Mechanical instability from degenerative disc disease

Exercises for patients with degenerative disc disease
For the mechanical instability, dynamic lumbar stabilization exercises for patients with degenerative disc disease can help stabilize the spinal segments. Good muscular control of the spine can help compensate for a degenerated disc and reduce both instability and pain.

These exercises, which are best learned with a physical therapist, consist of the following:

• Finding the position the spine is most comfortable in (neutral spine)

• Educating the back muscles to keep the spine in the neutral position

• Maintaining the neutral position through a series of movements that apply more and more degrees of freedom of motion.

Two other important components of an active exercise program for those with degenerative disc disease are a daily hamstring stretching program and aerobic conditioning.

1. Hamstring stretching for degenerative disc disease
   
   Hamstring stretching is very important for patients who have degenerative disc disease. If these muscles are tight they lock the pelvis, causing all the motion and stress to be transmitted to the lumbosacral junction. If the hamstrings are kept stretched, the pelvis will be allowed to rotate and relieve some of the stress on the lower lumbar discs.
   
   Hamstrings are like any other tendon or muscle; the more often they are stretched the more effective the stretching will be. When stretching the muscle, 30-60 seconds of continuous tension should be applied without bouncing (bouncing triggers a reflexive spasm in the muscle).
   
   Since hamstring stretching needs to be done every day, preferably twice a day, this activity should not be linked to other exercises that may be done less frequently. It is easier to get into a stretching routine if you do the stretching at the same time every day, such as in the morning when you get up, and right before going to bed.
   
   
2. Aerobic conditioning for degenerative disc disease
   
   Conditioning is very important since it has been shown in large studies that individuals who are well conditioned have less pain than those who are deconditioned.
   
   The aerobic exercise should be low impact so that it is well tolerated by the back and degenerated discs. Walking is an excellent low impact aerobic exercise, and stationary biking and swimming are also good options.
   
   The goal of an exercise program for degenerative disc disease should be to work up to 30 to 60 minutes of exercise three times weekly, and the exercise needs to be continuous. A lot of patients walk at work and feel that further exercise is unnecessary. However, this stop and start type of activity is not adequate. There is actually a biochemical reaction the body generates with continuous aerobic activity, and it is thought that this reaction helps decrease pain.