Benefits of Back Exercises
Exercise is one of the most effective ways of preventing and treating recurring or chronic back pain. Strengthening muscles that support the spine with exercises can prevent, reduce and in some cases eliminate lower back pain. Stretching shortened muscles that are pulling the spine out of alignment can also relieve lower back pain.
Weak core muscles are often at the root of lower back pain. The muscles of the back, the abdomen, hips and buttocks (the core muscles) work together to support the spine. The core muscles are the spine's main defense against gravity.
The core muscles help maintain proper posture and stabilize the spine (keep it firm in its natural alignment during movement - walking, running, lifting, exercising, etc. Improving core stability reduces the risk of injury to the spinal joints, discs, back muscles & ligaments during such activities. Exercises to increase strength, endurance and coordination of the core muscles improve core stability.
Strengthening the upper back muscles is also important to prevent slouching, which is a common cause of neck and shoulder pain . Strengthening the upper back and the back of the shoulders helps maintain upright posture, as muscles in the upper back help keep the shoulder blades down and back . See Upper Back Posture Exercises page.
Strong quadriceps (front of thigh muscles) are 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.
Shortened muscles can pull the spine out of alignment and contribute to back pain . Stretching exercises lengthen shortened muscles and can relieve back pain. Tight back muscles, tight chest muscles, tight buttocks muscles, tight muscles in the front of the hip can affect the alignment of the spine. Stretching the back also increases mobility of the joints of the spine.
Note: Exercise is not recommended for acute low back pain , although continuing with daily activities is usually recommended. If you have a back injury or current back pain read: Post-injury exercise page first.
Aerobic exercise can also improve chronic or recurring back pain. Weight-bearing aerobic exercise (legs support weight of body) such as brisk walking improves bone density and muscular strength/endurance of the lower body. Aerobics also improve also relieves stress and improves sleep, which helps to reduce chronic pain. See Aerobic exercise page for more info.
How successful an exercise program is in relieving back pain depends on whether other factors that are contributing to back pain have been corrected particularly chronic poor posture, which increases stress on the back muscles, ligaments and discs. Posture awareness along with strong and flexible muscles help maintain proper posture. See posture page for more info.
NOTE: Starting out with exercises that are too difficult (for your current level of fitness) or doing too many can cause back pain. Strengthening the back with exercises must be done progressively. The body adapts to gradual increases in exercise, increasing exercise too quickly can cause injury and cause or increase back pain. Patience and restraint are needed to give exercise a chance.
Stretching or Strengthening Exercises First? Stretching after strengthening exercises helps relieve the muscle tightness that can occur from strengthening exercises and may be more beneficial that stretching before strengthening exercise (you can either do all your strength exercises first and follow with all your stretches or alternate strength and stretching exercises, stretching the same muscles just strengthened). However it is largely a matter of personal preference - stretching and strengthening exercises can also each be done on separate days if desired. Remember to warm up first.
Note: If you have a back injury or condition or back pain, consult a physiotherapist who can advise you what exercises and how many repetitions of each exercise would be the safest and most beneficial for you.
Many people tend to overdo it when starting strengthening exercises for the back, resulting in back strain. Back pain caused by doing too much too soon sets one back even farther. But the ultimate goal is to be able to do the back strengthening exercises. Strengthening the back can't be rushed. It takes patience but it is well worth the effort.
How Often to do Strengthening Exercises:
Strengthening exercises (for the same muscle group) should not be done on consecutive days. Every second day or 3 times a week is fine, with a minimum of twice a week. The days off give your body a chance to recover. Strengthening exercises done daily can result in overuse injuries. This does not apply in every situation. Exceptions include exercises used for rehab.
Some gentle rehabilitation exercises may be done every day, in some cases more than once a day. When muscles are seriously deconditioned - perhaps from lack of use after an injury or an extremely sedentary lifestyle - "rehab" exercises are often used when more difficult "regular" strength exercises would overload the muscles and cause injury. Gentle stretching exercises are also often done more than once per day. If you have back problems or if in doubt, consult a physical therapist.
