Lower back pain exercises

Lower back pain presents in so many different ways.  On the contrary, two people with the same set of symptoms may respond to completely different treatment plans.  Perhaps the one thing all of us have in common, is our fight against gravity.  We are all subject to the compressive stress of gravity and therefore, the overwhelming majority of us may benefit from spinal decompression.

The following set of exercises, is an easy-to-do at home routine that will unload your spine from the compressive stress experienced during prolonged sitting, standing and existing on planet Earth.

More information about spinal decompression exercises and how to use a back block.

Spinal Decompression Exercises

Each and every one of us, for the rest of our lives, will be engaged in the battle against gravity.  It is a constant force applied to us every single day.  Coupled with the hours we sit, the sports we play, and the unexpected trips and falls we might endure, this translates to massive compressive forces placed upon the spine.

To deal with this, the spine has ‘discs’ between each vertebra.  They are fluid-filled shock absorbers and prevent bone-on-bone friction.  Since they do not have a blood supply, nourishing the discs occurs via osmosis.  Movement throughout the spine is thus vital to preserve and feed these structures, so that the discs can prevent excessive wear and tear to the vertebral column.

Incidental spinal movements throughout the day create a physical pumping effort which shunts nutrient-bearing fluids in, and stale fluids out.  Well-hydrated discs become plump which gives better bony separation and ultimately renders the spine more able to accommodate compression, impact and jarring.

The force of gravity means the discs naturally lose fluid throughout the day – people can lose up to 2cm in height by the end of the day.  Sleeping horizontal at night allows the natural fluid exchange within the discs to be carried out – fresh nutrients are drawn in, whilst stale fluid is expelled.

Prolonged sitting is a risk factor for maintain healthy discs.  In the first two hours of sitting, one can lose up to 10% of intradiscal fluid. Slumped sitting is particularly bad for the discs, as is any low activity posture.

The majority of back pain that exists today, is often due to compressive forces applied to the spine. In the age of chronic sitting, performing spinal decompression exercises daily may serve the overwhelming majority of back pain sufferers.

Using a back block is an easy and effective way to perform spinal decompression.  Lying backwards passively over a block exerts lumbar traction and both stretches the compressed disc wall and passively elongates tight local muscles and ligaments that have tethered and contracted the spine down.  This method works by stimulating pressure changes within the intervertebral discs by alternately loading and unloading the discs within their physiological range.  The physical separation of the spinal segments also counters the fluid loss and the slow deflation of the discs.

Using the back block

  1. Lie on the floor on your back with your knees bent so that your feet are touching the floor.
  2. Lift your backside off the floor and slide the block, on its flattest edge, to rest lengthways under your sacrum (the hard flat bone at the base of your spine).
  3. Straighten your arms above your shoulders to rest on the floor, then straighten out one leg at a time until both legs are relaxed.
  4. Remain in this position for 60 seconds only.  Expect some initial discomfort as your body adapts to the position.
  5. For a greater effect, you may progress to using the block on its second highest edge on subsequent sets.  Always start using the lowest edge first.
  6. After 60 seconds of lying over the back block, bring your arms back down to your sides.  Then return your legs, one at a time, to the starting position (take care as this can be uncomfortable).
  7. See the following pictures to reference the correct positioning of the block.

 

The challenge when in the final back block position, is to let go of all muscular tension.  If you are suffering back pain, your body may resist completely relaxing your back over the block.  Take your time.  With each exhale, attempt to let the muscles around your pelvic floor, hip flexors and lower back give way, so that you can begin to feel the traction sensation building up through your spine.

Pelvic rock

  1. Lie on your back with your knees bent and feet on the floor. In this position note that your lower back is somewhat raised (or arched) off the floor.
  2. Flatten your back against the floor (push fairly hard) and then relax.  Do this fairly quickly for about 30 seconds, aim for 30 repetitions.

