HEALTHY BACK

Table content.

• See A Healthy Weight for a Healthy Back.Choosing the Right Foods for Optimal Nutrition.See Calcium Requirements for Kids' Growing Bones.See Osteoporosis Prevention.See Sources of Calcium in Food.SeeVertebrae in the Vertebral Column.Causes of Back Pain.Back Exercises.

As most patients are well aware, good nutrition and a balanced diet are important components of overall health.

What may surprise people with back problems is that diet, exercise, and maintaining a healthy weight also play a major role specific to back health—including the prevention of many problems and improved healing.


See A Healthy Weight for a Healthy Back


Following proper nutrition can help to decrease the risk for back pain, joint pain and muscle strain.

See Nutrition and Diet for Weight Loss


The bones, muscles and other structures in the spine need proper nutrition so they are strong enough to support the body and to perform their other functions. As a general rule, it is recommended to include the following back-friendly nutrients into a daily diet.


Choosing the Right Foods for Optimal Nutrition


Eating a balanced diet with the right amount and variety of vitamins and nutrients can reduce back problems by nourishing the bones, muscles, discs and other structures in the spine. While a healthy diet calls for many vitamins and nutrients, this partial list highlights a number of healthy choices that can be directly beneficial for back pain patients.


Calcium has received much attention as the most prominent of bone minerals. It is essential for bone health and helps maintain the necessary level of bone mass throughout the lifespan, and especially in old age. Adequate calcium intake is particularly important to help prevent the development of osteoporosis, a disorder characterized by weak and brittle bones that can result in painful vertebral fractures in the spine.


See Calcium Requirements for Kids' Growing Bones


However, calcium alone will not make strong bones, as evidenced by the high rate of osteoporosis despite high calcium supplementation. Calcium must be balanced with other synergistic nutrients for strong bones.


See Osteoporosis Prevention


Calcium is found in many foods, most popularly in dairy products such as yogurt, cheese, and milk. Other common sources of calcium include dark green leafy vegetables such as kale and bok choy, many legumes, some types of fish such as sardines and salmon (for example, canned with bones), and a variety of other foods such as almonds, oranges, tofu, and blackstrap molasses.


See Sources of Calcium in Food


Magnesium is a key mineral in the structure of the bone matrix and is also required for more than 300 biochemical reactions in the body. If blood magnesium levels drop, magnesium will be pulled from the bones. Magnesium deficiency is common and supplementation can assist in maintaining bone density and preventing back problems. This nutrient also helps in relaxing and contracting muscles, making it necessary for strengthening the muscles that support the spine.


Magnesium is found in green leafy vegetables, fish, beans, seeds, nuts, whole grains, yogurt, avocados, bananas, and dark chocolate (70% cocoa or higher).


Vitamin D3 helps the body absorb calcium, which is crucial for the development of strong and healthy bones. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Vitamin D deficiency is common. Levels in the body can be measured with a blood test that can be ordered by your healthcare professional.


See Calcium and Vitamin D Requirements


Vitamin D is found naturally in only a few foods, including fatty fish (salmon), liver (or cod liver oil), and egg yolks. In the U.S., milk and some cereals, juices, and breads are fortified with vitamin D. It can also be attained through nutritional supplementation and time spent in the sun.


In This Article:


Food for Thought: Diet and Nutrition for a Healthy Back Lifestyle and Diet Tips for Healthy Bones Calcium Is Needed for Strong Bones


Vitamin K2 acts as a director for bone minerals, properly distributing calcium out of the soft tissues and depositing it into bone. It is critical for healthy bone metabolism and is often deficient in the diet.


The combination of vitamin K2 and calcium works to help bones in the spine and throughout the body stay strong and healthy. Vitamin K1 is the plant form of vitamin K, which is converted to vitamin K2 by healthy digestive bacteria.


Vitamin K2 is found in healthy fats of meats, cheeses, egg yolks, and other dairy products, and K1 is found in green leafy vegetables such as spinach, kale, and broccoli.


