EK: Low Back Pain: Online Program (3-25-20)

  • 4-1-20 Updates
    • Based off of what you told me I am going to have you try the sequence below
    • I always like to have a movement or position that we can retest to see if what we are doing is helpful, for you that will be the forward fold position. periodically after doing a movement that I give you below, I want you to do one forward fold. I want you to ask yourself, does my ability to bend forward get better, get worse, or feel the same after doing each exercise that I give you
      • If the answer is it is the same or better then that movement will stay in the program
      • If the answer is a little worse then we may try to substitute that for something else
    • The initial sequence is meant to be easy so don’t push it too hard and make sure you are feeling what I describe in the videos. if something doesn’t feel right, hold off until we discuss it
    • Try the sequence below for about a week and then email me some feedback. based on your feedback we can either set up and video call or just make adjustments to the program
    • Daily Sequence:
      • This can be done 2-3x/day and before and after strenuous activity as a warm up/cool down
      • 18) Puppy Pose Progression VIDEO
        • This is like the quadruped rocking but hands out infront a little further
        • 10-15 reps
      • 126.6) Step Back Leg Heelraise VIDEO
        • This is helpful to get some motion through calf and hip
        • 10-15 reps each side
        • Since this might be the source of some pain try the the movement below
          • 35.1) Supine Knee to Chest VIDEO
            • Resist the knee with hand and hold for 5 sec, repeat 10-15x each side
            • Let me know if it feels different one side compared to the other
      • 17.1) Thoracic length Post Seated, Stand, Wall bar VIDEO
        • This is a nice way to create some self traction and will pull more so on the tighter side. Stick with sitting and try to incorporate the breathing I discuss
        • 10-15 reps
  • A couple key aspects of this program
  • When dealing with low back pain, especially if leg pain/nerve pain is involved, there are some generally accepted principles that should be considered and followed
    • It is never good to increase symptoms into the leg, especially if it is from a pinched nerve
    • Certain movements typically increase pain, while others are less likely to cause pain
      • Some people feel better to sit, bend forward, tense their abdominals, pull their knees to their chest
        • They are considered to have a flexion preference and those movements may be the initial focus
      • Some people feel worse with some of the above movements, feel better to lean back stand and walk compared to sit, have increased pain with cough/valsalva.
        • Those individuals are said to have more of extension based preference
      • Sometimes neither feel great and you have to try lateral movements
      • Sometimes moving into any direction too far doesn’t feel great but you may be able to tolerate certain movements if you only go through 50% of the motion. If the symptoms are highly irritable and agitated, any movement done too aggressively may hurt and you may have to focus on light movement short of pain which can allow the symptoms to improve. You then can monitor if the amount of movement your body tolerates is getting better.
    • THE INITIAL KEY IS TRYING TO FIND 1-2 MOVEMENTS THAT:
      • Do not increase leg pain
      • Make you feel better or at least are completed with no worsening of symptoms
    • Look at the videos below: Let me know what you feel with the various positions