Having just followed the back block routine, your back may now be feeling slightly sensitive.  Traction through the spine is a force we are not usually accustomed to. It can be a mildly painful experience following this decompression exercise.  The pelvic rock is a gentle way of alleviating any immediate discomfort experienced through the lower back after using the back block.

Knees rocking

  1. Raise your knees, one at a time, towards your chest so that your thighs are parallel to the floor.  Cross both ankles and relax your knees outwards.
  2. Place your hands around the outside of each thigh to hold your knees so that all the weight of your lower body is held in your hands.
  3. Gently oscillate your knees towards your chest for 30 seconds, do this rhythmically as if rocking a baby to sleep.

The knees rocking movement is an excellent way to restore lumbar flexion range of motion.  This helps to loosen the large lumbar erector spinae muscles of the lower back and facilitate further, the imbibition of fluid into the intervertebral discs.

Reverse curls

  1. Start in the same position as for the knees rocking exercise but instead, interlace your fingers behind your head.
  2. Using your lower abdominals, bring your knees towards your chin, attempting to lift your backside off the floor.
  3. Try to keep your stomach pulled inwards as you lower your legs perpendicular to the floor.  Ensure your thighs do not pass beyond this return point (90 degrees).  This will cause your back to arch and potentially become painful.
  4. Do 15 repetitions.

The reverse curl exercise activates the abdominal corsetry that serves to lift your spinal segments off one another.  In this way, the lower abdominals act as the body’s own spine sparing function enabling spinal decompression.

Child’s pose

  1. Start on all fours, then sit your backside onto your heels.
  2. Keep the knees pointing outwards at roughly 45 degrees, then lower your torso forwards with the arms stretched out in front of you.
  3. Relax in this position for up to 30 seconds.

This yoga pose has many benefits but is used in this instance as another means for spinal decompression.  If you have a history of hip, knee or ankle injuries, you may struggle to morph your body into this position.  If so, some simple forward bending off the edge of a seat, or toe touches will suffice.  See the below suggestions.

Forward bending (below left), Toe touches (below right)

 

Since compression builds up in our spines throughout the day, the best time to perform this routine is at the end of the day.  You can however follow this routine as many times as you like.  Remember, in the mornings after sleep, you would have already been somewhat decompressed throughout the night.  It would thus be less effective doing these exercises upon waking.  Ideally, you would attempt to do this routine between 12 and 3pm, and just before going to bed.

Back blocks are available for purchase at Cartwright Physcialtherapy.

Pain relief for powerlifters

The sport of power or weight lifting has certainly had an impact in the health and fitness industry. Gyms are adding more weight plates, squat racks and dead-lifting platforms to their floors. Despite this, it seems gym-goers almost have to form a cue to use all of this gear as it has become so popular, almost faddish in the gym community. Whether you are a competitive power lifter or someone who regularly incorporates power lifting exercises into your weekly workout routine, there are some vital therapeutic exercises you should consider doing to prevent injury.

Powerlifting revolves around three primary lifts: the squat, the bench press and the deadlift, but powerlifters incorporate many more movements into their exercise programs. These may include shoulder pressing, front squats, sumo deadlifts, clean and jerks, and the list goes on.

The three fundamental exercises of powerlifting share a common risk factor with regard to joint health in the body compressive force. The squat and the deadlift produce large amounts of compression through the spine, whilst the bench press creates compression mostly through the shoulders.

The following exercises are designed to unload those joints most affected by the exercises involved in powerlifting. Doing these exercises post training or in-between training sessions will ensure greater longevity in the sport.

Exercises

1. Back block

Position the back block under your sacrum about level with your bottom. Extend your arms and legs one at a time. Lying backwards over the block passively opens up the lumbar spine, like pulling open an accordion. This exercise creates a traction, or pulling, force between the vertebra which is opposite to what the spine experiences during squatting and dead lifting. Lie like this for two minutes.

 

2. Pelvic rock

After using the back block, it is common to feel sensitive through your lower back. Bring yourself to a position where your knees are now bent so that your feet are flat on the floor. Repetitively flatten and relax your back against the floor as if trying to squash your lumbar spine against the floor.

