. Something I can’t advise this subscriber on, because I haven’t seen them perform the exercise.

https://www.instagram.com/p/BouHgkLhEgA/

Also, a final consideration is the type of bird-dog they are performing. There are different progressions and regressions to the bird-dog. If Subscriber X is performing an advanced progression of the bird-dog that they are not ready for — they could trigger their symptoms from failure to maintain technique or by increasing the compressive loads on the lumbar spine. Starting with a basic bird-dog or perhaps a regression is where Subscriber X needs to start.

As you can see from the above examples, there are many factors to consider when it comes to exercise and low back pain. The context always matters, and every factor that influences low back pain and exercise needs consideration.

Cheers, 

Remi

References

1. Jensen, M. C., Brant-Zawadzki, M., Obuchowski, N., Modic, M. T., Malkasian, D., & Ross, J. S. (1994). Magnetic resonance imaging of the lumbar spine in people without back pain. The New England Journal of Medicine, 331(2), 69-73.

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