Strengthening and Back Pain Exercises

By: Peter F. Ullrich, Jr., MD

Just like reinforced steel can bear more weight than sheet aluminum, a strong, well-conditioned back can withstand more stress, and protect the spine better, than a back that has not been conditioned through exercise. Conditioning through flexibility and strengthening exercises not only helps the back avoid injury, or minimize the severity of injury if the spine is traumatized, it also can help relieve the pain of many back conditions.

Many exercises can help strengthen the spinal column and the supporting muscles, ligaments and tendons. Most of these exercises focus not only on the back, but also the abdominal (stomach) muscles and gluteus (buttocks) and hip muscles. Taken together, these strong ‘core’ muscles can provide back pain relief because they provide strong support for the spine, keeping it in alignment and facilitating movements that extend or twist the spine.

Two of the most well-known strengthening exercises are: Mckenzie exercises and Dynamic Lumbar Stabilization.These back exercises are generally first learned by working with a physical therapist who can demonstrate the exercises and correct a patient’s form to ensure strengthening and/or back pain relief is achieved. Although McKenzie exercises and dynamic lumbar stabilization exercises tend to be used for specific conditions, when appropriate the two forms of physical therapy exercise may also be combined.

McKenzie exercises

These back exercises are named after a physical therapist in New Zealand who found that extending the spine through exercise could reduce pain generated from a compromised disc space. Theoretically, extension exercises may also help reduce the herniation of the disc itself and reduce pressure on a nerve root. There is a wide range of McKenzie exercises, some of which are done standing up while others are performed lying down. All of them use core muscle contraction and, usually, arm motions to stabilize the trunk and extend the spine.

For patients who are suffering from leg pain due to a disc herniation (a radiculopathy), extending the spine with McKenzie back exercises may also help reduce the leg pain by "centralizing" the pain (moving the pain from the leg to the back). For most patients, back pain is usually more tolerable than leg pain, and if a patient is able to centralize the pain, they may be able to continue with non-surgical treatment (such as exercise) and avoid a surgical discectomy.

When the pain is acute, the exercises should be done frequently (every one to two hours). To be effective, patients should try to avoid flexing the spine (bending forward) during exercising as this undercuts the strengthening motion.

McKenzie exercises may also be helpful for those individuals who have back pain due to degenerative disc disease. While sitting or flexing forward can accentuate low back pain for patients with degenerative disc disease, extending the spine can serve to relieve the pressure on the disc. Note that the opposite is true in elderly patients who have facet osteoarthritis and/or lumbar stenosis (extending the spine jams the facet joints on the back and increases pressure across the joints, so these patients will typically feel better sitting, and have more pain with extension).

Dynamic lumbar stabilization exercises

With this back exercise technique, the physical therapist first tries to find the patient’s "neutral" spine, or the position that allows the patient to feel most comfortable. The back muscles are then exercised to teach the spine how to stay in this position. This back exercise technique relies on proprioception, or the awareness of where one’s joints are positioned. Performed on an ongoing basis, these back exercises provide pain relief and help keep the back strong and well positioned.

These lumbar stabilization exercises may also be done in conjunction with McKenzie exercises. The McKenzie exercises serve to reduce back pain, and the stabilization exercises help strengthen the back. Stabilization exercises can be rather rigorous and therefore may not be well tolerated by all patients. It may be advisable for elderly patients or patients in significant pain to use other less strenuous means of physical therapy and back exercise to strengthen the back.

The above two exercise programs are commonly prescribed to treat low back pain and leg pain, but many other forms of exercise can also provide pain relief and help with rehabilitation. The important aspect is that the exercise includes controlled, progressive strengthening exercises. Alternative forms of strengthening exercise that can be gentle on the back include Pilates, yoga and tai chi. There are several forms of these disciplines, and they are best learned working with a certified trainer or practitioner.

via spinehealth

Getting a Good Workout with Low Impact Exercise

Low impact exercise is often used in conjunction with the words gentle, easy or light and is often recommended for people who don't want a high intensity workout. But what if you want to work hard, but don't want all the jumping around? Can low impact exercise help you burn calories and lose weight as well as high impact moves? Absolutely.

High Impact Exercise Isn't for Everyone

If you're trying to lose weight, you know that getting into the middle-high range of your target heart rate zone (about 65% to 85% of max heart rate) is important for burning calories. You also probably know that it's easier to get your heart rate up when you're jumping around. But, for some people, high impact exercise just isn't an option. Some reasons you may have to avoid high impact are:

• Pregnancy
• Injuries in the joints, bones or connective tissue
• Chronic problems like arthritis, osteoporisis or stress fractures
• Being a beginning exerciser
• Being very overweight
• An aversion to high impact exercise

While it's important to have some type of impact in your workouts for healthy bones, you don't necessarily have to jump around to get an intense workout. Many low impact exercises (which is when one foot is always in contact with the ground) can get your heart rate into your target heart rate zone...the catch is, you may have to work a little harder.

Making the Most of Low Impact Exercise

If you've ever added any running into your walking workouts or tried some jump roping for the first time in years, you probably noticed how high your heart rate can shoot up as soon as you add higher impact. But, if you can't or don't want to do high impact exercises, there are some alternatives. The following are just a few of the most popular low impact activities along with some tricks for getting the most our of your workouts.

Walking

Walking is by far the most popular low impact exercise, but in order to get your heart rate up there are some things you may need to do.

