4 tips to reduce low back pain with cheerleading
Low back pain is a top reason cheerleaders miss practice or events and one of the top reasons for a visit to the emergency room. While there are some catastrophic events that can contribute to low back pain such as a fall from a significant height that leads to a spinal fracture, these are not as common as overuse and strain injuries. This article we’ll talk about ways to reduce over use injuries.
The biggest contributor to low back pain that I see in the physical therapy clinic is related to postural changes and dysfunctional stability and motor control of the core. The core is generally defined as abdominals but it also include the lower back. In movement circles we also consider the respiratory diaphragm, pelvic floor and the upper back when we think of core stability. Technically the upper back relates more to the upper body, but there can be changes in the thoracic spine and rib cage that create more or less mobility in the lumbar spine, so I consider anything from the shoulder blades to the pelvis the ‘core’.
Postural changes that are common with cheerleaders are an increased arch in the lower back which may be called hyper-lordotic. This leads to a hyperextended spine. We also see increased thoracic kyphosis, or a more rounded upper back, similar to a question mark (?). This is a more flexed upper back. In combination, there will be less ability to achieve a good hollow position for stunting and tumbling. This can lead to repeated strain-or overuse-at the junction where the thoracic and lumbar spine meet (thoraco-lumbar junction) or at the lumbo-sacral region, where your lower back meets your pelvis. Without good movement and control through these spots, you may develop increased tightness in the muscles and joints, pressure on the nerves that come from that region, or even fractures of the pars interarticularis (or the outer parts of the spine) which can lead to one vertebrae moving forward on the one below.
All of these can be corrected with exercise and learning better movement techniques. Our body is designed to move in 3 planes of motion: Sagital (front to back); Frontal (side to side); and Transverse (rotation). When one isn’t moving efficiently another will take over.
1-Improve hip mobility. Cheerleaders need good mobility through their hip flexors, hamstrings, adductors and hip rotators. When any of the above is not moving well, either too much or not enough, the lumbar spine will compensate and it may lead to pain. This doesn’t always mean you will need to stretch a muscle. Sometimes building strength in a muscle will allow better mobility.
In this video I demonstrate a stretch of the rectus femoris, which is one of the quadricep muscles, that also flexes the hip.
And in this video, I demonstrate a way to create flexibility and strength in the hip flexors while using a lengthening (or eccentric) contraction.
2-Learn how to move pelvis in 3 planes. I find this challenging for most people because we rarely consider how our pelvis moves when we do anything. Learning how to isolate the 3 movements and do so without overutilizing our leg muscles or core muscles will allow for improved body awareness while flying, basing and tumbling.
3-This leads to also learning how to create better mobility in the rib cage in all three planes. I find cheerleaders and dancers have a bit better concept of rib cage mobility because we learn rib cage isolations early on in our life. Using them as part of a regular mobility routine and checking in with how we are moving helps control movement and reduce tightness throughout the lower back.
This video, though a bit longer, teaches you how to move the pelvis and ribs, which will lead to better overall spinal mobility and health.
4-Last but not least, building strength and stability in the core and hips will help reduce the risk of back pain. This includes strengthening the posterior core as well. One of my favorite exercises that I find cheerleaders have a hard time with is the bird dog exercise.
Typically when you don’t have good stability through the lower back muscles, nor thru the hips, which leads to the pelvis not holding stable and tipping to the side as you lift your leg. To make the exercise more challenging, and really focus on stability, try placing a basketball on your back and don’t let it fall off. If needed, just slide your knee on the floor until your leg is straight. This will train your body to know where center is. To make the exercise easier, only do the legs.
Working on improving hip mobility, pelvic and rib mobility and hip and core strength and stability will help reduce lower back strain and will also help improve posture for the long term.
If you’d like to learn more tips to reduce the risk of, recover from and return to cheerleading after an injury, come join the Healthy Cheerleading group on Facebook.
Until next time, keep moving and grooving to keep yourself cheering as long as you desire.