Over the past few months, I have had the pleasure of training one of our college athlete’s father. He comes in 3-4x/week and has had continuous extension-related low back pain since coming in. His back pain seems to always flare up when standing for long periods of time or if he runs. The uphill battle is that he loves to run and sometimes his job requires him to stand for extended periods of time. We typically incorporated our push, pull, knee dominant, hip dominant, anti-core movements in his programs and the pain would go away for periods of time if he would get away from the running. One of the prominent findings, and a reason why assessment for every client is unbelievably important is that his shoulder mobility is severely restricted (1s on the FMS) and he has a huge bilateral rib flair.
It did not click for me at first but now I have completely revamped his program which includes breathing with any mobility drill or stretching. He is typically a high-stress person and that is definitely linked with the rib-flair (upper chest-breather). Also because he is getting extension-related back pain that means that we will start back at the basics with core exercises lying in supine. The ones that I am going to experiment are the dead-bug (other variations to this as well), baby pallof press.
Supine Baby Pallof Press for breaths 5-6 breaths (isoholds)
Here are t-spine extensions and supine wall slides that I have incorporated. Cycle a full diaphragmatic breath before initiating any of the movements. With all of these, it improves as he gets further into the set or does multiple sets. These were the first sets. If you have any suggestions on how to improve this please feel free.