Vitamin C is necessary for collagen formation, the substance that holds the body together, found in the bones, muscles, skin and tendons, and is an important part of the process that enables cells to form into tissue. It also functions as an antioxidant. Adequate vitamin C intake is vital for healing injured muscles, tendons, ligaments, and intervertebral discs, as well as for keeping the vertebrae strong.


See Vertebrae in the Vertebral Column


Vitamin C can be found in fruits such as strawberries, kiwi and citrus fruits (oranges, guavas, grapefruits), as well as in many vegetables such as tomatoes, broccoli, spinach, red and green peppers, and sweet potatoes. It is commonly available in supplement form.


Proteins are critical components of bone, although they can be easily overlooked with all the focus on minerals. Protein is a key building block for body structure, so daily consumption is critical for maintaining, healing, and repairing the bones, cartilage, and soft tissues. Proteins also play a key role in digestion and the functions of the immune system.


Collagen proteins make up 35% of the dry weight of bone. Collagen formation requires a regular supply of amino acids along with adequate vitamin C to incorporate them.


Glucosamine is an amino acid, which can be found in high concentrations in cartilage and connective tissue. Chondroitin is a substance that occurs naturally in connective tissues and as a supplement, and is often taken with glucosamine.


See Research on Glucosamine and Chondroitin Sulfate Supplements


As a cautionary tale, some studies have shown that when patients consume too much protein in relation to calcium over a long period of time, calcium can be leached from the bones as excess protein is burned. While both protein and calcium are deemed necessary for healthy bones, more research is needed to determine the recommended consumption ratio of protein to calcium and how the two substances affect each other.1


Vitamin B12 is required in the formation of the body’s bone-building cells and is necessary for healthy formation of red blood cells in the bone marrow. Vitamin B12 deficiency anemia has been associated with osteoporosis.


See Osteoporosis Causes


Vitamin B12 is found in animal proteins such as eggs, fish, poultry or meat products, and dairy products such as milk, yogurt, and cheese. Since vitamin B12 is not found in plants, vegetarians should consider supplementing to prevent anemia.


Iron plays a role in the production of collagen and in the conversion of vitamin D to its active form. It is also a component of hemoglobin and myoglobin, two proteins responsible for delivering oxygen throughout the body, including to the tissues that support the spine.


See Spinal Anatomy and Back Pain


A severe iron deficiency is not common, but can result in anemia. Overall, iron is not a key nutrient generally associated with bone health, but does contribute to other systems that assist in bone development.


Iron is found in many meat products such as liver, pork, fish and shellfish, red meat, and poultry; green leafy vegetables; and lentils; beans; soy; eggs; and whole grains.


Other Sources of Vitamins and Nutrients



If one is not able to incorporate sufficient amounts of certain vitamins and nutrients into the diet through food, nutritional supplements can usually be taken to make up the deficit. Patients should take care to always consult a medical professional before significantly changing their diet or taking nutritional supplements.

Causes of Back Pain

Millions of people around the world  have ongoing back pain. It’s the leading cause of disability in people younger than 45, and many things can cause it.

Spine-Related Problems

Back pain often happens because something is off in the way your spinal joints, muscles, discs, and nerves fit together and move. Your doctor can check to see if you have:

Herniated or slipped discs: If your doctor mentions this, the soft tissue in the discs between your joints has come out. It’s usually caused by wear and tear. Herniated discs can cause pain in your lower back or hip because the nerves there are pressed.

Bulging discs: These protrude, or “bulge,” but not as much as with a herniated disc. You don’t usually have symptoms with this. You'll feel it if it pushes on a nerve root, though.

Degenerative disc disease: The discs, or “shock absorbers” between your spine’s vertebrae, shrink or tear. That causes the bones to rub together. This may happen as you get older.


