Back Clinic Power & Strength Training. These types of conditioning programs are for both athletes and the general population. They can reach higher levels of personal power and strength, making them capable of achieving their personal fitness goals. Power is defined as the ability to generate as much force as fast as possible. It’s needed for athletic movements such as workouts (clean & jerk), swinging a bat, golf club, tennis racket, and running through a tackle.
Power requires strength and speed to develop force. Strength is the amount of force muscle/s can exert against an external load. One rep maximum test is performed where individuals assess the greatest weight they can lift while maintaining proper form. The movement’s speed is not important in a strength test. Dr. Alex Jimenez offers insight into various stretches and exercises and explains the possible risks of injury on strength training through his numerous article archives.
Kettlebell training for the back muscles and back pain prevention can be part of a recommended treatment plan. When experiencing low back pain, many sports medicine experts recommend kettlebell exercise to strengthen the core and posterior chain. However, if not used correctly, kettlebell exercises can worsen back pain.
Kettlebell
They are made of cast iron or steel and are named for resembling a tea kettle with an oversized handle. They can be used in one and two-handed movements.
Exercises and Movements for Back Pain
For individuals that are not experiencing back pain, kettlebell training can be excellent for maintenance and injury prevention. They strengthen the core and back muscles.
The kettlebell swing is an essential exercise and is one of the most important exercises when dealing with back pain issues.
A kettlebell is placed on the floor about 12 inches in front while standing with the feet a little wider than hip-distance.
The hips become the hinge.
Extend the arms down to the bell and grip it.
Begin swinging it up and down through the legs and then upward and outward to chest level.
The shoulders are to stay relaxed.
The hips are used to thrust and create momentum to swing the kettlebell.
Keep the spine neutral throughout the exercise to prevent injury.
The arms are to hold the bell only.
Don’t swing with the arms or shoulders, but push through with the hips.
The exercise can be swung up over the head but is not recommended for those with back pain.
Benefits
They are portable and don’t require a lot of space.
With kettlebells, an individual can train more easily than with barbells.
Kettlebell workouts provide strength training and cardiovascular fitness.
Once the proper technique is learned, individuals can set up a regular regimen at home.
Proper Form and Mistakes
Proper form is crucial. The primary movement most individuals have difficulty with is getting the proper hinging motion at the hip. Most individuals flex at the lower back and place increased pressure on the discs. Proper hip hinge motion means:
Keeping the low back straight
Flexing at the hip
Pushing back out with the buttocks when performing the swing motion.
When done correctly, an individual should be able to stop at any stage and hold that position.
Posture Form Tips
Form issues with kettlebells include:
Hip Hinge
When picking up the kettlebell, remember to hip hinge instead of squatting to maintain the back in a neutral position.
Drive the hips back in the same way when sitting down on a low chair.
Arching the back
If the pelvis is tilted too far forward, the back arches a lot.
This can narrow where the nerves leave the spine in the low back.
Keep the abdominals tight to prevent the pelvis from tilting forward.
Using the incorrect weight can also cause problems; this could be going too heavy or too light.
Too heavy increases the risk of straining the body and back.
A kettlebell that is too light does not provide the correct resistance to strengthen the muscles.
Another common mistake is overtraining. Specifically, individuals over 50 whose bodies don’t recover as quickly.
Individuals over 50 are recommended to spread out the workout days with more than one rest day.
Common Injuries
Proper training before working with kettlebells is highly recommended, especially for those already dealing with back pain. Individuals are encouraged to work with a physical therapist, sports chiropractor, or personal trainer who can teach proper techniques and specific exercises, observe the individual’s process, and make corrections. Improper technique can lead to:
Muscle strains.
Muscle spasms.
Compressed or pinched nerves.
Added stress to pre-existing low back conditions.
Impact injuries to the wrist and forearm.
Body Composition
Exercise Ball Pikes
Exercise ball pikes are an advanced total body workout. Muscle groups worked out include:
Deep abdominals
Hip abductors
Quadriceps
Deltoids
Scapula stabilizers
Pectoralis major/minor
To do the exercise:
Start in a pushup position with the arms on the floor in front.
Lift the legs, so the tops of the feet rest on the exercise/stability ball.
