In the athletic world, the posterior chain is considered the most influential muscle groups in the body and are the prime movers of forward propulsion. You may be asking yourself right now, “why should I care? I am a nurse not an athlete”. As a nurse, a lot of the movements you perform are also seen in the “athletic” movement realm and are directly tied to your posterior chain. Reaching, bending over, transferring patients, etc. are all movements that put stress on your posterior chain. I wrote a blog about musculoskeletal injuries in nursing a few months back, and from my research and speaking with nurses I want to reduce the number one work injury to a nurse: the lower back injury.
How can you as a nurse prevent lower back injuries? I believe a well-rounded workout regimen with a focus on strengthening the posterior chain is the key! Personally, I have a pars fracture at L5 and spondylolisthesis at L4-L5. This injury occurred during a soccer game when I was 16 years old. For the next 14 years of my life I had constant back pain even though I was playing high school, college and professional soccer. When I turned 30 years old I decided to get back into working out and living a healthier lifestyle. Part of my training program consists of strengthening my posterior chain in both an endurance and power aspect. Now I get the occasional back pain, but it is easily managed.
The posterior chain consists of the gluteal muscles, hamstrings, and lower back muscles. These muscles perform a variety of movements including back/spinal extension, hip extension, hip rotation, knee flexion and support the spinal column. Strengthening these muscles in very specific movement patterns will directly help you while working with your patients. I have broken down the movements into lower stress movements and higher stress movements.
Lower Stress Posterior Chain Exercises:
Banded Good Mornings
Sliding Leg Curls
Leg Curl Machine
Swiss Ball Leg Curls
High Stress Posterior Chain Exercises:
Barbell Hip Thrust
Barbell Good Mornings
Single Leg Romanian Deadlift
Where should we start?! If you have not been consistently working out, I recommened starting with the following 4 exercises: Banded Good Mornings, Bridges, Supermans and either of the leg curl exercises. I do not recommend jumping straight into deadlifts or barbell good mornings if you do not have a solid posterior chain base already. Those are more complicated movements that need a certain level of strength in order to be performed correctly. I would start with 3 sets of 10 reps for the four exercises. Perform those 3x per week for 1 week then jump up to 3 sets of 15 reps 3x per week for a week. Keep adding 5 reps on until you get to 3 sets of 20-25 reps 3x per week. Once you get to that level you introduce Romanian deadlifts, deadlifts, barbell hip thrusts, and barbell good mornings with LIGHT loads. Just remember that you are in this for the long haul and to take it slow and steady.
On a side note, by strengthening your posterior chain you will start to notice certain changes in your physique that may bring a smile to your face when you put your scrubs on for your next shift!!
For demonstrations of most of these exercises please go to the FIT RN YouTube page at: https://www.youtube.com/channel/UCEcc2xzRccGlYYrxRUu0x8Q
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