Back Pain Myths

WebMD's back pain slideshow lets you in on the truth about the causes and treatments for back pain.

Inflammation and wear of the sacroiliac joint:This lies where your spine and pelvis come together. It doesn’t move much, but it’s important because it moves the load of the upper body to the lower body. Swelling and wearing away of the joint cartilage can happen after an injury, because of arthritis, infection, or even pregnancy.

Spinal stenosis : If you have this, your spinal canal has narrowed. That adds pressure on your spine and nerves. As a result, your legs and shoulders probably feel numb. This happens to many people older than 60.

Cervical radiculopathy : This is a pinched nerve. It’s usually caused by a bone spur or a herniated disc.

Spondylolisthesis: A bone in the spine slips forward and out of place, typically in the lower back. The degenerative form of this condition isarthritis, which weakens the joints and ligaments keeping the spine aligned. It can cause a disc to move forward over a vertebra.

Accidents and Injuries

Car accidents, falls, muscle sprains, strains, andfractures are also causes of back pain. Injuries can lead to some of the physical problems, but some can cause pain all on their own.

Spine or vertebral fractures: A break to your spine can be causes by a hit to the back, a fall, or if you have osteoporosis, a condition that weakens your bones.

Sprains and strains: Injuries to ligaments, muscles, and tendons that support the spine and its joints can lead to back pain. This often happens when you lift something and twist at the same time. It can also happen because of car accidents and sports injuries.

Spasms: You can get these when muscles and tendons are torn in your lower back. They usually happen when you’re weightlifting or playing sports.

Lifestyle Triggers

Back pain can be brought on by things you do -- or don't do -- in your day-to-day life, like:

Slouching at your deskLifting heavy objectsBeing overweightNot exercisingSmokingWearing high heels



Emotions in Play

Don’t underestimate the power of feelings to bring on pain. Stress can lead to muscle tension in the back, and depression and anxiety may make the pain feel even worse.

Other Causes

Back pain can also be caused by medical conditions like:

Arthritis: This is a joint disease that causes stiffness, swelling, and inflammation.

Osteoarthritis : This type of arthritis happens when your cartilage and bones break down. This most often affects people from middle age onward.

Ankylosing spondylitis : This is a type of arthritis that affects your joints and ligaments along the spine.

Scoliosis, or curvature of the spine: This is usually something you have from birth. If there’s pain, it typically starts in mid-life.

Pregnancy: The weight you gain when you’re expecting can strain your back.

Tumors: In rare cases you can get them in your back. They’re usually spread by a cancer that started somewhere else in your body.

Less-common causes of back pain are:

Kidney stones and infectionsEndometriosis, a buildup of uterine tissue outside the uterus)Osteomyelitis or discitis, infections in the bones and discs of the spineFibromyalgia, a condition that causes widespread muscle pain

Depending on the cause of your pain, your treatment could include lifestyle changes,medication, or possibly surgery. Talk with your doctor if your back isn’t feeling right. He can help you discover what’s causing the hurt and can help you feel better.



Back Exercises

Best Muscle-Building Back Exercises!


Not sure which exercises to select on back day? Check out my list of the 10 best back builders and get ready to grow!


When you crack your exercise toolkit open each week on back day, you've got a seemingly endless array of movements available. Knowing which tools are best suited for building a wide, thick back will help you get the job done faster, which is why we've assembled our list of top 10 mass-building back exercises.

While head-to-head exercise comparison research is a bit limited in this area, we selected the following 10 exercises based on factors such as available literature, how difficult each movement is, how much muscle each stimulates, and how unique each exercise is compared to others. This list will also help you figure out where to place each exercise in your workout.

If you get bowled over by the sheer number of rows you can do on back day, or even draw a total blank when thinking of new exercises to try, consider this list your new back blueprint. Give us your thoughts at the bottom in the comments and add any other recommendations you might have!