This is only a very gentle decompression movement that is more so a bridging exercise to progress the person from the back block to knees rocking which is more intense.

 

3. Knees rocking

Hold your knees with your hands so that the weight of your lower body is held entirely in your hands. Your ankles should be crossed and your knees spread apart wide. Pull your knees toward your chest repetitively but without tugging or bouncing. In addition to teasing out tight muscles and ligaments in your back, this exercise creates flexion movements between the lumbar vertebra.

 

4. Reverse curl

Perform 15 reverse curls for every minute spent on the back block. Doing these stimulates the lower abdominals which help to support the lower back. Failure to do this after the preceding exercises will perpetuate lower back stiffness and soreness.

 

5. Hanging

Hanging can help decompress the spine but depending on how your spine is put together, there may be a more effective way. When you hang, try bringing your head forward towards your chest whilst at the same time, bringing your knees towards your chest. This curling whilst hanging will open up your entire spine just a little more. This is particularly true in the lumbar region where straight-legged hanging may see your pelvis extending slightly and thus not really aiding decompression force very much.

 

6. Childs pose

The childs pose [from yoga] is a fantastic spine opening and decompressing posture. To add more effect, have a partner apply pressure over your lower back to increase the stretch.

 

7. Toe touches

These may seem controversial to the informed athlete. Toe touches involve a rounding of the back whilst bending forward and down. Contrary to what most lifters may think, forward bending with a rounded back is not harmful to the lower back, at least, not with ones own body weight. Again, this exercise merely opens up the lumbar spine and is a useful alternative to do throughout the day.

Whilst the above exercises may seem simplistic, rest assured there is quite a lot of science behind how and why these exercises help the spine. The purpose of this article is not to delve too deeply into this science but rather to provide people with an easy spinal decompression routine that does not require too much equipment.

 

Treatment

If you feel that your lifting of heavy weights has caused more injury than can be relieved by these simple strategies, there are some very effective conservative treatment options available.

1. Manipulation

Restoring range of motion to the joints where they have become restricted from repetitive lifting will alleviate almost instantaneously some causes of spinal pain as well as dramatically increasing ones ability to lift. Special attention to the sacroiliac joints [SIJs], hips and thoracic spine will see the most impressive results.

Improving range of motion at the SIJs and hips helps with the depth of squatting. Freeing up the thoracic spine will enable a more comfortable bar position during squatting, as well as enabling better posture during squatting and dead lifting.

2. Mobilisation

Mobilisation techniques are similar to manipulation techniques in that they improve joint range of motion. Mobilising the hip joints will provide a very beneficial stretch to the joint capsule. When addressing lower back complaints, a lack of hip motion can cause compensatory motion in the lumbar spine which in turn leads to increased shear stress and load to the spinal soft tissues.

3. Active Release Technique

This gold standard of soft tissue treatment is extremely effective for treating muscles, ligaments and nerves throughout the body. There are areas within the body which when treated, will greatly enhance performance of powerlifters in their sport. Treating the latissimus dorsi in combination with the lumbar erector spinae and lumbopelvic fascia will reduce tissue immobility and tightness. It also restores any irregularity in the normal functioning of these structures that can cause imbalances at the lumbopelvic region.

4. Massage

The dreaded tightness that follows tough workout sessions in the gym is a phenomenon powerlifters know all too well. Discomfort experienced when trying to tie shoe laces, bending forward or even moving to sit down on a chair can become very frustrating. This tightness can also be the reason for not returning to the gym sooner. A regular massage can help flush the body of the metabolic by-products of exercise and see you returning to the weight lifting room earlier and with reduced potential for incurring injury.

Competitive powerlifters in particular, should seriously consider receiving regular treatment from a health practitioner. In the same way that your car needs servicing every six months or 10,000kms (whichever occurs sooner), so too does your body. You probably use your body more so than your car so book it in for a tune-up regularly and reap the benefits of preventative therapy that keeps you lifting longer and stronger.

*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.