• Walk faster. One mistake we often make is walking too slowly to get the heart rate up. Wendy, About's Walking Guide, offers a great tutorial for How to Walk Faster. Picking up the pace can help you up the intensity of your workouts.
• Try interval training. By adding short bursts of speed or an occasional steep hill to your walking workouts, you can increase the intensity of your workouts as well as your calorie-burn. Try one of these Hill Workouts on the Treadmill or one of the Beginner Interval Workouts to get started.
• Use your arms. Make sure you're not holding onto the treadmill and, when you're outside, swing your arms to keep the intensity up. Holding weights as you walk is a no-no (it can cause injury), but consider using walking poles as an alternative.
• Mix things up. If walking is your sole source of cardio, cross-train with other activities to keep your body challenged. Walking is something we do every day and, therefore, we're very good at it. Learning something you're not as adept at can be a great boost to your endurance and fat loss.

Walking the Stairs

Walking up stairs, whether they're real stairs or the revolving staircase at the gym, can be an incredibly intense workout and a great way to get your heart rate up. If you're a beginner, try adding a few minutes of stairclimbing to your usual workout or hop on the stepmill at the gym for a quick five minutes towards the end of your workout. You'll find you don't have to go very fast to get your heart rate up.

Hiking

Hiking can be another tough low impact activity, especially if you're hiking up an incline. The changing terrain requires a lot of work from the lower body and walking up a mountain involves the large muscles of the glutes, hips and thighs - exactly what you want for an intense cardio workout. Add a backpack and you're burning even more calories.

Step Aerobics

Step aerobics can be a great alternative if you like choreographed exercise but can't handle the pounding of hi/lo aerobics. Because you're stepping onto an elevated platform, you can typically get your heart rate up without doing any jumping. Using the arms can add more intensity the the workout as well. Cathe Friedrich is just one video instructor who offers low impact workouts for the more advanced exerciser such as Low Impact Circuit, Low Impact Step and Low Max Step. You can also try group fitness classes or other more advanced videos that may include high impact and modify the workout to keep it low.

Other Alternatives

You can also choose other activities that have no impact, but still offer high intensity workouts like cycling, swimming, cross-country skiing, the Versaclimber or rowing. Any of these activities can be intense if you work hard, but you may also want to cross-train with impact activities to keep your body challenged in different ways.

Adding Intensity to Your Workouts

The key to making low impact exercise work is to work a little harder by involving your entire body in what you're doing. Try some of these ideas for making your workouts more intense:

• Add upper body movements. Upper body moves can contribute to your overall intensity so think of swinging your arms when you walk, raising the arms overhead during step or other types of aerobics or choosing machines at the gym with upper body options like a cross-country ski machine or elliptical trainer.
• Go Faster. Picking up the pace, whether you're walking, cycling or ellipticalling (did I make that up?), is another way to make your workouts a little tougher.
• Use big movements. Another way to add intensity is to use big, exaggerated movements. For example, if you were marching in place, you could make the move harder by bringing the knees up high and circling the arms overhead.
• Involve the lower body. Most cardio activities do involve the lower body, but you can add intensity without impact by doing things like squats or lunges to really get the legs involved. Add walking lunges or side steps with squats to your usual walking workout to increase intensity.

If you're looking for a low impact workout check out this Low Impact Cardio Blast Workout. This workout involves a circuit of intense, low impact moves that will get your heart going without any jumping.

Check out some of low impact cardio and strength training equipment at www.myfitnessspot.com.

Via about.com:health

5 Quick Tips to Help Prevent Back Pain

Back pain … we all get it sometimes. But there are things you can do to prevent it from happening too often or from becoming too serious. Here's 5 important ways to prevent back pain:

#1 - Get up and get moving
The most important thing you can do to keep your spine healthy, and the rest of your body, is to exercise. The best way to start is to think of an activity that you enjoy, and do it!! Your goal should be to exercise at least 30 minutes each day (or on most days of the week). Whatever activity you choose, make sure it gets you breathing a little harder than usual. This is good for your circulation. Also, include some strength training to keep muscles healthy and strong. Some examples are walking, jogging, biking, swimming, even gardening can be considered exercise if done vigorously!

#2 - See your doctor
Regular checkups with your doctor are really important, no matter what your age. Make a plan to see your physician at least once a year to make sure all your systems are working smoothly. If you are experiencing back pain, and can't seem to find any relief, it's definitely time to see your doctor. Today there are many treatment options available so you don't have to live with back pain.

#3 - Lose weight
It's estimated that over half of all Americans are overweight. It's important to know that obesity contributes to the development of heart disease, diabetes, high blood pressure, cancer, and back pain. While the spine is designed to carry and distribute the body's weight, excessive weight can strain the spine. Eventually, the spine will begin to wear out.

Give your spine a break by shedding those unwanted and unnecessary pounds. Don't know how to start? Talk to your doctor. He or she can help you find a weight loss and exercise plan that best suits your needs.

#4 - Good posture
You may think that slouching when sitting or standing is relaxing your muscles. But actually, it makes your muscles work harder. Good posture, which involves standing and sitting in a balanced and neutral position, is the best way to avoid straining your spine.

#5 - Rest easy and properly
Sleep is an essential nutrient for our bodies and where we sleep can make all the difference. If you are having trouble sleeping or find that you wake in the morning more tired than when you went to bed, you may need to take a good look at where and how you sleep. A good mattress allows you to maintain the same natural spinal alignment that you have when standing. When your body is allowed to rest in its natural position, muscles are relaxed and sleep is more refreshing.

While you may not be able to avoid some occasional back pain, keeping your back healthy will go a long way to keeping you in good shape!

Mark R. McLaughlin, MD
Neurosurgeon
Princeton Brain and Spine
Langhorne, PA

via spineuniverse.com