Exercise
for back pain
Healing through back pain exercise
Active forms of back pain exercise (physical therapy) are typically
necessary to rehabilitate the spine and help alleviate
back pain. Importantly, a regular back pain exercise routine
provides patients with the means to help avoid recurrences
of low back pain, and helps reduce severity and duration
of potential future episodes of low back pain.
The natural stimulus for the back to heal is active
back pain exercises, done in a controlled, gradual, and progressive
manner. Movement distributes nutrients into the disc
space and soft tissues in the spine to keep the discs,
muscles, ligaments and joints healthy. And the converse
is true too—lack of exercise can worsen back pain
by leading to stiffness, weakness, and de-conditioning.
Generally, a patient’s back pain exercise program should encompass a combination of stretching
exercises (such as hamstring stretching), strengthening exercises
(such as dynamic lumbar stabilization exercise, Mckenzie
exercise, or other back exercise programs) and low
impact aerobics (such as walking, bicycling,
water therapy or swimming). Depending the patient’s
specific diagnosis and level of pain, the back pain exercise
and rehabilitation program will be very different,
so it is important for patients to see a spine specialist
who is trained to develop an individualized exercise
program provide instruction on using the correct form
and technique.
Stretching as part of a back pain exercise routine
Almost everyone can benefit from stretching the soft tissues—the muscles,
ligaments and tendons—in the back and around the spine. The spinal
column and its contiguous muscles, ligaments and tendons are all designed
to move, and limitations in this motion can accentuate back pain. Patients
with chronic back pain may find it takes weeks or months of stretching to
mobilize the spine and soft tissues, but will find that meaningful and sustained
relief of low back pain typically follows the increase in motion.
Hamstring stretching exercise
The hamstring
muscles seem to play a key role in low back pain, as
patients who have low back pain tend to have tight
hamstrings, and patients with tight hamstrings tend
to have low back pain. It is not known which comes
first, but it is clear that hamstring tightness limits
motion in the pelvis and can place it in a position
that increases stress across the low back. Therefore,
it follows that stretching the hamstring muscles typically
helps decrease the intensity of a patient’s back
pain and the frequency of recurrences.
A hamstring stretching exercise routine should include
applying pressure to lengthen the hamstring muscle
for 30-45 seconds at a time, one to two times each
day. The pressure on the muscle should be applied evenly
and bouncing should be avoided, since a bouncing motion
will trigger a spasm response in the muscle being stretched.
The hamstring muscle may be stretched in a number of
different ways. Options for hamstring stretching exercises,
listed from most difficult to least difficult, include:
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The most common technique is to simply bend forward
at the waist, with legs relatively straight, and
try to touch the toes and hold this position.
-
If this approach is not well tolerated, less strain
is applied to the back by sitting on a chair and
placing the legs straight out in front on another
chair, then reaching forward to try to touch the
toes. One leg at a time may be stretched.
-
One of the least stressful stretching techniques
is to lie on the floor and pull the leg up and
straighten by holding onto a towel that is wrapped
behind the foot. One leg at a time may be stretched.
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Another less stressful option is to lie on the
floor, with the buttocks against a wall, and place
the foot up against the wall and then try to push
the knee straight. One leg at a time may be stretched.
With time the hamstring muscle will gradually lengthen,
reducing stress to the low back. Stretching should
not be linked to another back pain exercise routine, since those
exercises may not be done on a daily basis. In order
to make stretching exercise a part of one’s daily
regimen, it is best to stretch every morning when getting
up and before going to bed. Think of stretching exercises
as good back hygiene.
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