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Tuesday, August 11, 2020

“Good and Bad Exercises for Lower Back Pain”

 

LOWER BACK PAIN: HOW EXERCISE HELPS - You may feel like resting, but moving is good for your back. Exercises for lower back pain can strengthen back, stomach, and leg muscles. They help support your spine, relieving back pain. Always ask your health care professional before doing any exercise for back pain. Depending on the cause and intensity of your pain, some exercises may not be recommended and can be harmful.

AVOID: TOE TOUCHES - Exercise is good for low back pain -- but not all exercises are beneficial. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, patients should stop exercising and contact a doctor. Some exercises may aggravate pain. Standing toe touches, for example, put greater stress on the disks and ligaments in your spine. They can also overstretch lower back muscles and hamstrings.

TRY: PARTIAL CRUNCHES - Some exercises can aggravate back pain and should be avoided when you have acute low back pain. Partial crunches can help strengthen your back and stomach muscles. Lie with knees bent and feet flat on the floor. Cross arms over your chest or put hands behind your neck. Tighten stomach muscles and raise your shoulders off the floor.  Breathe out as you raise your shoulders. Don't lead with your elbows or use arms to pull your neck off the floor. Hold for a second, then slowly lower back down. Repeat 8 to 12 times. Proper form prevents excessive stress on your low back. Your feet, tailbone, and lower back should remain in contact with the mat at all times.

AVOID: SIT-UPS - Although you might think sit-ups can strengthen your core or abdominal muscles, most people tend to use muscles in the hips when doing sit-ups. Sit-ups may also put a lot of pressure on the discs in your spine.

TRY: HAMSTRING STRETCHES - Lie on your back and bend one knee. Loop a towel under the ball of your foot. Straighten your knee and slowly pull back on the towel. You should feel a gentle stretch down the back of your leg. Hold for at least 15 to 30 seconds. Do 2 to 4 times for each leg.

AVOID: LEG LIFTS - Leg lifts are sometimes suggested as an exercise to "strengthen your core" or abdominal muscles. Exercising to restore strength to your lower back can be very helpful in relieving pain yet lifting both legs together while lying on your back is very demanding on your core.  If weak, this exercise can make back pain worse. Instead, try lying on your back with one leg straight and the other leg bent at the knee. Keeping your lower back flat on the floor. Slowly lift the straight leg up about 6 inches and hold briefly. Lower leg slowly. Repeat 10 times, then switch legs.

TRY: WALL SITS - Stand 10 to 12 inches from the wall, then lean back until your back is flat against the wall. Slowly slide down until your knees are slightly bent, pressing your lower back into the wall. Hold for a count of 10, then carefully slide back up the wall. Repeat 8 to 12 times.

TRY: PRESS-UP BACK EXTENSIONS - Lie on your stomach with your hands under your shoulders. Push with your hands so your shoulders begin to lift off the floor. If it's comfortable for you, put your elbows on the floor directly under your shoulders and hold this position for several seconds.

TRY: BIRD DOG - Start on your hands and knees, and tighten your stomach muscles. Lift and extend one leg behind you. Keep hips level. Hold for 5 seconds, and then switch to the other leg. Repeat 8 to 12 times for each leg, and try to lengthen the time you hold each lift. Try lifting and extending your opposite arm for each repetition. This exercise is a great way to learn how to stabilize the low back during movement of the arms and legs. While doing this exercise don't let the lower back muscles sag. Only raise the limbs to heights where the low back position can be maintained.

TRY: KNEE TO CHEST - Lie on your back with knees bent and feet flat on the floor. Bring one knee to your chest, keeping the other foot flat on the floor. Keep your lower back pressed to the floor, and hold for 15 to 30 seconds. Then lower your knee and repeat with the other leg. Do this 2 to 4 times for each leg.

TRY: PELVIC TILTS - Lie on your back with knees bent, feet flat on floor. Tighten your stomach by contracting it as though you were preparing for a punch. You’ll feel your back pressing into the floor, and your hips and pelvis rocking back. Hold for 10 seconds while breathing in and out smoothly. Repeat 8 to 12 times.

TRY: BRIDGING - Lie on your back with knees bent and just your heels on the floor. Push your heels into the floor, squeeze your buttocks, and lift your hips off the floor until shoulders, hips, and knees are in a straight line. Hold about 6 seconds, and then slowly lower hips to the floor and rest for 10 seconds. Repeat 8 to 12 times. Avoid arching your lower back as your hips move upward. Avoid overarching by tightening your abdominal muscles prior and throughout the lift.

LIFTING WEIGHTS MAY HELLP: Done properly, lifting weights doesn't usually hurt your back. In fact, it may help relieve chronic back pain. But when you have acute (sudden) back pain, putting extra stress on back muscles and ligaments could raise risk of further injury. Ask your doctor whether you should lift weights, and which exercises to avoid.

TRY: AEROBIC EXERCISE - Aerobic exercise strengthens your lungs, heart, and blood vessels and can help you lose weight. Walking, swimming, and biking may all help reduce back pain. Start with short sessions and build up over time. If your back is hurting, try swimming, where the water supports your body. Avoid any strokes that twist your body.

TRY: SOME PILATES MOVES - Pilates combines stretching, strengthening, and core abdominal exercises. Under the instruction of an experienced teacher, it may help some people with back pain. Be sure to tell your teacher about your back pain, because you may need to skip some moves.

REVIEWED BY: Tyler Wheeler, MD on October 14, 2018

REFERENCES:

American Academy of Orthopaedic Surgeons: "Low Back Pain Exercise Guide."

American Council on Exercise: "Bird-dog," "Glute Bridge."

American Pain Foundation: "Back Truths: Debunking Common Myths About Back Pain."

Kell, R. Journal of Strength & Conditioning Research, March 2009.

La Touche, R. Journal of Bodywork and Movement Therapies, October 2008.

Long, A. Spine, December 1, 2004.

National Institute of Neurological Disorders and Stroke: "Low Back Pain Fact Sheet."

NHS: "Back Pain - Prevention."

NISMAT.org: "Low Back Program Exercises."

The President's Council on Physical Fitness and Sports: "Questionable Exercises."

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