1. Barbell Deadlift

Why it's on the list: This is technically more than a back exercise—it hits the entire posterior chain from your calves to your upper traps—but it's the absolute best for overall backside development. Technique is uber-important with the deadlift, but once you nail it, you can progress to lifting monster weights that will recruit maximum muscle, release muscle-building hormones, and help you get big.

There are also numerous deadlift progression programs you can follow to help you reach new personal bests. Physiologists love to prescribe the deadlift when programming for strength and conditioning because the exercise hammers your musculature and is one of the best choices to strengthen your bone structure.



There are also numerous deadlift progression programs you can follow to help you reach new personal bests.

Stick with the conventional deadlift on back day; other variations, like the popular sumo-style, increase the activity of muscle groups other than the back.

In your workout: If you're going heavy (sets of fewer than about 6 reps), do deadlifts first so you're fresh. If you're doing deads for repetitions, you can do them later in your workout.

2. Bent-Over Barbell Deadlift

Why it's on the list: This is probably the second-best back movement in terms of sheer weight you can lift. EMG research has suggested that hitting bent-over barbell rows will work the larger muscle groups of the upper and lower back equally, making this a great overall back builder. Like the deadlift, this is another technical move that requires excellent form but rewards you with a ton of muscle.


Bent-Over Barbell Row

In your workout: Do bent-over rows toward the start of your back workout for heavy sets in lower rep ranges, about 6-8 or 8-10. The Smith version is a suitable substitute; it locks you in the vertical plane, but your body has to be in just the right position relative to the bar. The bent-over barbell row has a significantly greater lumbar load than many other back exercises, so it's best done early in your workout in order to save your lower back. If you're wrecked from deadlifts, it may behoove you to skip this movement.

3. Wide-Grip Pull-Up

Why it's on the list: It's always a good idea to have an overhead pulling movement in your back routine, and the pull-up is one of the best. Wide-grip pull-ups are excellent for putting emphasis on the upper lats. A closer grip may allow for a longer range of motion, but it may be possible to load the wide-grip pull-up to a greater degree because of an optimized starting joint position. The biggest challenge here for most trainers is training to failure in the right rep range for growth, which is 8-12.

If you do pull-ups early in your workout, you might have to add a weighted belt. Of course, if you find them difficult, you can always use an assisted pull-up machine or a good spotter, or switch to the wide-grip pull-down, which is a solid substitute. If your shoulders are healthy, pulling behind the head is okay.

Good form is extremely important here. In the starting position, the scapula should be retracted—pull your shoulder blades down and toward each other—prior to initiating the pull.



Wide-Grip Pull-Up

In your workout: Because the pull-up range of motion is so long, several light reps make great warm-up moves for the shoulder joints. Since form is so important with these, it may be best to push pull-ups toward the front of your workout to ensure proper shoulder-joint positioning.

4. Standing T-Bar Row

Why it's on the list: We selected the T-bar row over a chest-supported version because you can pile on much more weight here, even though that typically translates into a bit of cheating through the knees and hips. For some, maintaining a flat back can be challenging, in which case the supported version is a better choice.

These aren't squats, so keep your legs locked in a bent angle throughout. You also typically have a choice of hand positions and width. A wider grip will put more emphasis on the lats, while a neutral grip will better target the middle back (rhomboids, teres, and traps). This exercise is probably one of the easier rows to spot.



These aren't squats, so keep your legs locked in a bent angle throughout.

In your workout: Do this toward the front half of your workout. Rather than slinging weight around with this movement, really focus on the stretch and contraction of the back. If you're an experienced lifter, load up with 25s instead of the 45s, and further increase range of motion by allowing a slight protraction of the scapula at the bottom of every rep. If you do this, be sure to "reset" with a flat back before initiating the next pull!