How Many Repetitions and Sets:
When just starting strengthening exercises, begin with five repetitions ( or less if your find the exercise difficult) of each exercise. If you can handle five repetitions without post exercise pain, then slowly add a couple of repetitions each week until you reach 10 - 15 repetitions. Your muscles should feel mildly fatigued by the of 10 - 15 reps. Although even one set of 10 - 15 reps is beneficial (the most benefit comes from the first set), to further increase endurance add a second set of 10 -15 repetitions after you can handle one set. In time, add a third set. Rest for about 30 - 60 seconds between sets. If the exercise involves holding your body in one position for the entire exercise (a static exercise), then 60 seconds is equivalent to one set
Warning: Do not hold your breath! Holding your breath can cause a spike in blood pressure! Concentrate on breathing while exercising.
Warm-up before Back Exercises: Be sure to warm up before doing back exercises with five minutes of walking, or using an exercise bike or elliptical trainer, or even marching on the spot. Warm-up exercises prepare your back for strength exercises or stretching exercises by increasing circulation to the muscles.
*Tighten the Abs First. Simply contract the abs as if you are about to be hit in the stomach, which will also automatically tighten muscles in the lower back. Tightening the stomach will automatically pull it in slightly. Do not overdo the abdominal tensing. It should not be difficult. Do not hold your breath. This is what "tighten abs" in the following exercises refers to. Tightening the stomach, often referred to as abdominal bracing, stabilizes and protects the lower back more than drawing in the stomach. See Abdominal Bracing or Hollowing Page for more info.
CORE Strength Exercises
Birddog (Opposite Arm and Leg Extension): Strengthens muscles running down sides of spine, back of shoulders, hips and buttocks
Begin on all fours, hands directly under your shoulders and knees directly under your hips.
Keep head aligned with spine (to help avoid tilting head, look at floor).
Keep buttocks and abdomen tight. Do not arch the back.
Lift one arm up and forward until it is level with torso; simultaneously lift the opposite leg in the same manner. Keep arm, spine, and opposite leg aligned as if they are forming a tabletop.
Balance yourself for 5 seconds then slowly return to starting position. Switch sides and repeat. Remember to breathe. Do ten repetitions.
*If you find the birddog exercise is too difficult, start with extending the leg only, and then extending the arm only and work up to extending both arm and opposite leg at the same time, which increases the challenge to the core and develops balance.
The Bridge: Strengthens several core muscle groups - buttocks, back, abs
Lie flat on back; bend knees at 90-degree angle, feet flat on floor. Tighten abs. Raise buttocks off floor, keeping abs tight. Tighten buttocks. Shoulder to knees should be in straight line. Hold for a count of five. Slowly lower buttocks to floor. Repeat five to fifteen times.
One-Leg Bridge:
To increase difficulty of the basic bridge, raise one leg off ground (squeeze buttocks firmly before you raise your leg). Hold for 5 seconds. Switch sides. Repeat five to fifteen times.
Remember to Breathe!
NOTE: The Plank and Side Plank are challenging exercises for beginners. Start with the easier version (balancing on knees). Beginners should also start with fewer repetitions to avoid muscle strain.
CAUTION: The side plank places more stress on the shoulder than the front plank as only one shoulder (and arm) is helping to support the weight of the body. Balancing from the knees rather the feet reduces the load on the shoulder and is less likely to cause or aggravate shoulder problems.
Crunches:
Note: Crunches are Optional if you do the Plank and the Side Plank exercises (shown above).
SQUATS
Squats strengthen muscles used in lifting with the legs (quads, hamstrings, buttocks), which reduces strain to the low back. Squats also activate the core muscles .
Squats are quite challenging for beginners. Only do a few repetitions to start. Beginners may wish to start with the chair squat or the wall squat. It is important that the knees do not go over the toes or go out to either side.
TIP: Use a mirror to check your form when learning a new exercise. When doing a squat, use a mirror to make sure your back is not rounding - alternatively, place an outstretched hand over the small of your back to make sure your lower back remains neutral (keeps its natural arch).
Be sure to do the anti-slouching strengthening exercises on the Upper Back Posture Exercise Page .
Note: If you have a back injury or condition or back pain, consult a physiotherapist who can advise you what exercises and how many repetitions of each exercise would be the safest and most beneficial for you.
How Often to do Stretching Exercises
Stretching exercises may be done daily but every second day is usually enough. Specific stretches are often recommended twice daily for those suffering from sciatica or other types of back pain or stiffness. A physician or physical therapist should be consulted if you are experiencing back pain, as the prescribed exercises will vary according to the cause of the pain.
