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Don't Back Away from Exercise
By Dr. Reuven Bruner, Ph.D.

If you have chronic back pain, it's tempting to think that it's best to rest, and even to stay in bed as much as possible. Wrong. Study after study has shown that exercise helps reduce low-back pain when you have it, as well as helping to protect against future back pain.

Back pain is often mysterious. Injury to muscles, ligaments, nerves or the spine may be responsible, but most people with back pain can't recall a specific incident that caused the pain. The pain can have other causes, such as chronic overuse of muscles, a muscle imbalance that throws the back off kilter, a herniated disk or other structural problems. Often MRIs and other imaging tools reveal no significant abnormalities in very painful backs, while scans of painless backs may show herniated disks and other abnormalities.

Whatever the source of your low-back pain, exercise is likely to be a part of the solution. If the pain is minor, a simple exercise routine may be enough. But generally, you're best off with a program tailored to your particular problem and that usually calls for advice and guidance from an exercise physiologist and a physical therapist.

You need to do not only exercises that stretch and strengthen weak back muscles, but also those that strengthen your abdominal muscles, such as curl-ups and crunches, since abdominal muscles help support the back. You should also do exercises that keep your hamstring muscles (at the back of the thighs) flexible; tight hamstrings, from walking or jogging, often play a key role in low-back pain. So can tight hip flexors. That's a large menu of muscles you may need to strengthen and/or stretch. The exercises described here are only a start (home-fitness-lifestyle program available).

EASY DOES IT: Begin any exercise program slowly, preferably with an expert to guide you, motivate you and assess your progress. Before starting to exercise, talk to your doctor or an exercise physiologist, if your back hurts. Stop if the pain gets worse or if you experience leg pain or numbness. Avoid exercises that increase stress on the spine, such as straight leg toe touches or backward bends. Before working out, always, always warm up and then gently stretch. Do the following exercises at least 4-5 times a week.

COBRA: Lying on stomach, push upper body off the floor by straightening your elbows. Hold for 10 seconds, then let your back relax as you lower your torso. Repeat 10 times.

PELVIC TILT: To strengthen abdominals. Lie on back with knees bent, feet flat on floor and arms at sides. Tighten abdominal muscles so that the small of back presses against the floor. Hold for 10 seconds, then relax. Repeat 10 times.

STRAIGHT LEG RAISES: (To strengthen abdominals). Lie on back with one leg straight and one knee bent (foot flat on floor). Tighten abdominal muscles to stabilize lower back. Slowly lift straight leg 6-12 inches and hold for 10 seconds. Lower slowly, repeat 10-15 times, then switch legs.

BRIDGE: (To strengthen lower back). Lie on back with knees bent, feet flat on floor and arms at sides. Tighten abdominal and seat muscles and slowly raise hips so body forms a bridge. Hold for 10-15 seconds, then slowly lower body. Repeat 10 times.

HAMSTRING STRETCH: Lie on back with legs bent. Grab one thigh behind the knee and slowly straighten knee until you feel the stretch behind the thigh. Hold for 20-30 seconds, relax, repeat 5-10 times; then switch legs. You can also use a towel or rope to gently pull your leg upright, as demonstrated.

LUMBAR STRETCH: Lying on back, clasp one hand under each knee. Gently pull both knees toward chest, pressing lower back into floor. Hold for 10-16 seconds, relax, then repeat. Alternatives: Pull only one knee to your chest, then switch legs. You can also do this on a bed.

AND KEEP IN MIND: Walking, jogging, swimming (but not breast stroke or the butterfly, which can put excessive strain on the lower back), and cycling are also good for the back. Sports that involve twisting, lifting, excessive arching of the spine, jumping, sudden starts and stops and/or collisions with other players (including golf, racket sports, bowling and basketball) are usually not recommended for people with chronic back problems.

LAST WORDS: Don't think that you can stop exercising when your back pain goes away. Continuing to exercise will help keep your back healthy.

Dr. Reuven Bruner, Ph.D., is a Health/Fitness/Nutrition & Total Lifestyle Consultant. For more information, contact him at: POB 1903, Jerusalem, 91314, Israel; Tel: (02) 652-7684; Mobile: 052 865-821; Fax: (02) 652-7227; Email: dr_bruner@hotmail.com

 

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