Low to Mid Back Pain. Anterior Pelvic Tilt?

Guys,

I have been struggling with pain in my lower back since I was 16 years old. I played football,baseball and basketball in hs and the slight pain was always there but doctors were never able to find anything to help. I am now 32, still active in weight training, softball and basketball but the pain has increased and expanded into other parts of my body. The more I research the more I think I have anterior pelvic tilt. I have recently started lifting with a purpose again but really think I need to refocus to get healthy and feel better before I start trying to improve my main lifts significantly.

My question is what type of program should I be doing to improve my posture, both upper and lower body? Should I continue performing bench presses and squats while trying to improve hip flexibility, upper back strength and core and hamstring strength or should I not squat and bench while I try to catch up in my upper back and hamstring strength?

Also, are there any specific tests you would recommend for apt? I did one very simple test and I think I have a pretty bad case but I am not positive.

Thanks in advance for your feed back! If this is what has caused my pain all along I will be relieved for sure but a little pissed I have lived with this for 16 years too!

video your lifts. video how you move. don’t stand there unnaturally (for you) awkwardly stiff aware that you are doing a posture photo / video. just video yourself moving and then watch yourself and see what you see… or post vids so other people can see what they see…

Well, having a baby has played hell on my workouts and I am now fatter than ever and weaker than I have been in a long time. I started the 5/3/1 BBB program last night and plan to stick with it. I think this will be good as I will be sure I am gettign the basics in on a weekly basis. I have been to the rhuematologist several times since this post and still no change in the pain levels in my back and other areas of my body.

I was able to record myself squatting last night and think I have some pretty major form issues. Should I continue to squat with my current movement patterns being this way?

Just as an fyi, my left ankle is extremely stiff due to several injuries but my right heel does stay on the ground . I am extremely stiff in my back and hips and have actually been consistent working on that even though I have not been lifting. Let me know what you guys think.

Not sure why the video didnt post???

[quote]jwrhoades1 wrote:
Not sure why the video didnt post???[/quote]

My first recommendation would be to postpone the 5 3 1 program for a few weeks and undertake a general physical prepardness program. Essentially begin lifting to get yourself in shape for 6-8 weeks, then jump into the 5 3 1. The 5 3 1 program is best suited when you already have a solid foundation of exercise.

As far as the back issues and pelvic tilt, its hard to say from the video, have you ever had any imaging performed on your back? As far as the weight goes, losing 15-20 pounds will do wonders for your back and your posture as it will improve your center of mass and decrease pressure on the vertebral column. Anterior pelvic tilt typically results in tight hip flexors, weak lower abdominals and glutes, and tight lower spine musculature. I feel incorporating a flexibility along with a core program would be beneficial for your current condition.

Thank you for the feedback! Just to be clear, I have lifted consistently in the past but have avoided squats and deads because of the some of the things you hear about them and back pain. I have also lifted over the past year, just not as consistently as I need to.

I completely agree with you about losing 15 to 20 lbs and I am working on that. I do think it will help but I will say that my back pain was significant even when I was 160 lbs.

I have had x rays several times. One doctor did see a vertabrae fused with my pelvic bone on one side but no other doctor has seen the same since. I actually have X rays next week so maybe something will show then.

In regards to preparing to lift, I am currently able to do the following.

Bench 240x2
Squat 240X10
Deadlift 240X10
OHP 135X1

At this point I only have 240 lbs of weight but will get more soon (Christmas). Do you think I still need to prepare for 6 to 8 weeks or is my strength at a point where 5/3/1 will be ok? I also agree with adding core and flexibility work. I have been doing Defranco’s Agile 8 randomly and I do stretch my hip flexors several times per day.

Is there a certain core program you would recommend? Would you perform that on lifitng days or off days? Thanks again for the feedback.

Not sure if it’s going to help you but you might wanna give it a try,

I’ve got a herniated S1 L5 and still play college football without much pain,

and i would give the whole credit to banded reverse hypers, they cured my back pain nearly entirely

2-3 times a week both banded and body weight to get a pump worked like magic.

[quote]jwrhoades1 wrote:
Thank you for the feedback! Just to be clear, I have lifted consistently in the past but have avoided squats and deads because of the some of the things you hear about them and back pain. I have also lifted over the past year, just not as consistently as I need to.

I completely agree with you about losing 15 to 20 lbs and I am working on that. I do think it will help but I will say that my back pain was significant even when I was 160 lbs.

I have had x rays several times. One doctor did see a vertabrae fused with my pelvic bone on one side but no other doctor has seen the same since. I actually have X rays next week so maybe something will show then.

In regards to preparing to lift, I am currently able to do the following.

Bench 240x2
Squat 240X10
Deadlift 240X10
OHP 135X1

At this point I only have 240 lbs of weight but will get more soon (Christmas). Do you think I still need to prepare for 6 to 8 weeks or is my strength at a point where 5/3/1 will be ok? I also agree with adding core and flexibility work. I have been doing Defranco’s Agile 8 randomly and I do stretch my hip flexors several times per day.

Is there a certain core program you would recommend? Would you perform that on lifitng days or off days? Thanks again for the feedback.

[/quote]

The consideration for delaying the 5 3 1 program is more to allow tendon and ligament strength to develop in preparation for heavier lifting. Tendons and ligaments respond to the stress you impose on them, after a layoff or inconsistency with your recent program I would allow this time to develop soft tissue strength.

I am somewhat familiar with the defranco 8, but I think you are intelligent enough to design a program around your own needs, and I dislike a few of his exercises such as the extreme flexion positions.

I think a simple Lower Body flexibility program incorporating some PNF techniques would be a solid foundation.

As far as a core program I think both static and dynamic core exercises on off days would be optimal.

Your APT is very pronounced as soon as you unrack the barbell. Coming out of the bottom you have zero glute involvement; no hip pop at at the top either. Overall looks like a typical squat when a lot of lordosis is involved.

Don’t worry about a “program” for correcting the issue. I would pick a couple glute exercises, a plank, and hip flexor stretch and do them as OFTEN as you can, EVERY DAY. A week of that should make you feel much stronger, more stable in the squat. Important! Do SOMETHING every day, multiple times a day to address the issue.

If squatting isn’t painful, I would spend ten minutes doing some hip extension movement to get your glutes pumped up. This makes a world of difference when you squat. RDL’s, kettlebell swings, glute bridges on the ground, bridges with shoulders on a bench. Focus on strong glute contractions and try to get a pump. This will get the glutes more involved in the squat.

If squatting is painful, front squat or goblet squat.

You have the power to make a big difference in a relatively short time if you focus time throughout the day to the issue.

Thanks so much for the responses. I will utilize these suggestions for sure. I have been stretching my hips out daily but have not been doing glute work every day. My back does not hurt any worse during squats, i just basicaly have a ton of stiffness, discomfort and a feeling of weekness in my back 24/7.

I will let you know how its going and post another video at some point.

Thanks again!

Have been doing various types of bridges and reverse hypers(on my kitchen island). The first day I did thw bridges it made my back feel better for a bit. It does feel weird that I am doing these exercises that make my back feel tight when I would really like my back to loosen up.

Do you guys think I should be concentrating on the bridges and other rehab type exercises for my back as well as the weight loss while not lifting or should I continue to lift as I try to improve my back health? If X rays show nothing this week Im hoping to get an MRI scheduled ASAP. Something has to happen soon.