Benefits of Back Exercises Exercise is one of the most effective ways of preventing and treating recurring or chronic back pain. Strengthening muscles that support the spine with exercises can prevent, reduce and in some cases eliminate lower back pain. Stretching shortened muscles that are pulling the spine out of alignment can also relieve lower back pain. Weak core muscles are often at the root of lower back pain. The muscles of the back, the abdomen, hips and buttocks (the core muscles) work together to support the spine. The core muscles are the spine's main defense against gravity. The core muscles help maintain proper posture and stabilize the spine (keep it firm in its natural alignment during movement - walking, running, lifting, exercising, etc. Improving core stability reduces the risk of injury to the spinal joints, discs, back muscles & ligaments during such activities. Exercises to increase strength, endurance and coordination of the core muscles improve core stability. Strengthening the upper back muscles is also important to prevent slouching, which is a common cause of neck and shoulder pain. Strengthening the upper back and the back of the shoulders helps maintain upright posture, as muscles in the upper back help keep the shoulder blades down and back. See Upper Back Posture Exercises page. Strong quadriceps (front of thigh muscles) are important to prevent back injuries when lifting. Proper lifting techniques involve using your legs and if your legs are weak, you may end up using your back. Shortened muscles can pull the spine out of alignment and contribute to back pain. Stretching exercises lengthen shortened muscles and can relieve back pain. Tight back muscles, tight chest muscles, tight buttocks muscles, tight muscles in the front of the hip can affect the alignment of the spine. Stretching the back also increases mobility of the joints of the spine. Note: Exercise is not recommended for acute low back pain, although continuing with daily activities is usually recommended. If you have a back injury or current back pain read: Post-injury exercise page first. Aerobic exercise can also reduce chronic or recurring back pain. Aerobic exercise increases core endurance. Weight-bearing aerobic exercise (legs support weight of body) such as brisk walking also improves bone density of the legs, hips and lower spine. Aerobics also improve also relieves stress and improves sleep, which helps to reduce chronic pain. See Aerobics page. How successful an exercise program is in relieving back pain depends on whether other factors that are contributing to back pain have been corrected � particularly chronic poor posture, which increases stress on the back muscles, ligaments and discs. Posture awareness along with strong and flexible muscles help maintain proper posture. See posture page for more info. NOTE: Starting out with exercises that are too difficult (for your current level of fitness) or doing too many can cause back pain. Strengthening the back with exercises must be done progressively. The body adapts to gradual increases in exercise, increasing exercise too quickly can cause injury and cause or increase back pain. Patience and restraint are needed to give exercise a chance. Stretching or Strengthening Exercises First? Stretching after strengthening exercises helps relieve the muscle tightness that can occur from strengthening exercises and may be more beneficial that stretching before strengthening exercise (you can either do all your strength exercises first and follow with all your stretches or alternate strength and stretching exercises, stretching the same muscles just strengthened). However it is largely a matter of personal preference - stretching and strengthening exercises can also each be done on separate days if desired. Remember to warm up first for at least 5 minutes of light to moderate aerobic activity such as walking. Note: If you have a back injury or condition or back pain, consult a physiotherapist who can advise you what exercises and how many repetitions of each exercise would be the safest and most beneficial for you. Many people tend to overdo it when starting strengthening exercises for the back, resulting in back strain. Back pain caused by doing too much too soon sets one back even farther. But the ultimate goal is to be able to do the back strengthening exercises. Strengthening the back can't be rushed. It takes patience but it is well worth the effort. How Often to do Strengthening Exercises: Strengthening exercises (for the same muscle group) should not be done on consecutive days. Every second day or 3 times a week is fine, with a minimum of twice a week. The days off give your body a chance to recover. Strengthening exercises done daily can result in overuse injuries. This does not apply in every situation. Exceptions include exercises used for rehab. Some gentle rehabilitation exercises may be done every day, in some cases more than once a day. When muscles are seriously deconditioned - perhaps from lack of use after an injury or an extremely sedentary lifestyle - "rehab" exercises are often used when more difficult "regular" strength exercises would overload the muscles and cause injury. Gentle stretching exercises are also often done more than once per day. If you have back problems or if in doubt, consult a physical therapist. How Many Repetitions and Sets: When just starting strengthening exercises, begin with five repetitions (or less if your find the exercise difficult) of each exercise. If you can handle five repetitions without post exercise pain, then slowly add a couple of repetitions each week until you reach 10 - 15 repetitions. Your muscles should feel mildly fatigued by the of 10 - 15 reps. Although even one set of 10 - 15 reps is beneficial (the most benefit comes from the first set), to further increase endurance add a second set of 10 -15 repetitions after you can handle one set. In time, add a third set. Rest for about 30 - 60 seconds between sets. If the exercise involves holding your body in one position for the entire exercise (a static exercise), then 60 seconds is equivalent to one set Warning: Do not hold your breath! Holding your breath can cause a spike in blood pressure! Concentrate on breathing while exercising. Warm-up before Back Exercises: Be sure to warm up before doing back exercises with five minutes of walking, or