Back Exercises

Original Editor - User Name

Top Contributors - Lucinda hampton, Oluwasegun Ajenipa, Kim Jackson and Oyemi Sillo  

Introduction

Today, exercise is recognized for its importance to healthy lifestyles, longevity, quality of life, mental health, and the management of many chronic diseases, including low back pain. Exercise is the best way to increase functional capacity.

• For the acute back pain patient, early activation towards normality that includes exercise should begin in the primary care setting. Unfortunately, a large percentage of primary care physicians do not recommend exercise to their back pain patients.
• Good evidence supports the use of exercise-directed therapy for patients with chronic back pain. When compared with other therapeutic approaches, exercise demonstrates positive results by itself and in combination with cognitive interventions.

Physiotherapy

Evidence suggests that in response to physical inactivity, skeletal muscles go through a process called adaptive reductive remodeling. This results in a loss of muscle mass and changes in muscle composition, leading to a decreased in muscle strength. Paraspinal muscles atrophy and increased in fat content are associated with low back pain from the result of physical inactivity.

Below are a selection of back exercises, choose according to client specifics from assessment.

Abdominal bracing

• Abdominal bracing with heel slides

• Abdominal bracing with leg lifts

• Abdominal bracing with bridges

• Abdominal bracing with standing row exercise

• Abdominal bracing with walking/standing

Erector Spinae/Multifidus

• Quadruped arm lifts and bracing

• Quadruped leg lifts and bracing

• Quadruped alternate arms and legs with bracing

Back Stretches

Cat Stretch

Prayer Stretch

Single Knee to Chest

Cow Stretch

Extension Based Exercises

Prone press up

Mckenzie Exercise is an exercise regimen used in the treatment of low back pain and sciatica, prescribed according to findings during mechanical examination of the lumbar spine and using a combination of lumbar motions, including flexion, rotation, side gliding, and extension. It is sometimes referred to as McKenzie extension exercises, but this is a misnomer because the regimen involves movements other than extension.

Flexion Based Exercises

Williams' flexion flexion exercises are a therapeutic exercise regimen used in the treatment of low back pain; it seeks to reduce lumbar lordosis through flexion of the lumbar spine and strengthening of the abdominal musculature.

Lumbar Stabilization Exercise

Lumbar stabilization exercise programs are used to improve the strength, endurance and/or motor control of the abdominal and lumbar trunk musculature. The stabilizing exercises focus on the re-education of a precise co-contraction pattern of local muscles of the spine. Stabilizing exercises along with routine exercises help with the reduction of pain intensity while increasing functional ability and muscle endurance and are recommended in the treatment of patients with lumbar segmental instability. The following videos are examples demonstrating progressions of spinal stabilization exercises that can be used for patients requiring this technique.

Proper Lifting Techniques

Many lower back injuries come about as a result of poor lifting techniques, something that physiotherapists are uniquely placed to address. Safe lifting techniques given below.

Squat lift

1. Plan The Lift: Know how heavy the object is. Clear a path and know where the object is to be placed.
2. Lift Close to the body: This will make the body stronger and more stable. Ensure there is a firm hold on the object and balance it close to the body.
3. Feet shoulder width apart: This allows for a solid base of support.
4. Bend the knees while keeping the back straight: Avoid any twisting motions.
5. Tighten the stomach muscles: This will hold the back in good alignment and prevent excessive force on the spine. Avoid breath holding.
6. Lift with the legs: The leg muscles are stronger than the back so use them.
7. Avoid straining, get help: Get help if the object is too heavy or it is in an awkward position.
   

                    

Squat - Remember to:

• Keep back straight
• Knees behind toes
• Keep knees parallel

Golfer’s Lift

• The Golfer’s lift is another lifting technique that is useful for picking something off the floor
• This works best when using something like a chair or table for support when bending
• Kick out the unsupported leg - This helps to keep the back straight

     

Diagonal Standing

• Stand with one foot slightly in front of the other and distribute the weight evenly between both legs
• This is a preferred position over straight standing
• Avoid putting all of the weight onto one leg while standing.

Aerobic Activity

Types: Walking, jogging, running, cycling, swimming, climbers, steppers, elliptical machines, ski machines, aerobic dance
Warm up/cool down – low to moderate activity

• 5-10 minutes of warm up (adjust to demands placed on the body)
• 5-10 minutes of cool down (recovery of heart rate and BP)
• 10 minutes of stretching AFTER the warm up OR cool down
  

ACSM Guidelines:=

• Frequency: 5 days/week
• Duration: 150 minutes per week (minimum)
• Intensity: 40-60% HRmax (HRmax = 220-age)

Benefits of exercise are improved joint health due to low impact exercises, increase bone density due to weight bearing exercises, improving energy, reducing health risks, improving circulation, and reducing stress and improving your mood. Aerobic activity is equally effective at reconditioning muscles as exercise and can also help in decreasing pain, improving your mood, and improving your functional capabilities. Lack of exercise increases your risk of obesity and other co-morbidities increases; this can lead to increased pressure on the spine and decreased flexibility.

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