Stretching and Core Strengthening
Stretching
Any form of inactivity, especially where an injured back is involved, is usually associated with some progressive stiffness. Therefore, it is necessary to gentle stretch the lower back. Individuals with chronic pain may find it takes weeks or months of stretching to mobilise the spine and soft tissues, but will find that the increase in motion provides meaningful and sustained relief of their back pain.
Strengthening Exercises
Core strengthening
Core stability training is essential for injury prevention and for rehabilitation following back pain. The body's core muscles are the foundation for all other movement. The core muscles of the spine act like a natural corset around the back that provides stability and support during movement
These core muscles lie deep within the torso. They generally attach to the spine and pelvis. When these muscles contract, the spine becomes stabilized creating a solid base of support. We are then able to generate powerful movements of the extremities.
Training the muscles of the core also corrects postural imbalances that can lead to injuries. The biggest benefit of core training is to develop functional strength - that is, strength that is essential to both daily living and regular activities.
The main concepts of core strengthening programs involve using many muscles in a coordinated movement. Rather than isolating a specific joint as in most weight lifting, stability exercises focus on working the deep muscles of the entire torso at once.
Dynamic stabilization exercises
These exercises involve the use of a variety of exercises and include the use of gym balls (see later). The point of dynamic stabilization exercises are to strengthen the secondary muscles of the spine and to help support the spine through various ranges of motion.
Low-impact aerobic conditioning
Finally, conditioning through low-impact aerobic exercise is very important for both rehabilitation and maintenance of the lower back. Aerobically fit patients tend to have fewer episodes of low back pain, and tend to experience less pain when an episode occurs. Well-conditioned patients are also more likely to maintain their regular routine, whereas patients with chronic low back pain who do not work on aerobic conditioning are likely to gradually lose their ability to perform everyday activities.
Examples of low impact aerobic exercise that many people with back pain can tolerate include:
- Water therapy/ Swimming (also called pool therapy or hydrotherapy). For people with a great deal of pain, water therapy provides a gentle form of conditioning as the water alleviates gravity and provides buoyancy as well as mild resistance. Swimming is also a great all round aerobic exercise.
- Walking. Many people think that walking as part of their daily routine (e.g. at work or while shopping) is enough. However, this stop-and-start type of walking is not adequate for aerobic conditioning. Instead, continuous walking at a sustained pace for a minimum of twenty to thirty minutes is required to provide aerobic conditioning.
- Stationary biking. Riding a stationary bicycle provides aerobic conditioning with minimal impact on the spine. This is also a good exercise option for people who are more comfortable positioned leaning forward.
