What type of exercise should be performed?
How can physical activity be maintained without aggravating pain? Many people are amazed at how well-chosen exercises can reduce pain. Some of the exercises in this brochure can provide quick and significant pain relief and speed recovery. Once the pain is reduced or gone, other exercises can help restore back movement and core strength. These will help you achieve a full recovery and prevent the pain from returning. Many doctors consider an increase in pain during activity to be acceptable, as long as the pain does not continue to increase after the activity is completed. So please try to stay as active as possible.
Remember, this is just a guide. Not all exercise is right for everyone. If you are exercising and your pain increases greatly, stop the activity and notify your health care provider.
Remember, this is just a guide. Not all exercise is appropriate for everyone. If you have a significant increase in pain while exercising, stop the activity and notify your health care provider.
Remember, this is just a guideline. Not all exercise is appropriate for everyone. If you experience a significant increase in pain while exercising, stop the activity and notify your health care provider.
When choosing your exercise program, it is important to monitor your pain and choose your exercise program carefully to avoid worsening back pain. One indication that your back pain is getting worse is the spread of symptoms.
Away from the center of the lower back? spreading to the hips; or down or further down, to the legs.
This can happen during movement and activity or with certain postures.
The good news is that the opposite is also true! Symptoms can disappear from the legs or hips, near the center of your lower back (called “pain concentration”). This usually means you are improving and recovering! You can find different exercises and postures to make this happen. Once all symptoms return to the center of your lower back, they tend to improve and disappear quickly with continued exercise.
The four most common exercise programs that focus & reduce symptoms are.
Walking on a flat surface; standing back up; face down elbow support; and push-ups.
When performing exercises, monitor your pain like any other activity. Make sure it is focused and disappears or at least aligned with the current pain rather than aggravated.
Posture is also important In addition to proper exercise, good posture is vital, whether standing, or sitting. When you are sitting, avoid being sedentary and avoid slouching. When your symptoms worsen when you sit (and may radiate to your hips or legs), check your sitting posture. For many people, sitting up straight can help focus and reduce pain. Sitting up straight can be used as a form of exercise to build muscle endurance and develop better sitting habits. Once the pain is gone, sitting up straight more often can prevent symptoms from coming back. When you must sit for long periods of time, it is best to place a firm support behind your lower back to deepen the natural inward curve of your lower back so that your hips are slightly above your knees.
Once the pain is relieved, exercise immediately. In many cases, it may only take a day or two to control or eliminate the symptoms. Once your pain improves or disappears, gradually and carefully increase your activity level, starting with some simple forward leaning exercises. Continue exercising as long as your symptoms do not return, worsen, or move away from the center of your back.
For most people, it is helpful to sit up straight consistently.
Strength training Many people with low back pain have weak core muscles. Strength exercises to help keep you away from possible future problems. Since all body movements and postures (including sitting up straight) require adequate muscle strength and adaptations, some strength exercises and stretching are needed. Moderate strength training is one of the most valuable things you can do for your overall health, and is especially vital if you suffer from low back pain.
Back strength exercises help in two ways.
1. it helps repair injuries by accelerating blood flow.
2. It improves daily function by increasing muscle strength and endurance.
In order to heal and repair an injury, nutrients must be delivered to the injury site through good blood flow. Back muscle strength training accelerates blood flow to the exercised muscles and nearby tissues. This is also true for aerobic exercise (e.g., walking, swimming, cycling), but especially for strength training.
Building strong muscles also increases your ability to stay active throughout the day. In addition to strengthening the lower back, the large muscles of the trunk and upper and lower extremities deserve attention. These muscles provide important stability to the back and trunk by improving balance and gait. It allows you to be more relaxed in your daily activities and reduces the likelihood of falls.
While specialized equipment and gyms are helpful, there are good, easy and inexpensive ways to build strength in the lower back muscles at home. Simply place a pillow or two under your lower back to add more resistance. Two other common pieces of simple equipment that are very useful include the popular Swiss ball or the basic Roman chair.
In summary good low back care includes pain relief exercises with proper stretching, followed by moderate strength building exercises. Self-care using these techniques can help you recover and prevent possible future symptoms.
Where to start?
Walking: Start with a 10-minute walk and gradually increase to 30 minutes or more. Increase the distance and speed that can be tolerated.
Standing back: Hold your hand and fingers over the lumbosacral area. Bend backward to a bearable angle and press fingers inward. Hold for 1-2 s. Repeat 10 times, trying to bend more each time. Repeat every 2 hours unless pain worsens.
Face down elbow brace: Using elbow brace, lift the body up so that the lower back is concave. Hold for 10 s. Repeat 3 times. Repeat every 2 hours unless pain worsens.
Push-ups: Support with your arms and lift your body upward, making a depression in your lower back. Return to prone position. Repeat 10 times, each time with a deeper depression. Repeat every 2 hours unless pain worsens.
Standing position: Head back, chin tucked, ears and shoulders down in line with hips and balanced with legs above (left side position correct; right side position wrong).
Seated posture: Ears and shoulders should be aligned with the hips, standing with the same forward convex curve of the lower back. (Wrong posture on the left; correct posture on the right)
Single knee to chest stretch: pull one knee to chest and gently pull for 10s. Repeat 3 times. Repeat for each knee.
Double knee to chest stretch: pull both knees to chest and pull gently for 10 s. Repeat 3 times. Make sure pain does not worsen. Repeat 2-3 times per day unless pain worsens.
Face down back extension: Place hands on back and lift head and shoulders off the floor. Hold for 5-10 s. Repeat 3 times.
Ball face-down back extension: Place hands on back and lift head and shoulders upward. Repeat 3 times.
Roman Chair Back Reach: This is a more advanced exercise and may not be suitable for everyone. With the hip pad at the top of the iliacus, lean your body forward as far as possible and use your lumbar muscles to lift your spine. Perform slowly (count of three on the way up, four on the way down). Repeat 5-10 times.
Bend knee double-headers: Arms are placed overhead toward the knee, pelvis is tilted, and back is flat. Raise head and shoulders from the floor. Hold for 5-10 s. Repeat 3 times.
Cat/Camel: Arms placed under shoulders, knees under hips.
(1) Arch your back up by contracting your abdominal muscles. Hold for 5-10s.
(2) Relax and dip your back.
Supine ball stretch: Arms on the floor, hips lifted from the floor. Hold for 5-10s. Repeat 3 times.
Sit up: Sit with arms crossed over chest; slowly stand up and slowly return to seat (count to three when standing up, count to three when sitting down). Repeat 5-10 times.
Ball/Stand against the wall: stand with knees straight and ball placed behind you. Slowly bend knees (3s) to ¾ position and hold for 5s. Slowly return to standing (3s). Repeat 5-10 times.