Please note that these are not just general opinion’s on low back pain (LBP). Everything here is based on clinical evidence and facts you can find in my book, Exercise Progression for Low Back Disorders – A Professional’s Manual, over 18 years of experience dealing with low back pain, and over 12 years of working in clinics and seeing clients for low back pain. This stuff is proven to work! References have been left out so as to not fill up space, but please inquire about any facts I have stated that you would like further research on.
Today’s lesson: Low back pain does NOT improve from exercise faster than nature’s healing course. In other words, it will heal itself just as fast as any exercise program we have ever documented. That being said, exercise and daily activity modifications (D.A.M.’s) are essential in preventing further incidences, increasing general function, and reducing the intensity of recurrences. Due to the wide variety of disorders and therefore great many solutions, we will stick to general concepts here. Please feel free to contact firstname.lastname@example.org for specific questions about your situation.
- It’s not what you DO, it’s what you DON’T do that helps LBP. You can do all the right exercises and stretches in the world, but if you bend at your back instead of your legs and hips when you; do laundry, pick up the kids, groceries, vacuum, toilet seat, water jug, suitcase, dog, cat…get the picture? Life is the gym! I will post videos and pictures later about the proper form for daily activities. The beauty of proper form is that once you do it all the time, life becomes a workout and you hardly need to exercise unless you desire specific results for sports and cardio.
- Don’t try to stretch yourself out of pain. It won’t work, trust me. It didn’t work for me and it hasn’t worked for any of the 1000′s of clients I’ve seen. In fact it usually makes things WORSE. Keep it simple and subtle. Don’t stretch as far as you can, rather as far as you should (it’s a fine line I know and only practice will teach you). It may feel great as you’re doing it, but inflammation in the spine can take up to 3 days to show up and therefore seem a mystery once it appears.
- Find positions of relief and assume them as often as possible. In general, sitting, flexing, forward bends and the like are BAD for the spine. It prefers to be vertical and extended (low back). The low back is naturally extended about 35 degrees and sitting tends to flex it and add a lot of stress to all the local tissues (discs, ligaments, joints, etc.), so in general, positions such as the following are great for relief*; 1. lying on stomach propped up on elbows 2. hip flexor stretches (see below) 3. walking 4. anything vertical and weightbearing. *Exceptions are stenosis and spondylolisthesis and other unique instances which prefer flexed positions.
- Sit-ups, crunches, and the like are ABSOLUTELY AWFUL for LBP! Please observe how the human body works in daily life so you can be armed with knowledge the next time someone tells you to do crunches to help your LBP. I can’t remember the last time any of my clients or I needed to lay on our backs and repetitively crunch up and down. It just doesn’t happen in real life. Not to mention the huge amounts of stress it puts on the spine (here’s that flexion force again…BAD!). The key is to keep stress low in the spine and strengthen it in ways that transfer directly over to daily life, such as standing lifts and twists using the stomach and hips as the power, not the back.
Please stay tuned for the next lesson; “Exercises for the Chair Jockey” and how to reverse the effects of sitting.
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