Over the years, we’ve all heard many recommendations on how to injury-proof lower backs in both sports and industry. Warehouse workers wearing “lifting belts,” football teams doing yoga for flexibility, and multiple versions of “core strengthening” exercises. Physical therapists look at the information to analyze the best way to interpret it, individualize it, and apply the information for specific sports and clients. With spine injuries we know the discs are best able to cushion and provide shock absorption when the back is in “lumbar neutral.”
It’s easier to experience than describe, so stand up: place your hands on your hips, and imagine your pelvis is a bucket of water. As you do an anterior pelvic tilt, you dump water out the front of the bucket. As you tilt your pelvis posterior (like a dog tucking his tail between his legs), the water would pour out of the back of the bucket. This motion takes your lumbar spine into flexion and extension. Lumbar neutral is that point halfway between the anterior pelvic tilt and posterior pelvic tilt positions, where the imaginary bucket would hold water. (The pictures show Josh in a squat posture: one with a neutral lumbar spine and curve to his low back, the other with a flat low back. The flat low back is a more injury-prone position.)
When your lumbar spine is at neutral it is most protected from injury
The pictures show Josh in a squat posture: one with a neutral lumbar spine and curve to his low back, the other with a flat low back. The flat low back is a more injury-prone position.
In sports, the spine has to move and does not maintain lumbar neutral position. The important moment to maintain lumbar neutral is the moment of impact. In golf, the swing should rotate through the spine and the hips, so that when club meets the ball, the lumbar spine should be at neutral. In that moment, lumbar neutral doesn’t just prevent injury, it helps translate the energy of a fluid swing into real power on impact. That same ballistic moment exists for volleyball players, and baseball players batting and throwing. The moment when there is impact with a ball the core has to instantaneously be rigid and strong followed by a fluid range of motion through the spine. The spine and lumbar joints better tolerate moment of impact when the athlete’s posture is at lumbar neutral.
The best way to train these moments is a program with flexibility, core strengthening, and ballistic coordination (finding that lumbar neutral posture to stabilize and push from). This training should be done early in practice, while athletes are fresh and not fatigued. It involves quality, intensity, and proprioception (position-sense in the joint). By getting used to lumbar neutral first at rest, and then in practice, it becomes a natural instinct even during competition – making the quality of early training important to protecting athletes well into the future.
When working to prevent spinal injuries, lumbar neutral helps, core strengthening helps, flexibility helps, and good posture helps. Injuries happen when the joint is loaded in a position of side bend and rotation, when the disc cannot absorb the shock and the joint is compressed. Often, a single episode of loading a flexed joint does not produce an injury, but repetitions of the motion produce the wear and tear that go forward to cause an injury.
In football, when a wide receiver is tackled, lumbar neutral is the last thing he is concentrating on, for example. There is no perfect solution to prevent spine injuries. However good flexibility, good core strength, good postural alignment, and agility all help with injury prevention.