May 25th, 2020

Exercise and Lower Back Pain

Background:

• Low back pain has many possible etiologies: muscles strains, structural/postural spinal anomaly (stenosis, scoliosis, kyphosis, lordosis), a ruptured disc, sciatica, arthritis, kidney infections, cancer of the spinal cord and more.
• Pain can be acute, subacute or chronic.

• Massage, physical therapy, chiropractic care, stretching, and various forms of exercise have all been proven to be reduce lower back pain when coupled with the appropriate rest of the injured musculoskeletal group.
• Compression, rotation and flexion of the lumbar spine are known movement patterns that cause lower back pain.
• Lower back pain is often associated with tight or shortened muscles (hip flexors, hamstrings, piriformis, back extensors) and weak muscles (glutes, abdominals).

Do's:
• Consult a doctor, physical therapist, chiropractor, massage therapist or personal trainer as appropriate.
• Exercise programs should include mobility exercises for hips, ankles, thoracic spine and stability exercises for knees, lumbar spine and shoulders.
• Use a foam roller to massage tight muscles (hip flexors, glutes, etc.)
• Strengthen glutes:
o o Frog leg bridges - video
• Strengthen abdominals:
o o McGill curlup - video
o o Palloff press - video
• Learn to brace your abs at will
• Learn to reach or bend over in a split stance (one foot ahead of the other)
• Learn to rotate through the thoracic spine and/or hips
o o Thoracic spine mobility - video
o o Cable lift

Don'ts:
• Avoid movements that flex the lumbar spine. (sitting with rounded back, situps, bending over or lifting with a rounded back)
• Avoid movements involving twisting of the lumbar spine. Instead rotate through the hips or upper thoracic spine.
• Avoid compression of the lumbar spine, especially when combined with lumbar flexion. (loaded barbell on shoulders, heavy lifting)
• If it hurts, do not do it! However, limited movement with tolerated pain can be therapeutic. (for example, short walks)
Best,
Dave

Dave Fairhall is a personal trainer who specializes in adult fitness. He has developed a unique perspective of optimal ways to exercise and achieve age appropriate fitness. Dave can be found at the Snap Fitness Facility in Davidson.