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Exercising for Lower Back Pain - Step One Restoring Flexibility by Emery Paredes, PT
In his previous article “Exercising for Lower Back Pain – Where Do You Start?”, Jason Gruss, MD, FAAPM&R wrote that the place to start is where you are the least fit. In most cases patients with lower back pain are probably in need of flexibility exercises to restore basic movement patterns that will be essential in restoring strength the next step. If you have yet to read Dr Gruss’ article it would be wise to do so before continuing here. Click here to read “Exercising for Lower Back Pain – Where Do You Start?”
Rehabing chronic lower back can be highly successful when the proper exercises are done in the proper sequence. Using this approach we’ve been able to keep a high percentage of our patients out of surgery. Those who do require surgical intervention recover a lot faster primarily because they are in better physical condition. In this article I will talk about step one in the rehab process - restoring flexibility. It is the mandatory first step in the process because without doing it all other exercise routines will fail over time.
Before we get into actual rehabilitation exercise it’s important to understand the time to start is not when you are having a flare up. If you are experiencing a high level of pain you need start with passive care. The goal of passive care is to reduce pain, spasm and inflammation.
In our clinic we prefer to handle flare-ups with a combination of medications and spinal manipulation along with modalities like ultrasound or muscle stimulation. Starting any exercise program too early, when too many movements cause pain will totally negate the benefit of exercise. In fact, there is a strong chance of making your condition worse.
Here are a few basic rules in flexibility exercising:
1. Start slowly and keep it gentle
2. Warm up the muscles and joints by walking for 5 minutes before you start
3. Stretches may be slightly uncomfortable to perform but never painful
4. Avoid bouncing during stretching
5. Maintain normal breathing throughout each stretch
6. Hold stretch for 30 seconds to 2 minutes
7. Perform each stretch 3 to 5 times
8. Stop if pain or symptoms worsen and consult your health care provider to better help you plan an exercise regimen that is individualized to fit your needs.
While everyone is an individual and classically exhibits different patterns of inflexibility, most lower back patients have similar patterns. The exercises that follow conform to those patterns. As a health care provider I must advise you that the recommendations below are not meant to substitute and diagnosis by a competent physician or guidance by skilled providers and therapists.
Okay so lets get started. Make sure you have read and understand the rules I laid out above at each and every workout. Pick one exercise form each group and perform once daily. Note some exercises can be done at work on breaks or through out the day for extra benefit.
COMING IN AUGUST . . . STEP TWO, STRENGTHENING YOUR LOWER BACK AND CORE
• Low back stretch
• Hamstring stretch
• Hip flexor stretch
• Piriformis stretch
• Gluteal stretch
• Iliotibial band stretch
• Calf stretch