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
