The typical back story is usually something along the line of “I have had back pain on and off for years that will bother me for a few days and then it gradually goes away. Over the past few years I have noticed the pain is more intense, takes longer to go away, and happens more frequently.” As a physical therapist who works a lot with people who have back and hip problems, this is a pretty common scenario with some people in worse shape then others.
The truth of the matter in as concise of a summary as can put it is: every time you experience pain the muscles in that general region become weaker and tighter which is accompanied by subconscious changes in the way that you move which effects the original problem area as well as other surrounding structures (Sorry for the run on sentence). This movement progression attempts to break bad habits and mobilize/strengthen the areas above and below to reduce pressure on the low back. One theme you will see through my exercise progressions is to maintain abdominal control completing all transitional motions. I don’t believe that all movements are appropriate for everyone so if any of these movements feeling like they are increasing pain anywhere don’t do them or try to stop short of recreating pain.
TWO VERY IMPORTANT RULES:
A VERY small amount of discomfort is alright if:
- The discomfort is not getting worse as you do it, meaning it stays the same or feels better the more you do it
- You don’t feel like your pain is worse immediately after or even the next day.
*The most important aspect of any exercise is feeling what you are supposed to and knowing what is supposed to be happening with a desired exercise. We will talk a lot about what you are supposed to feel with each movement because this is absolutely the biggest downfall with any rehab or strengthening program. Your body will subconsciously work around the weakness and recruit other muscles to move your body. Whether its exercise, playing the piano, or building a house; its all about the basics and small details that the most successful people master.
- Lay on your back with knees bent and finger tips on lower abdomen. Lightly press low back flat into the floor while tensing your lower abdomen. This tension should push your lower abdomen into your finger tips similar to a cough/sneeze. You should be able to hold this light tension for 5-10sec while breathing comfortably. Repeat 5-10x
- Step/Chair Lunge: Back foot straight, Keep abdominal tension as front knee bends into a forward lunge while raising up onto the back toe. Should feel light tension in the front of the hip of the leg that is back. 10-20reps slowly in and out each side
- Wall sit with overhead shoulder flexion: Lean back against wall with lower abdominal tension and back flat against wall. Keep Back flat as you raise your arms overhead holding a band or pillowcase. slowly up and down with brief pause at the top 10-20x
- Car Stuck in the Snow plank: Lean against wall or table, the lower the surface the harder the exercise is. Another good place is the stairs with the ability to use a lower step for more challenge or higher step to make it easier. On your hands in a push up oriented position with your body in a straight line, push one heel into the floor behind you and squeeze your butt on that leg as you raise the opposite knee up towards your chest. pause 5sec then switch feet. Repeat 10-20x each leg