Strengthening
exercise program for low back pain relief
The next few exercises are
examples of some basic stabilization exercises that aid in
low back pain relief. Having strong midline support is critical
to decreasing the stresses placed upon the lumbar spine (lower
back) and pelvis. It should be noted, however, that often
muscles that appear to be weak may actually be inhibited by
an antagonist muscle (muscle on the opposite side of the joint)
or by faulty lumbar facet joint mechanics. Generally, an inhibited
muscle will not respond to resistance training. Therefore,
if low back pain or hip pain is being experienced, it is important
to first see a spine therapist in order to screen for muscle
inhibition. Attempting to strengthen an inhibited muscle may
cause a substitution pattern that only reinforces a painful
movement pattern. In general, it is advisable to see a spine
specialist who specializes in back pain prior to beginning
any exercise program.
In addition, unlike stretching
exercises, it is important to take a few days off per week
from strengthening exercises to allow the body to rest and
build strong muscles. A licensed physical therapist can help
design a strengthening exercise program to fit an individual’s
specific needs and help with pain relief. In general, a spinal
stabilization exercise program usually includes strengthening
the abdominal muscles in the front and the gluteal muscles
in the back.
Transversus Abdominis muscle
strengthening (abdominal exercise)
Many people think of performing abdominal crunches or situps
to strengthen the abdominal muscles. While “six pack
abs” look nice to some, it is more important to work
the Transversus Abdominis (TVA) through abdominal exercise
to achieve spinal stability. When retraining the TVA, it is
important to maintain a neutral lumbar spine (don’t
try pushing the back all the way into the floor). The back
is most often in a neutral spine position, so it makes less
sense to strengthen the back in a flexed or extended position.
Lie on one’s back with the knees bent. Knees and feet
should be shoulder width apart. Draw the belly button toward
the spine while maintaining a neutral spine. Upon exhalation,
reach toward the ceiling as if trying to grab a trapeze overhead.
Then raise the head and shoulders off the floor, just to the
point where the shoulder blades are barely touching the floor,
and hold 1-2 seconds. Inhale upon return and repeat at the
end of the next exhalation. Continue until it is not possible
to maintain a neutral spine or when fatigued.
* Hold 1-2 seconds
* Repeat until fatigued
* 1 time per day
* 4-5 days per week
Gluteus Maximus muscle strengthening
(buttock exercise)
To strengthen this muscle, lie on the stomach with the hips
and legs off the end of a table or bench. Tighten the buttock
on one side and extend the leg up toward the ceiling while
maintaining a neutral spine. Movements should be slow. Initially,
it is common to only be able to perform a few repetitions
at a time.
* Hold 5 seconds
* 4-10 repetitions per side
* 1 time per day
* 4-5 days per week
Gluteus Medius muscle strengthening
(hip abductor exercise)
This muscle (the hip abductor) is used to raise the leg laterally
at the hip and also supports the pelvis when standing on one
leg (single leg stance). If this muscle is weak or inhibited,
the opposite pelvis will drop when single leg stance is performed.
Functionally, single leg stance is performed whenever someone
walks. A weak gluteus medius will result in the opposite hip
dropping during the gait cycle and can cause an increase in
low back pain and hip pain with walking. To strengthen the
gluteus medius, lie on one’s side with the back against
the wall. Draw the belly button in while maintaining a neutral
spine. Raise the upper leg with the toes slightly pointed
toward the ceiling and the heel maintaining contact with the
wall. Perform slowly with a 2 second hold at the top.
* 10 repetitions per side
* 1 time per day
* 4-5 days per week
Optimizing exercise programs
for pain relief
As with all exercise programs, these low back stretching and
strengthening exercises should be preceded by warm-up and
followed by cool-down activities, such as walking and gentle
stretching. It is advisable to always consult a medical professional
prior to beginning any exercise program, and if pain, such
as low back pain or leg pain, is felt or aggravated, it is
best to consult a spine specialist and/or physical therapist
that specializes in these types of exercise programs.
| Authors Details: Exercise Program by
Robert J. Daul, MPT
Web Site |
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