Knees should be bent to start the movement.
Extend the legs out as straight as possible.
Hold the position for a few seconds.
Return to the starting position.
References
Common Injuries Associated with Kettlebells: ACSM’s Health & Fitness Journal (March/April 2017) “Managing Risks of Training with Kettlebells to Achieve Optimum Benefits.” journals.lww.com/acsm healthfitness/Fulltext/2017/03000/MANAGING_RISKS_OF_TRAINING_WITH_KETTLEBELLS_TO.6.aspx
When back pain presents for a prolonged period, the back muscles reduce in mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.
Back muscles development
With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body’s ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:
Back muscles and core muscles increase in function and performance.
Muscles are strengthened.
Lean muscle mass increases.
The range of motion of the spine increases.
Body fat decreases.
Guidelines while using weights
When weight training, it is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:
Severe pain.
Back pain that originates from:
Previous spinal surgery
Tumor
Nerve root compression
Neurological symptoms
Sciatica
Spinal fracture/s
Spinal infection/s
Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.
Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
Trained physical/occupational therapists and sports chiropractors can educate an individual on:
Correct techniques
Frequency
Type of training that will help an individual’s condition.
Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.
Smaller weights build strength progressively
Effective ways to strengthen the spine.
Begin with small/light weights and exercise slowly.
Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
It is recommended to start with:
Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
Simple stretches
Exercise machines can be recommended instead of free weights.
Exercise machines can provide safe, effective, and progressive resistance to the exercises.
The machines can help reduce/prevent injury compared to free weights.
The machines can maintain proper support on the back and spine.
It is recommended to combine regular walking activity with a weight training program.
Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
This promotes healing and reduces stiffness.
Training program and benefits
Gaining the most benefits from strength training, tips to keep in mind:
Warm up for a few minutes using heat therapy and simple stretches.
Try for 2 or 3 times a week for 30 minutes.
Focus on building strength in the core muscles – back, abdominals, obliques, buttocks, and pelvic leg muscles.
There is no need to join a gym or buy expensive equipment.
Work out at home with small hand weights, resistance bands, and body weight.
The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
If back pain presents with a sustained increase, take time off or modify the strength training exercises.
Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.
Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.
Body Composition
Carbohydrates and Muscle Growth
Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.
Carbs prevent muscle weakness.
Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.
Carbs help muscles recover after exercise.
Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.
References
Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.
Lee JS, Kang SJ. Strength exercise and walking effects on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325
Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.
Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050
There are different types of muscle from a biological perspective, however, there is no such thing as lean muscle. Lean suggests the absence of body fat. But the fact is that all muscle is lean muscle. It is important to build muscle mass as the body ages, however, it is more important to build lean body mass. Here is the difference.
Lean Body Mass
Lean Body Mass is the total weight of an individual’s body minus all the weight from the fat mass.
Lean Body Mass (LBM) = Total Weight – Fat Mass
Lean Body Mass includes the weight of the:
Skin
Body Water
Bones
Organs
Muscle Mass
Because Lean Body Mass consists of various components, any change in the weight of these areas is recorded as changes in lean body mass. However, the weight of the body’s organs will not change. Bone density does decrease with time and age, but will not significantly affect the weight of lean body mass. With lean body mass, 2 areas of focus include:
Body water
Muscle mass
Lean Muscle
Sometimes, individuals use the term lean muscle referring to the shape of the muscles. However, both types of muscle are lean and fat-free.
The difference between muscle mass and lean muscle
The strict definition of muscle mass is the weight of the muscles of the body. When individuals say they are gaining muscle mass, they typically mean that the muscles look and feel bigger.
Lean muscle masson the other hand is a term often used when someone is referring to the weight of the muscles, not factoring in the amount of fat that could be present within a muscle.
Combining Lean Gains
Increases in Skeletal Muscle Mass are also an increase in Lean Body Mass. What tends to happen is individuals combine them as lean mass gains or lean gains. However, an increase in Lean Body Mass does not always increase muscle.
This is because body water makes up a significant portion of an individual’s Lean Body Mass. For example, a body composition analysis of a 174-pound male.
98.1 Total Body Water + 35.5 Dry Lean Mass = 133.6 Lean Body Mass
Water makes up more than 55% of total body weight
This is normal for healthy adult males
Lean Body Mass consists of three components, two of which are water.
