I had a friend reach out recently and tell me that she and a friend of hers had hurt their lower backs (my friend at her job as a massage therapist and her friend in the gym) and was curious what they could do to start strengthening those muscles. She asked if they should focus on hinge work or what exactly. Here’s what I sent her:
Core Weakness and Endurance
So! To make this as long and as elaborate as possible, I’ll start from the beginning. It sounds like it’s not necessarily (only) an issue with hinging, but an overall core weakness / lack of endurance.
I can’t speak to working as a massage therapist (I did date a girl one time who was an LMT and she had back pain as well – she went to a PT and it ended up being something serious though, so I’m not sure exactly with her), but I can see where being slightly bent over all day can cause fatigue and pain in your core / lower back. I’d say double-check with a seasoned massage therapist about what they do / have done and follow their advice as well.
Core Strengthening Exercises
As for core strengthening exercises, I’d say you should build it from the ground up (pun intended). Start doing core stability exercises like planks, side planks, bird dogs, dead bugs, and glute bridges. Strengthen those really well and add seconds to your sets over time to improve your endurance.
You can also begin to add in loaded carries (farmer’s carry, suitcase carry, front-loaded carries, etc.) to strengthen those muscles and improve your endurance. A lot of the time, a weakness in your abs can make the lower back “overcompensate” and then it becomes tired and injured. Utilizing your core while still moving through space (forwards and backwards) improves the overall neuromuscular control and strengthens them to be able to endure more.
Strengthening Abductor Muscles
As for strengthening abductor muscles so your knees don’t cave in, you can do the above-mentioned glute bridges, clamshells, hip thrusts, and banded side steps. Those are all great for making the glutes (the primary abductor muscles) a lot stronger.
Hinging Exercises
And with hinging exercises, I’d ask what exercises are you guys doing? Maybe try doing 45-degree hyperextensions first (an easier version of hinging), adding in reverse planks (uses posterior chain in a manner of stabilizing like a regular plank does), and keep going with the glute bridges for now. Eventually, you can progress to dumbbell Romanian Deadlifts, but if you’re having back pain at the moment (and I’d be hesitant to move you too fast so that you’re not so exhausted or sore you can’t work), I’d say to really master and progress the bodyweight stuff first.
Suggested Routine
Now! In a way to make all that more digestible and easier to understand, here’s what I’d suggest (assuming you’re going to the gym 3x a week):
Add this is along with the other training you’re doing
First Day 1
- Glute Bridges (3 sets of 15 reps)
- Suitcase Carry (3 sets of roughly 50 yards – 6 sets altogether)
- Full Planks (think like push-up position) – 3 sets of 20 – 30 seconds
Hitting Day 2
- 45 Degree Hyperextensions (3 sets of 5 – 12 reps) MAKE SURE THESE ARE GOOD FORM TO HELP PREVENT ANY FUTURE INJURY
- Planks On Elbows (3 sets of 20 – 30 seconds)
- Dead Bugs (3 sets of 16, 8 each side)
Finishing Day 3
- Glute Bridges (3 sets of 15 reps)
- Side Planks (3 sets of 15 sec hold, each side – 6 sets altogether)
- Bird Dogs (3 sets of 3×10 sec hold each side, 6 “holds” each set)
Additional Tips
And I think periodically adding in what’s called a zercher carry or front-loaded carry will benefit you guys as well. Do Reverse Planks from time to time as well.