Choosing the right exercise for banishing back pain

Weak muscles are often at the root of back pain, especially
lower back pain. The muscles of the back, the abdomen, and the buttocks
all support the spine - these muscles are called the core muscles.
Muscles
are the spine's main defense against gravity. Strengthening the muscles
that support the spine with exercises, can prevent, reduce and in some
cases eliminate back pain.
Strong abdominal muscles (especially
the deep abs) are as crucial as strong back muscles for supporting the
lower back and preventing lower back pain. Strong quadriceps (front of
thigh muscles) is important to prevent back injuries when lifting.
Proper lifting techniques involve using your legs and if your legs are
weak, you may end up using your back.
If you are suffering from an
episode of acute back pain, start with the appropriate exercises as
soon as you can move without too much pain - probably about a day after
the attack began. Progress to the exercises in the middle column when
the severe pain has subsided. The exercises in the third column are for
stretching and strengthening, to help you to avoid back trouble.

Condition	During acute attack	After severe pain	Prevention
Acute lumbar pain (caused by disc syndrome)	• Pelvic tilt • Passive extension • Mountain and sag	• Passive extension • Standing extension • Low back stretch • Side gliding • Gentle rotation • Side bending	• Hamstring stretches • Abdominal exercises • Leg exercises
Acute wry neck (caused by disc or facet joint)	• Passive extension	• Retraction and lengthening • Passive extension
Acute pain in the leg	• Pelvic tilt • Passive extension	• Passive extension • Low back stretch • Gentle twisting	• Hamstring stretches • Abdominal exercises • Leg exercises
Lumbar instability	• Pelvic tilt	• Passive extension • Low back stretch • Stabilizing exercises	• Abdominal exercises • Leg exercises • Back strengthening
Facet joint disease	• Pelvic tilt	• Low back stretch	• Abdominal exercises • Standing pelvic tilt
Strained muscles		• Gentle rotation • Side bending • Low back stretch
Tense muscles	• Low back stretch • Gentle rotation • Side bending • Leg muscle stretches • Neck stretches
Trigger points	• Specific exercises to stretch the affected muscles

Therapeutic exercises for lower backs
These
may help acute pain in the lower back or sciatica. Always follow your
physiotherapist's or doctor's advice about exercising your back. But if
you have recurrent attacks and are familiar with the exercises, or if
you feel that your attack is not sufficiently severe to warrant a
consultation, then it may be worth trying any of the following
exercises. Begin the exercises about a day after the pain first started,
but stop at once if the pain increases or spreads away from your spine.



Pelvic tilt

This helps most types of acute lumbar pain by relieving pressure on the
facet joints and gently stretching the muscles and ligaments of the
back. It strengthens the abdominal muscles that indirectly support the
spine. If practiced regularly, it encourages better posture. Do it on
the floor at first, but later try it standing up. If it's easier,
support your legs on cushions in the fowler position.
• Lie on the floor with your arms at your sides, your feet flat on the floor and your legs bent at a comfortable angle.

• Gently press the small of your back against the floor and tilt your
pubic bone upwards by tightening your abdominal and pelvic floor
muscles. Hold for at least six seconds, then relax slowly. repeat up to
ten times.



Passive extension

This helps many kinds of backache brought on by sitting. Don't try it if
it increases your pain. If bending backwards or staying upright is
difficult because you are already stuck in a stooped position, lower
yourself slowly until you are lying face down and relax for a few
minutes before you start. Try the exercise two or three times initially.
• Lie face down with your hands flat on the floor and level with your shoulders as if you were about to do a press-up.

• Push up with your arms, leaving your hips on the floor. Lift your head
and shoulders as high as you can. Let your back sag in. Breathe out,
then slowly lower your trunk, using your arm muscles only. Repeat up to
ten times.

• Back-strengthening exercises

• Chronic back pain can lead to weak back muscles. The traditional
exercises for strengthening back muscles tend to raise pressure in the
discs and facet joints of the lower back. They may aggravate the
condition if started too intensively or too soon after an acute
flare-up. Evidence suggests that dynamic strengthening of the extensors
(muscles used to straighten up the back and limbs) and recruitment of
the deep stabilizing muscles can help in preventing a relapse.


All 4's raising one leg

Core stability comes from learning to use the deep abdominal muscle
layer (transverse) to support the lumbar spine while moving the limbs.
This exercise helps you to use your buttock muscles more independently.
•
Get down on your hands and knees, with your legs together and your
hands parallel and pointing forwards. Breathe out and suck in your lower
abdomen until your spine is flat. Hold for ten seconds while continuing
to breathe. Repeat ten times on the exhale.

• From the basic position, with your lower abdomen drawn in and your
spine straight and flat, slowly raise one leg towards the horizontal.
Hold for ten seconds. Don't allow the spine to hollow or your pelvis to
rotate up or down. Repeat five times on each side.


Alternate limb raise

This exercise is one of the many exercise which train the back,
transverse and hip girdle muscles to work together to improve stability
and posture.


Hold the parallel

From step 2 of the all 4's position, stretch out the opposite arm and
leg parallel to the floor. Hold for ten seconds, then lower. Repeat with
the other arm and leg. Repeat five times each side.


Horizontal raise

In this exercise, do not raise your legs or shoulders above the
horizontal, since this would increase the stress on your facet joints.
• Lie face down on a pillow across a firm table, with someone holding your ankles to keep your legs in place.

• Raise your whole trunk until your body is horizontal. Do not pass
beyond this point. Lower your trunk and relax. Repeat ten times in one
session. Increase gradually over three months to 100 repetitions.



Both legs lift


Like the horizontal raise, this exercise is vigorous and makes a good
contribution to the long-term prevention of lower back pain.
• Lie
forwards over a firm table and hold on to the sides with both hands.
Bend your knees so that the weight of your legs is held entirely by your
back muscles.

• Extend your knees and raise your legs outwards to a horizontal
position and then return. Repeat this ten times during the first
session. Subsequently, increase the number of repetitions gradually to
between 50 and 100 over a three-month period.

• Every workout should consist of back strengthening exercises; however
the truth is that most people never think about this problem until they
are screaming out in pain from their chronic back pain. Our bodies are
built to take care of us as long as we are willing to do what it takes
to take care of them.

In addition to the exercises described above, research
suggests that other low-impact exercise can be beneficial for
maintaining a healthy, pain-free back. Good examples of such activities
include:

• Swimming

• Pilates

• Aerobics

• Walking

• Yoga