How Long to Hold a Stretch For stretching exercises, the total time stretching a muscle should generally be about 60 to 90 seconds. Holding a stretch for 30 seconds only requires 2 or 3 repetitions. Holding a stretch for 5 or 10 seconds of course requires more repetitions. The optimal amount of time to hold a stretch to achieve best results is not an exact science - even a single 10-second stretch may have some benefits, although a minimum of thirty seconds in total for stretching each muscle is generally recommended.
Note: You should feel a gentle stretch / tension on the muscles you are stretching. You should NOT feel pain.
Always warm up before stretching exercises . Five minutes of walking, or exercise bike, elliptical trainer, or even marching on the spot is enough. Not warming up before stretching leaves your back susceptible to injuries. Warm muscles are more flexible than cold muscles and are less likely to tear.
*Check with your physician before doing exercises that involve twisting or arching the back if you have a back condition.
Keep Breathing. Do not hold your breath!
HAMSTRING STRETCHES :
You can pick one or two of the following hamstring stretches per exercise session.
HIP FLEXOR STRETCHES
Shortened hip flexors and quadriceps can contribute to sway back (excessive arch of low back)
Stretching using an Inversion Table
Inversion therapy has been around for a couple of thousand years. Your feet are securely supported as your body hangs upside down - and the spine is stretched by the weight of your body. For more information see Inversion Tables Page.
Be sure to do the anti-slouching stretching exercises shown on Upper Back Posture Exercise Page .
Balance Exercises
Stability Ball Exercises
*Also called the Swiss ball, exercise ball, balance ball
Stability ball exercises require constant adjustments of the core muscles to stabilize the spine (maintain firm neutral alignment of the spine) as you balance yourself on the unstable surface of the stability ball.
An exercise ball is inexpensive and adds variety to your workout. While the plank, side plank, bridge exercises (shown above done on the floor) can be done using an exercise ball to challenge balance; they can also be made more challenging by lifting one leg off the ground.
Pick an exercise ball where your legs are parallel to the floor when sitting on it. Exercise balls are over inflated balls. The softer the exercise ball, the easier it is to balance on it. The further the ball is from your body, the harder the exercise. When doing exercises using an exercise ball, keep the abdomen tight.
Note: Exercises done on a stability ball challenge balance but do not replace standing balance exercises
Standing Balance Exercises
Most exercises improve balance somewhat - even walking, as you shift your center of gravity from one side to the other with each step.
One of the simplest ways to improve balance is standing on one leg (see below). Another is walking heel-to-toe in a straight line. Walking improves dynamic balance, while standing on one leg improves static balance.
Low Impact Aerobic Exercise
Aerobic Exercise (walking, running, cycling, swimming) increases cardiovascular fitness. Aerobics also promote back health.
Low-impact, weight-bearing aerobic exercise such as brisk walking increases muscular strength and endurance of the lower back, hips, buttocks, and abdomen, as well as the legs. Weight-bearing aerobics, where the legs support the weight of the body, also reduce bone loss in the lower spine, hips, and legs. See Aerobics Page. Walking is relatively safe for people who are very out-of-shape and/or have back pain.
While walking is safe for almost anyone, it is also effective. Brisk walking is a moderate-intensity aerobic activity - 150 minutes per week is the minimum amount of moderate-intensity aerobic activity recommended by the World Health Organization for significant health benefits. Though many people get in a lot of sporadic walking during the day, aerobic exercise must be done in bouts of at least 10 minutes to be effective. Walking must be done at a brisk pace to get the heart rate up enough to be considered a moderate-intensity aerobic exercise. Strolling doesn't cut it.
Low-impact aerobics (one foot is always on the ground) such as brisk walking are generally safer for those with back problems than high-impact aerobics. High-impact aerobics (where both feet leave the ground at the same time) such as jumping rope or running puts more stress on your back than low-impact aerobics. When your feet hit the ground extra stress is placed on the intervertebral discs and joints of the spine.
Aerobics increases circulation and the amount of oxygen in the blood, which promotes healing. Aerobic exercise decreases muscular tension, stress and depression and improves sleep, which all help to reduce back pain.
You Will See Results
Keeping fit with an exercise plan that includes exercises that stretch tight muscles that contribute to poor posture and exercises that strengthen core muscles needed for spinal stability is very effective for the prevention of recurring back pain. Strong quads (front of thighs) are also needed to lift to objects with the legs without rounding the back.
Increase the duration of back exercises gradually to avoid overuse injuries. It may take a couple of months, but if you stick with it, you will see results.
*Check with your physician before doing back exercises if you have a back condition or other medical condition.
Original article and pictures take www.bigbackpain.com site
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