Everything else grouped together makes up the individual’s Dry Lean Mass.
This includes bone minerals, protein content, etc.
Muscle gains contribute to Lean Body Mass gains, but so does water. The difference is that water levels can fluctuate throughout the day depending on:
Hydration levels
Diet
Physical activity
The muscle tissue itself contains a significant amount of water. Muscle tissue is comprised of up to 79% water. Research has shown that resistance training increases intracellular water in both men and women. This creates an issue when looking at lean gains.
Lean Mass gains can happen quickly, and the increases are mostly body water
Measuring Lean Body Mass and Muscle Mass
What not to do
Don’t try to use a scale to calculate changes in Skeletal Muscle Mass. A popular method used is to estimate muscle gain from the number on the scale and applying fitness websites/magazine tips. The problem with this technique is that estimating progress has many factors that can influence an increase in body weight. These include:
It is the difference between total body weight and body fat weight. However, these calculations are more for helping physicians determine the appropriate amount of prescription medication/s or if an individual will be undergoing anesthesia and not a computation of overall body composition.
Paying Attention to Weight Loss
Paying attention to weight loss is an inaccurate reflection of lean body mass, muscle mass, or lean mass.
Weight loss, or gain, does not reflect overall health and body composition.
Resistance training/weightlifting workouts combined with added protein will generate a muscle mass percentage increase
Skeletal Muscle Mass is connected with Lean Body Mass
Everyone’s body composition is different, making the proportion of an individual’s skeletal muscle mass to Lean Body Mass unique.
Lean Mass or Lean body mass is the safest term to use to describe gains.
Which Is More Important?
When it comes to tracking muscle gain or fat loss, it all comes down to what tools are being used to measure progress.
If working with just a weight scale, an individual will only know their weight increases or decreases.
This is difficult to see the difference in weight gain from water, muscle, or body fat.
For individuals that want accurate measuring of their muscle gain and assessing their health, then body composition analysis is the key.
Body Composition Difference
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico
References
Galán-Rioja, Miguel Ángel et al. “Effects of Body Weight vs. Lean Body Mass on Wingate Anaerobic Test Performance in Endurance Athletes.” International journal of sports medicine vol. 41,8 (2020): 545-551. doi:10.1055/a-1114-6206
Köstek, Osman et al. “Changes in skeletal muscle area and lean body mass during pazopanib vs sunitinib therapy for metastatic renal cancer.” Cancer chemotherapy and pharmacology vol. 83,4 (2019): 735-742. doi:10.1007/s00280-019-03779-5
Ribeiro, Alex S et al. “Resistance training promotes an increase in intracellular hydration in men and women.” European journal of sports science vol. 14,6 (2014): 578-85. doi:10.1080/17461391.2014.880192
Ten Haaf, Dominique S M et al. “Protein supplementation improves lean body mass in physically active older adults: a randomized placebo-controlled trial.” Journal of cachexia, sarcopenia and muscle vol. 10,2 (2019): 298-310. doi:10.1002/jcsm.12394
High-intensity interval training or bodybuilding? Getting to the gym, choosing a strength-training method, and figuring out which method is right for you can be frustrating and confusing. With all of the options available, there�s just no easy way to figure out which training regimen is right.
Here are two of the most popular training methods broken down. The principles behind each training method and how they influence body composition. The journey to getting healthy goes a lot smoother when knowing which training program will help reach optimal fitness goals.
Not all training programs are the same
Bodybuilding is about physical appearance. This means big muscles and low body fat which is accomplished by heavyweight training workouts. High-Intensity Interval Training/HIIT workouts focus on performing high-intensity exercises in large volume repetitions quickly to raise an individual’s heart rate, cycling between high intensity and rest. This is accomplished by using:
Light weights
Bodyweight
Cardio exercises
It�s important to understand that different training methods will affect body composition differently. Body composition is about painting an accurate picture of what�s going on in the body. The key is to break down:
What each training program looks like
What it does
How to choose the program that�s best for the individual
Gaining Lean Body Mass
Losing Fat Mass
Bodybuilding
Bodybuilding at its core is about gaining muscle while minimizing body fat. Minimizing fat is a key to building a muscular-defined physique, and requires a detailed focus on protein and calorie intake. It is the emphasis on aesthetically increasing muscle size and reducing body fat. Bodybuilders focus on higher reps and lighter-weight workouts. This encourages muscle hypertrophy. Other factors in bodybuilding are:
Adequate cardio
Consistent protein intake
Calorie restrictions
These are important aspects of this type of regimen and building visually impressive musculature.
