A typical response to experiencing back pain is to take it easy – either staying in bed or at least stopping any activity that is at all strenuous. While this approach is understandable and may even be recommended in the short term, when done for more than a day or two it can actually undermine healing. Instead, active forms of back exercises are almost always necessary to rehabilitate the spine and help alleviate back pain.
When done in a controlled, gradual, and progressive manner, active back exercises distribute nutrients into the disc space and soft tissues in the back to keep the discs, muscles, ligaments, and joints healthy. Consequently, a regular routine of lower back exercises helps patients avoid stiffness and weakness, minimize recurrences of lower back pain, and reduce the severity and duration of possible future episodes of low back pain.
Depending upon the patient’s specific diagnosis and level of pain, the back pain exercises and rehabilitation programs will be very different, so it is important for patients to see a spine specialist trained to develop an individualized program of back exercises and to provide instruction on using the correct form and technique.
Just like reinforced steel can bear more weight than sheet aluminum, a strong, well-conditioned back can withstand more stress, and protect the spine better, than a back that has not been conditioned through exercise. Conditioning through flexibility and strengthening back exercises not only helps the back avoid injury, or minimize the severity of injury if the spine is traumatized, it also can help relieve the pain of many back conditions.
Many back exercises can help strengthen the spinal column and the supporting muscles, ligaments, and tendons. Most of these back exercises focus not only on the back, but also the abdominal (stomach) muscles and gluteus (buttocks) and hip muscles. Taken together, these strong ‘core’ muscles can provide back pain relief because they provide strong support for the spine, keeping it in alignment and facilitating movements that extend or twist the spine.
Two of the most well-known back strengthening exercises are: McKenzie exercises and Dynamic Lumbar Stabilization. These back exercises are generally first learned by working with a physical therapist who can demonstrate the exercises and correct a patient’s form to ensure strengthening and/or back pain relief is achieved. Although McKenzie exercises and dynamic lumbar stabilization exercises tend to be used for specific conditions, the two forms of physical therapy exercise may also be combined when appropriate.
Along with specific back exercises, aerobic exercise that increases the heart rate for a sustained period is very beneficial for helping back problems. Aerobic exercise increases the flow of blood and nutrients to back structures which supports healing, and can decrease the stiffness in the back and joints that lead to back pain. While many patients with back pain are able to participate in vigorous exercise like running or step aerobics, others find it easier to engage in low-impact exercise, which does not jar the spine.
Reconditioning through aerobic exercise is very useful for both rehabilitation and maintenance of the lower back. Patients who regularly undertake aerobic exercise to condition the back will benefit in several ways:
- They have fewer episodes of low back pain, and will experience less pain when an episode occurs.
- They are also more likely to stay functional (e.g. continue working and carry on with recreational activities), whereas those patients with chronic low back pain who do not engage in aerobic exercise are more likely to experience the gradual loss of functional capabilities.
- It is easier to control weight or lose weight, decreasing the stress placed on the spine structures and joints.
- An increased production of endorphins after 30 or 40 minutes of exercise can combat pain. These bio-chemicals are the body’s natural painkiller, and frequent release of them can help patients reduce their reliance on pain medication.
- Endorphins can elevate mood and relieve symptoms of depression, a condition common in those with back pain or a back injury.
Here are several types of aerobic exercise that are gentle on the back and, when done on a regular basis, highly effective in providing conditioning.
- Walking. In general, walking for exercise is very gentle on the back, and walking two to three miles three times per week is very helpful for patients. Walking also has the advantage of not requiring special equipment (except a good pair of shoes suitable for walking) and it can be done inside or outside, in almost any location, including at home on a treadmill.
- Elliptical trainer or step machine. These machines provide a low-impact workout because the participant is using pedals suspended above the ground to move in a continuous oval motion, as opposed to continuously stepping on a hard surface. The motor on the machine facilitates a smoother step or forward glide motion, which is less jarring than walking. The benefit of these machines is that they provide an aerobic workout as well as strengthening or resistance training because the arms of most cross-training machines can be pushed and pulled, thus working the upper body, and the resistance of the pedaling motion increased to require greater muscle exertion to maintain the movement.
- Water therapy. Doing exercise in the water provides for effective conditioning while minimizing stress on the back because the buoyancy of water counteracts the gravitational pull that can compress the spine. When ‘unweighted’ in water, a patient becomes more mobile, and stretching and strengthening exercises are less painful. Exercises such as hip abduction lifts, bicep curls, arm circles to exercise deltoids and shoulders, and tricep kickbacks are all easier done water for most people. All these muscles build strength in the low back or neck, and reduce back pain. Water therapy exercise is especially useful for patients in too much pain to tolerate land exercises on a mat or hard floor, or for elderly patients.
- Stationary bicycling. For those patients who are more comfortable seated rather than standing, biking or stationary biking may be preferable. Bicycling or ‘spinning’ classes have grown in popularity over the last decade as more people realize the benefits of this lower impact form of exercise. There are several upright and recumbent (reclining) bikes that can be purchased for home use, and many come with programs preloaded so that patients have a good variety of sessions from which to choose.Whatever low-impact exercise is used, the exercise should be vigorous enough to increase the heart rate to the target zone (which is scaled to the age of the patient) and keep it elevated. Elevating the heart rate for at least 20 minutes is required to improve cardiovascular strength, burn excess calories, and make noticeable strides in fitness.
Note: If you are experiencing chronic back pain, please seek a specialist. A professional can give you a proper diagnosis and assign the proper physical therapy regimen to alleviate the pain. For more information or to make an appointment with Dr Chambers, please call (304) 263-4927.
Source: Full article and additional links can be seen here http://www.spine-health.com/wellness/exercise/low-impact-aerobic-exercise.