I have chronic back pain. Although I want to exercise to stay in shape, I’m worried about further damaging my back. What exercises are safe?
We used to tell people to rest and reduce exercise to manage their back pain. We now know that this strategy actually contributes to greater dysfunction and increased pain because the muscles that support the back are not being conditioned. People with back pain are now told to be as physically active as they can tolerate.
Experts suggest a combination of stretching, aerobics and strength training for optimal back health. Stretching exercises should be done before any workout for at least 15 minutes to warm up and lengthen the muscles. Try these stretching exercises:
Lie flat on your back with both knees bent, feet flat on the floor. Lift one leg (keep your knee bent) toward your chest with both hands and hold for about 15 seconds. Repeat with the other leg, doing several repetitions on each let.
Get on all fours, keeping your back flat. Slowly tuck your chin towards your chest and gently round your back (like a cat does) as you breath out. Return to a level position on the inhale. Then slightly arch your back as you exhale, looking up toward the ceiling. Return to a level position on the inhale. Repeat several times.
The best aerobic exercises for people with back problems are those that involve the lowest impact and minimize twisting: walking, swimming, bicycling on a stationary bike, and running on a treadmill or a cross-country ski machine. Be sure to consult your doctor before beginning any exercise program; if you feel increased pain, or an onset of pain, while exercising, call your doctor before continuing. (Sometimes the impact of jogging, for example, can cause a delayed pain response; be mindful of recurring next-day pain.)
Once your doctor has given you the go-ahead, keep several things in mind.
Start slowly with the first few sessions, exercising no longer than 15 minutes (in addition to the 15 minutes of stretching). Add another five minutes per session each week, gradually building up to 30 or 40 minutes of continuous exercise.
If you are jogging, do so on a treadmill or other soft surface, like a track, that has some degree of “give.” Jogging on pavement is more dangerous because it doesn’t absorb shock.
Replace your exercise shoes often — either every six months or every 300 to 400 miles — to ensure proper support.
Building up the muscles in your stomach, hips and thighs helps support your back and can reduce injury. The American Academy of Orthopaedic Surgeons recommends the following back-saving strengthening exercises:
Floor leg lift – Lie on your stomach, tightening the muscles in your buttocks and legs. Slowly raise one leg several inches off the floor and hold for a count of 10. Return your leg to the floor and repeat with the other leg. Do several repetitions.
Roll-up – Lie on your back with knees bent, feet flat on the floor. Reaching both hands out in front of you, slowly raise your head and shoulders off the floor (don’t sit all the way up). Hold to the count of 10 and lower. Repeat five times.
Upright leg lift – Stand with your hands on the back of a chair. Lift one leg back, keeping the knee straight, a couple feet off the ground (don’t let your back arch). Return the leg to the ground and repeat with the other leg. Do five repetitions on each leg.