Specific exercise
strategies
The following guidelines and insights are designed
to help patients plan and follow through with a safe
and effective exercise program to condition the back.
The key goals of engaging in exercise and fitness activities
are to aid the healing process for an injured back
and alleviate existing back pain while helping to prevent
(or at least minimize) future problems.
- Find the right type of professional to help
with the exercise and fitness program. Patients
should always consult with a physician prior to
beginning any exercise or fitness program. A healthcare
professional can assist with the development of
an appropriate list of back exercises and activities
in which to engage or avoid. Health professionals
such as physical therapists, chiropractors, and
physical medicine and rehabilitation physicians
(physiatrists) often have specific training and
expertise with exercise and fitness programs for
pain relief. It’s particularly important
to see a health professional with expertise in
spinal conditions and back pain, as different back
conditions often require very different exercise
programs.
- Expect some initial discomfort when beginning
a new exercise and fitness program. However,
start slowly, because the results of back exercise,
such as soreness, may not be felt for 24 to 48
hours after the exercise session. Beginning an
exercise program after an episode of back pain
will likely cause some increase in pain in the
beginning. However, the back pain experienced during
exercise should be "good pain." This
pain is to be expected as a natural part of increasing
activity and stretching tissues that have become
stiff and deconditioned.
- Set a careful pace when starting to exercise. When
returning to activity after an episode of pain or
following surgery, ease into back exercise and physical
activity. Be careful not to overwork or strain muscles
that may have become deconditioned after a period
of inactivity. Taking into account that there may
be some initial discomfort, a cautious approach to
back exercise can help keep back pain under control
and prevent a flare-up.
- Include a combination of stretching, strengthening
and low-impact aerobic conditioning exercise. Utilizing
these three components of exercise will help heal
existing problems, avoid injury and prevent future
problems. Muscles will become strengthened and
more flexible, repairing strained muscles that
cause back pain. Low-impact aerobic conditioning
helps to stretch and strengthen the back as well
as the abdominals and hamstrings, two muscles that
help to support the back.
- Engage in gentle forms of exercise, such as
water therapy or walking. For patients experiencing
higher levels of back pain, exercise may be more
comfortable in the water than on land. Water therapy
provides the therapeutic effect of relieving pain
and also can help prepare the body for more extensive
exercise. Another form of gentle physical activity
is exercise walking, a good option for patients
in less pain who are ready to move onto more intensive
exercises on land.
- Consider alternative forms of exercise, such
as Pilates, yoga, or Tai Chi. Pilates, yoga
and Tai Chi provide gentle strengthening and stretching
exercise that can help alleviate present back pain.
They help improve overall fitness and posture,
which in turn prevents future episodes of back
pain. Other benefits of alternative therapies like
Pilates, yoga, and Tai Chi are stress relief and
relaxation, which can also assist with back pain
relief.
- Know when to reassess the exercise and fitness
program. If back pain during exercise becomes
severe, it is important to redesign the back exercise
program with the help of a professional. The individual
patient is the best judge of whether the pain during
exercise is normal discomfort or if the level of
pain is signaling that the patient should discontinue
the specific exercise.
- Build a motivating support system during the
course of the exercise program. Friends and
family may often encourage patients to rest and
avoid physical activity because of the common misconception
that exercise causes back pain. However, the opposite
is true when patients perform the appropriate back
exercises. The patient may need to educate others
about the importance of back exercise and fitness
for back pain relief. Telling friends and family
about plans to increase start exercising and asking
for their encouragement may help the program’s
success.
- Keep a written record of progress made during
the exercise and fitness program. Tracking
progress is useful for the patient as well as for
health professionals who are helping with the exercise
program. Records could include a list of the specific
back exercises performed, number of sets and repetitions,
duration of exercise and pain and sensations experienced
during exercise. This helps both the patient and
the exercise professional track progress toward
fitness goals and ensures that information is accurately
communicated among different professionals and
to the patient. Monitoring progress may also help
keep the patient motivated to continue with the
exercise and fitness program.
By: Stephen H. Hochschuler, MD
August 4, 2004
|
|