This impressive musculature is not only for looks, as it can help with fat loss as well. This is because resistance training/weight training can burn a lot of calories and lose a substantial amount of fat. A study by the Department of Exercise Science showed that 10 weeks of resistance training can reduce fat weight by 1.8kg and increase resting metabolic rate by 7%.
Body Composition
For the average person, if the focus is on building visible muscle while keeping a low body fat percentage, bodybuilding is a great choice. Ideal body composition focuses on keeping fat content to a minimum without compromise.
High-Intensity Interval Training/HIIT
Modern training programs like CrossFit utilize HIIT-style workouts. HIIT burns calories through workouts that significantly increase heart rate. The exercises are short, loaded with mini-breaks in between high-intensity sets designed to test cardio. The focus is on high repetitions. However, HIIT workouts are so intense that professional trainers recommend individuals only train 2-3 times a week, to avoid overstressing the body. There are bodybuilding exercises included like:
However, they are done with different goals in mind. The priority of a HIIT workout is to reduce fat, improve cardio, and developing some muscle.
Body Composition
Scientists from Ohio State University observed more than 40 subjects at all levels of cardio fitness. Over the next 10 weeks, the subjects completed a variety of HIIT workouts. The scientists realized that the individuals were developing a more capable cardio system, and their body fat percentages were dropping significantly.
If the goal is to get stronger and lose weight, then bodybuilding is the best option.
If the goal is to have stronger cardio and lose serious weight then HIIT workouts are the best option.
No matter what training program is chosen. Remember that achieving a healthy body composition that the individual feels comfortable with is the most important thing. Making positive changes and achieving optimal health is the objective. Both workout strategies can be incorporated into a regular strength training regimen. Both training methods can be challenging, but the health benefits are absolutely worth it. Contact us today to help figure out which training regimen will achieve optimal health.
InBody
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Ross, Leanna M et al. �High-intensity interval training (HIIT) for patients with chronic diseases.��Journal of sport and health science�vol. 5,2 (2016): 139-144. doi:10.1016/j.jshs.2016.04.005
Westcott, Wayne L. �Resistance training is medicine: effects of strength training on health.��Current sports medicine reports�vol. 11,4 (2012): 209-16. doi:10.1249/JSR.0b013e31825dabb8
PODCAST: Dr. Alex Jimenez, Kenna Vaughn, Lizette Ortiz, and Daniel “Danny” Alvarado discuss nutrition and fitness during these times. During quarantine, people have become more interested in improving their overall health and wellness by following a proper diet and participating in exercise. The panel of experts in the following podcast offers a variety of tips and tricks on how you can improve your well-being. Moreover, Lizette Ortiz and Danny Alvarado discuss how they’ve been helping their clients achieve their optimal well-being during these COVID times. From eating fruits, vegetables, lean meats, good fats, and complex carbohydrates to avoiding sugars and simple carbohydrates like white pasta and bread, following a proper diet and participating in exercise and physical activity is a great way to continue to promote your overall health and wellness. – Podcast Insight
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Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
PODCAST: Dr. Alex Jimenez and Dr. Marius Ruja discuss the importance of personalized medicine genetics and micronutrients for overall health and wellness. Following a proper diet and participating in exercise alone isn’t enough to make sure that the human body is functioning properly, especially in the case of athletes. Fortunately, there are a variety of tests available that can help people determine if they have any nutritional deficiencies that may be affecting their cells and tissues. Vitamin and mineral supplements can also ultimately help improve an individual’s overall health and wellness. While we may not be able to change certain aspects of our genes, Dr. Alex Jimenez and Dr. Marius Ruja discuss that following a proper diet and participating in exercise while taking the proper supplements, can benefit our genes and promote well-being. – Podcast Insight
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share us.
Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
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