Is Back Pain Killing Your Double Leg?

Grappling matches are often won and lost in the first few moments of the match. You can ask me how I know. While I don’t have specific winning percentages for whoever scores the first points, it stands to reason that being first on the scoreboard puts you in a better position to move on in the tournament or match. I recently gave a knee and ACL injury prevention seminar at Gustavo Dantas Brazilian Jiu Jitsu which had a slide referring to the critical nature of core and proximal stability for the purpose of transferring power, torque, and momentum from the lower and upper halves of the body. I related this to the ‘kinetic chain’ principals (successively arranged joints constituting a complex motor unit) and I wanted to revisit that topic and provide a little more insight into how dysfunction in the “core” of our bodies, and especially for those already suffering from lower back pain (LBP), can affect our quality of life and be of detriment to performance. 

The “core” of the body is comprised of the diaphragm as the top border, the abdominals and oblique muscles as the front and side borders, the paraspinals (the big muscles that run next to the spine) as the back border, and the pelvic girdle below that holds all the contents of the abdomen. This can be thought of as a corset for the spine. Within the core, beyond a ton of digestive, neurological, and vascular structures are 3 subsystems that are responsible for maintaining the spinal column and its overall structural integrity. First, we have the passive control subsystem such as vertebrae, intervertebral discs, ligaments, and connective tissue surrounding the vertebral joints themselves. These structures simply hang out with no active component to them, meaning we cannot voluntarily relax or contract them but they do provide feedback to how we move and the location of each joint. Secondly, the active control subsystem which is comprised by the muscles mentioned above (and several more) that provide dynamic stability to our spine and skeleton. This system (and the passive control system) also provides movement feedback into our last system: the neural control system.  The neural control subsystem is the control center for incoming and outgoing feedback that produce and maintain the stability in our core. All 3 of these systems work together and are required to maintain static and dynamic stability. Dysfunction in any one of these systems can result in decreased stability and/or pain resulting in a myriad of different presentations that can affect your daily life and overall performance. The good news is that these systems can be trained and improved. 

Before moving on, I think it’s important to provide a little more insight into the transfer of power and spinal stability. The muscles within our core can be classified as local stabilizers and global stabilizers. They do exactly what they sound like; stabilize locally at the spine and globally within the core and body with respect to whatever we require our bodies to do. Our local stabilizers are small deep muscles in our core that work locally right around the vertebral joints themselves whereas global stabilizers are big muscles we can generally see (think 6 pack abs here) and produce large amounts of torque and power for movement. Both of these categories are incredibly important and during the knee and ACL prevention class we talked extensively about how the core is incorporated into injury prevention programs with great success at preventing knee injuries. This concept can be seen in a study by Zazulak et al. who demonstrated that female athletes who sustained knee ligament injuries had deficiencies in core neuromuscular control when compared to uninjured athletes. Core stability may be associated with risks of knee injury particularly in the female population. This makes perfect sense thinking about our proximal stability for improved mobility down the kinetic chain concept and is also why each of our knee injury prevention protocols emphasize core strength and stability. 

Remember, the human body takes the path of least resistance…ALWAYS. The human body is incredibly efficient with its energy utilization and does not bother doing movements correctly especially once injury or pain is already being experienced. It wants to move from point A to point B efficiently regardless if it is the correct way to do a movement. Let’s say we take our 3 subsystems for core stability and introduce back pain (or some form of injury to the core) to the system. It has been well established that those experiencing LBP display changes in the recruitment of local stabilizer muscles and increased fatty “infiltrate”, or deposits, into those muscles. This effectively limits our ability to stabilize our spine locally and give correct and accurate feedback into our neural control subsystem. This one injury changed all 3 systems because each of these systems work together. The entire system is essentially in disarray now. Regardless of pain, life goes on and we still need to get things done throughout the day. In order to do so, other systems have to pick up the slack though they may not have the right tools for the job. This is like taking a payroll processing employee and sending him/her to the jobsite because someone called out sick for an undetermined amount of time. The payroll processing employee is not well-equipped for the job so everyone else is having to work harder, the phones and emails aren’t being answered in the office, and everyone in the company is angry because they aren’t getting paid this week. The anger represents lower back pain. On top of it all, the powerful leadership in the corporate hierarchy and the powerful employees out on the jobsite responsible for getting the job done have difficulty communicating with each other about problems they are facing in their areas of specialty. The lack of communication represents power generation from the upper and lower body that cannot be transmitted through the core. I must clarify though; this can be a complicated area in the grand scheme and is not the same for every person’s LBP. 

With all that said, dysfunction in the core can be of severe detriment to your activities of daily life. In the case of Brazilian Jiu Jitsu, dysfunction in the core can prevent you from winning a match or tournament from the moment you shoot in for a double leg takedown. The purpose of sprawling is to move the persons center of mass forward and apply increasing loads through the spine and hips to render power generation ineffective. With any sort of pre-existing injury and/or LBP, this is going decrease the ability to maintain a rigid spine, maintain posture, and prevent force transmission up and down the kinetic chain. The long and short of this story is you didn’t finish the double leg and now your opponent is spinning to take your back. Interestingly enough, this dysfunction started even before you took your penetration step. There are muscles in the core whose role is to prepare a ridged spine for upcoming dynamic movements and in normal conditions they activate before a single step is taken. This does not happen when pain and dysfunction are on board. This doesn’t have to be during a double leg takedown either, simply walking or moving from sitting to standing is dynamic. Pain and dysfunction in the core and spine have been shown to alter appropriate recruitment patterns to maintain spinal stability. If you are shooing in on a double leg takedown and these recruitment patterns are already altered, the likelihood of being in the correct position, with adequate power generation, and with the ability to transmit forces up and down are already decreased and you are now playing your Jiu Jitsu game from a place of reactivity rather than proactivity. These concepts can easily be applied to most, if not all, positions in Jiu Jitsu. They apply to most other sports and even doing something that sounds as simple as reaching above your head to get something off of a shelf, walking, or moving from sitting to standing. 

As I already mentioned, this can all be improved. We can get our sick employee back to work, return the payroll processor back to the office to get paychecks processed, printed, and mailed and let the corporate higher ups know things are being handled in the office now. From a rehab standpoint, I view most things as having neurological influence and you will commonly hear the term “motor control”. It’s the ability to appropriately activate and control a specific movement with appropriate muscle sequencing and firing rates. For the case of LBP and core dysfunction, getting the local and global stabilizers to return to their jobsites and doing their job appropriately and with control is important. Once that happens, we can load whatever movement patterns we want and train into movements that previously caused us problems. We can transmit power, torque, and momentum top to bottom better. With all the office and jobsite dysfunction resolved, we can finish the double leg and put our opponents on their back, score 2 for the takedown, win our matches in a more dominant manner, and perform our best in our daily lives. 

Thanks for reading,

Wesley Reed, PT, DPT

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Huxel Bliven, K. C., & Anderson, B. E. (2013). Core stability training for injury prevention. Sports health, 5(6), 514-522.

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Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. The effects of core proprioception on knee injury: a prospective biomechanicalepidemiological study. Am J Sports Med. 2007;35:368-373.

Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. Am J Sports Med. 2007;35:1123-1130