Low back pain affects 80% of Americans at some point in their lives. Low back pain may be the result of trauma, degenerative changes or congenital anomaly. Regardless of the cause low back pain responds well to a vigorous and controlled conditioning program. Many clients with chronic low back pain have deconditioned cardiovascular systems along with weakened muscles in the trunk and extremities. Many conditions may affect the spine. Disc herniations, spinal stenosis, degenerative joint disease, spondylolithesis, and muscle imbalances are the common conditions that affect the spine. Exercise significantly improves the functional capacity of clients with low back pain.
Pain in the spine is usually caused by spinal instability. The instability may be caused by trauma or degenerative changes. Exercise counteracts the effects of the instability. The exercise does not have to be done in a large range of motion. The goal of the training program is to increase muscle recruitment and strength of the trunk and extremities. Increased muscle recruitment will increase spinal stability. The training should be done in patterns that will enhance the strength and ability to perform functional activities.
Standing Hamstring Stretch
- Stand tall with your right foot on a bench.
- Bend your right knee slightly and pull your abdominals gently inward.
- Lean forward from your hips.
- Keep your shoulders down and relaxed; don’t round your lower back.
- Repeat the stretch with your left leg forward.
Quadruped arm/leg raise
- Sit on your hands and knees on an exercise mat.
- The hands are directly beneath the shoulders. The knees are directly beneath the hips.
- The core is tight and the spine is neutrally aligned.
- Extend one leg and lift the opposite arm until they are in line with the body.
- Return to the starting position and repeat for the prescribed number of repetitions.
- Switch sides.
- Lie on your right side with your legs straight.
- Prop yourself up with your right forearm so your body forms a diagonal line.
- Rest your left hand on your hip.
- Brace your abs and hold for 60 seconds.
- If you can't make it to 60 seconds, hold for 5 to 10 seconds and rest for 5; continue for 1 minute. Be sure your hips and knees stay off the floor.
- Lie on your back with your legs straight and your hands by your sides.
- Bend your left leg and hold on behind your knee.
- Gently pull your knee into your chest.
- Hold this position for the desired duration before relaxing and changing legs.
- Try to keep your head and shoulders on the floor throughout this exercise.
- Lie facedown, legs hip-distance apart and extended straight, arms at sides with palms facing down, head and neck in a neutral position.
- Press up on the hands while the pelvis remains in contact with the floor.
- Keep the lower back and buttocks relaxed for a gentle stretch.
Cat and Camel
- Get down on your hands and knees on the floor.
- Relax your head, and allow it to droop.
- Round your back up toward the ceiling until you feel a nice stretch in your upper, middle, and lower back.
- Hold this stretch for as long as it feels comfortable, or about 15 to 30 seconds.
- Return to the starting position with a flat back while you are on all fours.
- Let your back sway by pressing your stomach toward the floor. Lift your buttocks toward the ceiling.
- Hold this position for 15 to 30 seconds.
- Repeat 2 to 4 times.
- Lie on your back on the floor with your knees bent.
- Flatten your back against the floor by tightening your abdominal muscles and bending your pelvis up slightly.
- Hold for up to 10 seconds.
- Tighten your abdomen and curl halfway up, keeping your head in line with your shoulders.
- Hold for 5 seconds. Uncurl to lie down.