using an exercise bike or elliptical trainer, or even marching on the spot. Warm-up exercises prepare your back for strength exercises or stretching exercises by increasing circulation to the muscles. *Tighten the Abs First. Simply contract the abs as if you are about to be hit in the stomach, which will also automatically tighten muscles in the lower back. Tightening the stomach will automatically pull it in slightly. Do not overdo the abdominal tensing. It should not be difficult. Do not hold your breath. This is what "tighten abs" in the following exercises refers to. Tightening the stomach, often referred to as abdominal bracing, stabilizes and protects the lower back more than drawing in the stomach. See Abdominal Bracing or Hollowing Page for more info. back exercises continued... Birddog (Opposite Arm and Leg Extension): Strengthens muscles running down sides of spine, back of shoulders, hips and buttocks Begin on all fours, hands directly under your shoulders and knees directly under your hips. Keep head aligned with spine (to help avoid tilting head, look at floor). Keep buttocks and abdomen tight. Do not arch the back. Lift one arm up and forward until it is level with torso; simultaneously lift the opposite leg in the same manner. Keep arm, spine, and opposite leg aligned as if they are forming a tabletop. Balance yourself for 5 seconds then slowly return to starting position. Switch sides and repeat. Remember to breathe. Do ten repetitions. *If you find the birddog exercise is too difficult, start with extending the leg only, and then extending the arm only and work up to extending both arm and opposite leg at the same time, which increases the challenge to the core and develops balance. The Bridge: Strengthens several core muscle groups - buttocks, back, abs Lie flat on back; bend knees at 90-degree angle, feet flat on floor. Tighten abs. Raise buttocks off floor, keeping abs tight. Tighten buttocks. Shoulder to knees should be in straight line. Hold for a count of five. Slowly lower buttocks to floor. Repeat five to fifteen times. One-Leg Bridge: To increase difficulty of the basic bridge, raise one leg off ground (squeeze buttocks firmly before you raise your leg). Hold for 5 seconds. Switch sides. Repeat five to fifteen times. The Plank: Strengthening exercise for back, abs and neck (also strengthens arms and legs) Lie on stomach, place elbows and forearms on floor. In a push-up position, balance on your toes and elbows. Keep your back straight and legs straight. (Like a plank) Tighten abs. Hold position for 10 seconds. Relax. Repeat five to ten times. If this exercise is too difficult (as it often is for beginners), balance on your knees instead of your toes. The Side Plank: Strengthens the obliques (side abdominal muscles) Lie on right side. Place right elbow and forearm on floor. Tighten abs. Push up until shoulder is over elbow. Keep your body in a straight line � feet, knees, hips, shoulders, head aligned. Only forearm and side of right foot are on floor (feet are stacked). Hold position for 10 seconds. Relax. Repeat three to five times. Repeat on left side. If this exercise is too difficult, balance on stacked knees (bend knees and keep feet off floor) instead of feet. Alternating Leg and arm raises (Supermans): Strengthens back, lower back and glutes Lie on stomach, arms reached out past your head with palms and forehead on floor. Tighten abs. Lift one arm (as you raise your head and shoulders) and the opposite leg at the same time, stretching them away from each other. Hold for 5 seconds and then switch sides. Repeat 5 - 10 times. Note: crunches are optional if you do the plank exercise Basic Crunches: upper abdominal exercise Lie on back, knees bent, feet flat on floor. Do not anchor feet. (Anchoring the feet or keeping the legs straight along the floor can strain the lower back). Head and back should be in neutral position. A rolled up towel may be placed under the natural curve of the lower back to provide extra support - the small of the back should be about an inch above the floor. Place hands behind head with elbows pointing outward. Your hands are used to support your head (to avoid neck from tiring out before abs) but do not pull head forward. Tighten abs. Raise your head and shoulders off the floor - three to six inches is enough. Look at the ceiling to help prevent tilting your head. Keep elbows back. Exhale when raising your head and shoulders off the floor and inhale when lowering. Do ten - fifteen repetitions. When using your hands to help support your head, be very careful not to pull on your head or you could overstretch (strain) a neck muscle! Don't start out doing too many crunches - the number of crunches performed should be increased slowly. Stop if you experience back or neck pain. Crunches also strengthen the neck but doing too many too soon can cause neck strain. Move slowly when performing crunches - do not rely on momentum. Only the shoulders and head are lifted off floor. Lower and mid-back should remain on the floor in neutral position (slight curve in lower back). Pelvis should not move � do not arch your back. Rotational Crunch: obliques exercise (sides of the abdomen) Rotational crunch is a slight variation of the regular crunch shown above. The variation - the direction you raise your head and shoulders off floor is diagonal. Lie on back, knees bent, feet flat on floor. Do not anchor feet. Head and back should be in neutral position. Place hands behind head with elbows pointing outward. Your hands are used to support your head but do not pull head forward. Tighten abs. Rotate your body so that the weight rests on left shoulder. Raise your head and shoulders off the floor and raise your right shoulder higher than the left. Move slowly. Exhale when raising your head and shoulders off the floor and inhale when lowering. Do ten - fifteen repetitions. Reverse Crunch: lower abdominal exercise Lie flat on back, feet in the air. Bend knees 90 degrees. Place hands under buttocks for support and make sure your lower back remains flat on the floor. Tightening your lower abdomen, lift your buttocks a few inches off your hands. Hold for a moment and lower back down. Do 5 to 15 repetitions. back exercises continued... Original article and pictures take http://www.bigbackpain.com/back_exercises.html site
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