A lot gets asked of our low back. We need it to be highly mobile and be highly stable at the same time. The confounding thing about that is that mobility and stability are 2 polar opposite adaptations that occur within the body. So what I mean by that is that if you work on stabilizing your low back, your muscles of the low back get stronger and can resist more forces acting on your spine, but you will lose mobility. On the other hand, if you improve mobility and lengthen those muscles and tissues so you can move better, then you can not generate as much force in those back muscles and won’t be able to resist as much force acting on the spine. So how do you go about working to help your low back feel better and move better? The answer is to do both mobility and stability work. Even though I just said that those 2 adaptations are polar opposites and as you work on one the other is diminished, you can dial in the right ratio of mobility and stability for your everyday life. So the next question is, do you need more stability or more mobility?
The simple answer to this is that people need to work on the one in which they are deficient in. I generally see 2 types of people come into the office. The first patient is the very mobile and unstable low back, or the opposite stable and very immobile low back. A classic example would be the weight lifter and the yogi. Someone who lifts a lot of weights needs a very stable spine. Without it they couldn’t lift the weights they do. Many of these people have difficulty tying their shoes because their low backs are so stable they don’t move, but they are the best people to help you move furniture around because their spines can handle a ton of weight. The opposite of this is the yogi, who can move their spines through massive ranges of motion and completely fold up, arch, and rotate. The issue with this is that these people can’t stabilize their spine enough to lift heavy things and are often injured when they need to pick something off the ground. These are not the best people to help you move furniture. Both of these examples are the opposite ends of the spectrum, and the ideal goal for most people is to be somewhere in the middle. Where you sit on this spectrum is going to be dictated on your goals, values and the tasks of your everyday life. So how do you know what the right blend of mobility or stability is right for you?
The first thing to do is find out where you currently are on the mobility-stability spectrum. Are you more stable or more mobile? After that question is answered, the next question is what are your daily tasks or requirements? Do you need to pick a lot of stuff off the ground or move heavy objects? Or do you need to get into a bunch of awkward positions or crawl/move around on the ground a lot? If you are more stable and have problems getting into or staying in positions, you need to work on mobility. If you are more mobile and have issues picking things up off the ground you need to work on stability. What if I am more stable but still have problems picking things off the ground? Well, in that case the answer is to work on your stability because you do not have enough of it. And the person who is mobile but has pain getting into positions? Also a stability concern. When someone is lacking stability and they injure the back the tissue that gets damaged are the avascular (very little blood flow) tissues such as the discs and supporting ligaments. These injuries heal much slower and have more complications than the vascular tissues which are the muscles and tendons. Muscles and tendons are injured more frequently when mobility is limited. So it’s better to air on the side of caution and prioritize stability over mobility when in doubt. Just be careful though as too much stability can be detrimental if it reduces your mobility to much. After you figure out your needs assessment then you start working on mobility work until you reach your required mobility or vice versa and start implementing stability work until you are able to handle the stresses placed on your back everyday.