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A staggering 85% of us will experience back pain at some point in our lives.  For some, it can be a life-threatening situation but for most it’s just a painful discomfort.

Exercise is also very good for the care of your back.  The right type of exercise can not only correct painful symptoms but also deal with the root cause of backache.   The wrong type of exercise however, can create or even worsen the problems.

The fitness industry is no stranger to poorly trained instructors with little knowledge of spinal pathology.  Some of these trainers may even encourage their clients to perform detrimental exercises which place stress on a weakened or injured vertebrae, disc or joint, causing more damage.

Sit Ups

Have you ever noticed that when you perform a sit up you get back pain?
Standard sit ups often cause back pain in a healthy spine, so imagine what they do to the 85% of us with some back pain or injury.

Is this sit up bad for your back?

Lets look at why sit-ups can cause back injury.  It’s not uncommon to see trainers getting their clients to perform the standard sit up with the feet tucked under a bar to make the exercise easier to do (see picture 1).

This is bad news.  When the feet are anchored, the hip flexors bend the trunk forward.  These muscles are attached to the lower spine and because they are very strong, take over from the rectus abdominus (six pack) in this movement. 
While that may seem  harmless enough, in fact they are pulling the spine into anterior pelvic tilt.  This may lead to injury because the greater the curvature of the spine, the greater the pressure on the discs.

But what about a standard sit-up, without your feet hooked under a bar?  In my opinion, even this can be dangerous.  When you perform a sit-up, as you bend the trunk forward the internal organs move backward to create space for you to bring the abdominals together. 

For people with undiagnosed disc problems a sit-up is dangerous because as you bend forward the internal organs can press against the discs causing injury.

Finally, when performing more than 20 repetitions, the client will place their hands behind the head as the neck muscles fatigue (see picture 2).  Pulling the head forward is also bad because it makes the cervical flexors (in the neck) weaker than the abdominal muscles.  Progressively, the abdominals get stronger while the neck muscles get weaker, begetting one of many muscle imbalances.

The route to a safe six-pack

My advice therefore is to avoid the conventional sit up.   If you want to work your outer unit or six pack muscles you should only perform sit-ups or crunches on a Swiss ball (picture 3). 

Exhale as you bend forward, inhale as you lower and never perform more than 12 repetitions per set.

It’s also important to make sure you size the Swiss ball correctly for your height.  Here’s a rough guide:
5” -5”3 should use a 45cm ball
5”4-5”7 should use a 55cm ball
5”8-6”2 should use a 65cm ball
6”2-6”5 should use a 75cm ball

Remember, if you have any concerns about your health or you feel unwell, the first thing you should do is consult your doctor.

Warren Williams is a regular contributor to Geoff Schumann's Sunday night show and can be heard fortnightly after 11pm.