Low Back Pain - Part 3 of 3
Now on to the specific exercise part. Dr. Stuart McGill (2007) an expert on low-back health and injury prevention, recommends that people with low-back pain keep the following in mind:
Low-back exercises have the most beneficial effect when done daily
DO NOT exercise through low-back pain (though, as someone who has had incidences of low-back pain, there was no chance that I could exercise while I had low-back pain)
Combining low-back exercises and cardiovascular activities (like walking) have been shown to most effective for rehabilitation and injury prevention
There is less spinal fluid between the discs of the vertebrae first thing when rising from bed in the morning. Therefore, it’s good to stay away from full-range spine motion while under load shortly after rising from bed.
It’s best to focus on more repetitions of less demanding exercises will lead improved low-back endurance and strength.
There is no such thing as one perfect set of exercises for all people.
Be patient and try to stick with a low-back training program. It can take 3 or more months to have increased function.
Four Specific Exercises
NOTE: Do Not Do Any Of These If You Have Any Pain.
1. Cat-Camel
This exercise is meant to be a motion exercise - not a stretch! Therefore, don’t ‘push’ at either end of the range of motion. This motion acts as a way to reduce friction and internal viscosity and ‘floss’ the nerve roots at each lumber level.
Begin on all fours.
Slowly lower your head, while you raise your back up, for the cat portion of the exercise.
Do this movement slowly, without forcing or pushing it at the end of the movement, taking 3-4 seconds from neutral to the end of the movement.
Start into the opposite movement by slowly raising your head into extension, while dropping your back into a downward arch. Do this movement slowly, and unforced, taking 3-4 seconds again. This is the camel portion.
Then return back into the cat pose, again slowly lowering your head, and arching your back up.
Aim to do these movements for 8-10 repetitions, to fully mobilize your lumbar spine or low back area. Try to do this 1x/day.
2. Modified Curl-Up
Lie flat on a fitness mat, face up, with a rolled-up small towel are placed under your lower back. Do’t flatten your back to the floor as this puts too much pressure on your lower back.
One knee is bent with your foot flat on the floor and the other leg is straight. This helps with locking your pelvis and lower back.
Alternate your bent leg midway through your total repetitions.
Aim to do these movements for 8-10 repetitions, to mobilize the anterior abdominal exercises. Try to do this 1x/day.
3. Birddog
This exercise is good for building low back function, as it engages both the core and back muscles at the same time.
Find a soft surface to kneel on and enough space to extend both an arm and a leg at the same time. An exercise mat is a good choice of surface. (NOTE: Don’t attempt this one if you have shoulder issues)
Kneel with knees hip-width apart and hands firmly on the ground about shoulder-width apart. Brace the abdominals.
Practice lifting one hand and the opposite knee just an inch or two off the floor while balancing on the other hand and knee and keeping your weight centered.
When you feel steady and ready to move on to full range of motion, point the arm out straight in front and extend the opposite leg behind you. You should form one straight line from your hand to your foot, keeping hips squared to the ground. If your low back begins to sag, raise your leg only as high as you can while keeping your back straight.
Hold for a few seconds (no more than 7 or 8 seconds), then return your hands and knees. There is evidence that it is better to increase endurance through more repetitions rather than extending hold time.
Switch to the other side.
Keep the abs engaged throughout the entire exercise, and work to minimize any extra motion in your hips during the weight shift.
4. Side Bridge
The side bridge works the lateral muscles of your torso. These are important for optimal stability.
Start by lying on your left side with your weight on your elbow and knees, with your legs stacked. (Once you’ve mastered this, you can move to bridging your weight between your elbow and your stacked feet) Inhale to prepare.
Exhale, pull your abs to your spine, and lift your pelvis off the floor, coming into a side elbow-plank. Really lift your bottom waist up. Pull your shoulder blade down your back so your shoulder stays away from your ear (this will work your lat, too).
Maintain a neutral neck and spine position.
Start slow, holding for 10 seconds (assuming no pain), and build up the hold time gently and slowly over time. Remember, this is about endurance.
SOURCE: American Council on Exercise Personal Trainer Manual Fifth Edition, Chapter 14 Exercise and Special Populations, Pages 549 - 551.