5. Wide-Grip Seated Cable Row

Why it's on the list: Just about everyone defaults to the close-grip bar on rows. If that sounds like you, you'll find using a wide grip on a lat bar a nice change of pace because it shifts some of the emphasis to the upper lats. Wide rows mimic some back machines, so don't do both in your workout unless you make some other kinds of changes, like grip or target rep range. You might even try flipping your grip—and going about shoulder-width apart—which better targets the lower lats as the elbows stay tighter to your sides.



Wide-Grip Seated Cable Row

In your workout: Like machines, cables are best done toward the end of your workout. Choose a weight that enables you to complete no more than about 12 reps.





6. Reverse-Grip Smith Machine Row

Why it's on the list: Reverse-grip movements mean two things: The biceps play a greater role, and with the elbows now pulling back close to your sides, the target becomes the lower portion of the lats. The Smith machine allows you to concentrate only on pulling as much weight as possible, since you don't have to worry about balancing it.

Bend over about 45 degrees, staying close to the bar, and expect a little contribution from the hips and knees when you're pounding out the heavy sets. While some gym rats consider the Smith machine taboo, the fixed plane of the movement and ability to really control a weight (think tempo of four seconds up and four down) can be both a novel and humbling exercise.

In your workout: You don't need more than a single reverse-grip movement in your routine. Do it about midway through your workout, after your heavy overhand pulls. At any point in your back workout, don't be afraid to throw on some wrist straps. Your goal is to hammer your back and put it through the wringer, not be constantly limited by your grip strength.

7. Close-Grip Pull-Down

Why it's on the list: Since we've already covered the wide-grip pull-up, the wide-grip pull-down is too similar, so we opted for the close-grip handle for our pull-down selection. EMG research suggests that use of a close neutral grip activates the lats similarly to a regular grip, so you're not missing out on any muscle fibers. As mentioned earlier with pull-ups, a closer grip does allow for a longer range of motion and increased time under tension for the lats, which is great for building muscle.



A closer grip does allow for a longer range of motion and increased time under tension for the lats, which is great for building muscle.

In your workout: This exercise can make a good warm-up move for your shoulders, but when used as a mass-building exercise, it's best placed toward the end of your workout for sets of 8-12 reps.

Slow down the rep tempo on these, squeeze hard at the bottom of each rep, and allow a good stretch at the top.

8. Single-Arm Dumbbell Row

Why it's on the list: This is a great unilateral exercise—each side works independently—that allows you to move a lot of weight. You'll get greater range of motion when training unilaterally, and you won't be restrained if your weaker side fails first. You may also be better able to support your lower back—which may have taken plenty of punishment by now—when placing one hand on a bench. Allowing a slight degree of rotation of the trunk may engage a greater degree of "core" musculature, as wel



Single-Arm Dumbbell Row

In your workout: Unless you intentionally flare your elbow out wide, this exercise focuses more on your lower lats. Do it anywhere from the middle to the end of your workout for sets of 10-12.

9. Decline Bench Dumbbell Pull-Over

Why it's on the list: Pull-overs for back? Absolutely! This one mimics the straight-arm cable pull-down you're probably familiar with. Yes, this is a single-joint move, but it allows you to really target and torch your lats. The decline version puts your lats under tension for a longer range of motion than when using a flat bench. Just make sure the dumbbell clears your head, and drop it on the floor behind you when you're done.



Decline-Bench Dumbbell Pull-Over

In your workout: In almost all cases, single-joint movements should be done last in your body-part routine. Keep the reps on the higher end for a nice finishing pump, around 12-15 per set.

10. Single-Arm Machine Row

Why it's on the list: This bad boy is basically a single-arm dumbbell row performed on a Smith machine. It's a great and novel choice for your lower lats. Stand sideways to the machine, grasping the bar toward the middle, and keep your body close to the apparatus using a split stance and bent knees for balance. As you pull the bar up as high as you can, your body may sway a bit to keep the movement natural, which is OK.

In your workout: Do this exercise toward the end of your back routine for sets of 8-10 or 10-12. Do it in place of the single-arm dumbbell row—not both—since the exercises are similar.