Lower Back pain and Exercise

​by Jane Marchant, physical therapist
Lower back pain is experienced by most people at some time in their lives. The muscles which support our back are in constant use, while our body is in motion, but also while simply sitting or standing. This constant stress on the back easily results in back pain. Most back pain is caused by muscle or ligament strain, however there are other causes such as damage or injury to spinal nerves, discs or bones. Sometimes back pain is linked to stress, anxiety and depression.
Recurring lower back pain can be prevented by the regular practice of specific exercises designed to strengthen the muscles which support your back, stretch shortened muscles and correct your postural alignment.
Exercising is beneficial for most conditions causing lower back pain. In case of acute back pain, the exercise program – except for very gentle stretching exercises – should be started only when most of the pain has subsided. Lying on a firm mattress and applying cold packs on the area for a couple of days will help relieve muscle spasm and pain. If your back pain is severe or is accompanied by numbness or pain down the leg, a doctor should be seen immediately.
I recommend doing the exercises first thing in the morning. If your bed has a firm mattress you can exercise even before getting up, if not, use an exercise mat on the floor. Each exercise indicates the breathing pattern.  Synchronize the movement with slow and deep breaths. Keep the movement fluid. Gradually increase the number of repetitions, as you make progress over the weeks.
 

1. Pelvic Tilt : Lie on back, knees bent, feet flat on the mat. Inhale and slightly arch lower back, lifting navel upward without lifting hips. Exhale and flatten lower back to the mat, contracting abdominals. 10 repetitions.
2. Knees to chest : Lie on back, knees bent, feet lifted and hands placed on the knees. Inhale deeply and slowly, exhale and hug knees to chest. Inhale and release. 10 repetitions.
3. Spinal Twist : Lie on back, hands out to the side, feet flat on the mat. Inhale, exhale and bring both knees down to right as close to floor as feels comfortable and turn head to left. Inhale and bring knees and head back to center. Exhale and bring knees down to left and turn head to right. 3 to 5 repetitions on each side. Gradually increase range of motion. To increase the twist, lift the feet off the mat.
4. Bridge : Lie on back, knees bent, feet flat on mat. Inhale and gently roll hips up, lifting buttocks first and vertebras one at a time, engage abdominals by tucking buttocks under. Exhale and roll down, one vertebra at a time, buttocks coming down last. Head stays on the mat. 4 to 10 repetitions.
5. Abs 1 : Lie on back, press lower back on mat, lift feet up, hips and knees bent at a 90 degree angle, hands behind neck. Inhale, exhale and lift head, shoulders and shoulder blades bringing right elbow to left knee. Inhale, come down and vice-versa.  Keep lower back pressed on mat throughout exercise.  5 to 10 repetitions on each side.
6. Abs 2 : Lie on back, feet up in the air, knees bent at 60 degrees.  Place thumbs under buttocks, press lower back on mat. Inhale to prepare, exhale and lift buttocks slightly off mat, bringing feet up toward ceiling. Lower and inhale. 5 to 10 repetitions.
7. Cat and dog : roll to your side and come up onto all fours.  Place hands below shoulders and knees below hips. Inhale, look up and slightly arch back, exhale, look to navel, round back. Progressively increase the range of motion. 5 to 10 repetitions.
8. Balancing Table : on all fours. Bring right arm up and forward to horizontal and left leg up and backward to horizontal. Keep belly in and chin tucked in. Straight line from hand to foot. Hold for 3 to 6 deep breaths. 1 to 3 repetitions on each side. Alternate with exercise # 9.
9. Child Pose : rest with buttocks on heels, arms stretched out in front of you. Take 3 to 6 deep breaths. Omit if uncomfortable for knees or ankles.
10. Hamstring and Piriformis stretch : lie on back, knees bent, feet on mat. Hold right foot in right hand and try to straighten leg up. Hold for 5 deep breaths. Then place right foot over left knee and hug both knees into chest. Hold for 5 deep breaths. Switch sides.

To this exercise program you need to add correct posture while sitting and standing and proper bending and lifting techniques explained in the December 2007 issue of the VON. Learning how to relieve stress, by exercising or relaxation techniques, healthy nutrition and hydration, as well as not being overweight complete the conditions required to eliminate lower back pain.
Should you wish to join an exercise class or start the regular practice of a sport to prevent or relieve lower back pain, chose low-impact aerobic exercise such as swimming, walking or an exercise class which does not involve running and jumping. Water aerobics is a good choice, as well as exercising with the Gymnic Ball. Exercising with the Ball allows you to safely and effectively develop the strength of the muscles that stabilize and move the trunk, including the abdominals and muscles of the back. Not only does it develop their strength but also their ability to work in an efficient and coordinated way to maintain correct alignment of the spine while the  body is in motion.
Stronger abdominals and back muscles, as well as improved flexibility, balance, coordination, heightened body awareness and corrected posture will help you protect your lower back in your daily activities.