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Self help: why exercise?

Back specific exercises are designed to support the musculo-skeletal structure of the spine in maintaining joint mobility and muscular strength. A secondary benefit of this type of exercise is increased postural awareness, and the ability to correct poor posture. Many back problems begin with poor posture. The advantage of learning back specific exercises is that postural awareness is an integral part of the exercise.

It is important to mention here exercises for the neck and shoulders. It is often presumed that back exercises are only for the lower back. From our perspective the back involves both upper and lower back exercises.

Exercise as a preventative measure

Regular exercise (15 minutes a day) can minimise the chances of repeated attacks of back pain. In the event that pain should occur, the stretches in the program will help you to minimise the symptoms and to maintain as much movement as you can. Check our exercise section for some basic ideas for mobilizing your back. Maintaining good muscular strength of all the spine-supporting muscles is an integral part of any preventative measures that you should consider.

The abdominal muscles, particularly the lower abdominal muscles (transversus abdominus) play a major role in maintaining the correct alignment of the pelvis.

When these muscles are slack, then the pelvis has a tendency to dip forward causing a “sway back”. This in turn can lead to a range of back problems, ranging from mild discomfort to debilitating pain. In many cases, the simple exercises that are used for rebalancing, muscle tension are often enough to begin to ease back pain.

The buttock muscles (gluteal muscles) and the back muscles all play an equally important role, as do the muscles that form the waist girdle (internal and external obliques). All of these muscles come together to form a corset of muscle that can support the spine in a balanced way.

Frequently asked questions

What should I do if the pain in my back is so severe that I cannot stand or move comfortably?

In this case a few days of rest will do you good. Keep your back warm, and try to lie on your side with your knees bent up in foetal position. If you prefer, you can lie on your back so long as you make sure that your knees are bent and that you have a few thick pillows under your knees so that the hollow of you back is relaxed.

Try some of the stretches from our exercise section. These should help you with your back pain. As you lie in bed resting, you can actively participate in your own healing by using the stretches to gently assist your healing.

Ask your doctor for medication that will help you with your pain. Depending on your condition, your doctor will prescribe an anti inflammatory medication, or a muscle relaxant. It is always best to follow your doctor’s instructions with regards to medication. Avoid self medication.

Book an appointment to see your osteopath as soon as possible.

What should I avoid if my back is hurting me?

Avoid sleeping face down on your abdomen. Choose instead a position on your side with your knees drawn up as in foetal position, with a pillow between your knees. If you prefer to lie on your back, make sure that you have a pillow under your knees to enable the hollow of you back to relax as much as possible.

If you are a woman, avoid wearing high-heeled shoes.

Avoid sitting in one position for too long. Try to get up and walk to mobilize your back as much as possible.

Avoid carrying anything that is too heavy and that might place an additional strain on your back.

Try not to let your back get cold.

If you need to sneeze or cough, bend your knees and try to hold a pillow in front of you, hugging it towards you to prevent the sudden muscular contraction that can cause sudden and sharp pain.

What are good ergonomics in the workplace?

The correct use of the spine in the workplace is called correct ergonomics.

Ergonomics in the workplace is extremely important to ensure that each person is able to work with ease and comfort, without causing any discomfort or pain to the body. The correct ergonomic rules vary with each individual and the work that they do. The following examples may illustrate this point better.

Exercises

This section features the four most important exercises which will release tension and relieve pain from the lower back.

Back stretch for pain in the lower back
Lying on your back, bring your knee in towards your chest. Breath normally as you hold this stretch, breathing out tension and pain in the lower back. Allow the muscles to stretch gently as you hold the stretch for 30 seconds to a minute. Repeat on the other side.

Nerve mobilization and hamstring stretch
Lie on your back with both knees bent. Gently straighten the lower leg up towards the ceiling. Pull your toes back towards your shin. If you have pain running down your leg, repeat this movement gently bending and straightening the knee as far as you can. Never force this stretch. As you ease the leg upwards, you will find that you are able to increase the range of stretch. Always maintain a regular rhythm of breathing whilst doing these stretches. If you are holding your breath it is a sign of forcing the stretch. Repeat this movement at least 10 times on each side, holding the stretch for 30 seconds on each side. Lying on your back, with both knees bent, avoid arching your back as in the picture below.

Pelvic Tilt
Flatten the hollow of your back onto the surface that you are lying on. Try not to hold your breath as you do this, but rather use your exhalation to gently contract your lower abdominal wall as you flatten the hollow of your back onto the surface that you are lying on. Repeat this movement gently and often to help ease any ache in your back. (20-30 gentle rolls will start to ease out any discomfort) If you have a tendency to have a very curved lower back (hyper-lordotic), then this movement should be repeated often to release tension and to rebalance the pelvic tilt.

The pelvic tilt is a continuation of the back flattening exercise, and as you can see from the picture, the buttocks have come off the surface as the hollow of the back is pressed into the surface. Do not arch your back as above.

Spinal twist
On your back, rotate both knees to the side. Place the foot of the top leg onto the knee of the lower leg, and press down with the hand on that side. This movement should never be forced. Turn your head in the opposite direction, and try to breath as normally as you can without holding your breath. It is important not to force this stretch. Do not bounce the knee either. Just wait for 30 seconds or more for the stretch to “develop”. Repeat three times on each side.

Cat Stretch
Position yourself your hands and knees. Make sure that your back is flat and not arched. Gently hold your abdominal wall inward. Take a deep breath in, and as you exhale round your spine up like a cat. Repeat 5 times.

Common mistakes:

Make sure that you drop your head down unlike this picture where the model is straining her neck as she attempts to round her spine up. Do not arch your back while transitioning from flat back to rounded back.

This is a seated spinal rotation that can be done anytime when you are unable to lie down to release tension in your spine. Hold the position for a count of 10 and then change sides (below left).

Sit back on your heels and stretch, resting your chest on your knees and your forehead on your forearms. If you are pregnant, or your abdomen gets in the way, then just open your knees wide apart as you keep your toes together. This is a wonderful way to relax a tired and aching back. This exercise can also be done seated on a chair (at work, or on a plane, when you are unable to lie down). As demonstrated in the picture above right.

Disclaimer: The exercises presented on these pages are intended as an educational resource. Prior to undertaking these, you should consult a health care professional, particularly if you are pregnant or nursing, or if you have chronic or recurring conditions. Do not continue with any exercise that causes you pain or severe discomfort. Neither the author of the information nor the owners of this site make any warranty of any kind concerning the content of the information presented in this section.

Exercises for pregnancy

Exercises for pregnant women are very important for the following reasons:

  • To maintain muscular tone, joint flexibility and cardiovascular fitness
  • To prevent incontinence (weak bladder control)
  • To prevent or minimise back pain
  • To provide additional muscle support for the heavier breasts and for the growing abdomen
  • To prepare your body for the demands of motherhood
  • To help regain your figure quickly after giving birth

Breathing and relaxation exercises

It is very important to learn relaxation techniques to assist you in having a stress-free pregnancy and childbirth. Childbirth is painful, but even more so when you are stressed. We encourage pregnant women to attend regular relaxation sessions at our Centre. Along with the relaxation exercises, you will be taught correct breathing techniques to assist you through the different stages of labour.

Ante Natal and Post Natal exercises

Helping the new mother to regain her muscular strength and joint mobility, this is a gentle return to exercise. Sessions have been structured with great consideration to the new mother who has had sleepless nights, and has to cope with the demands of a new baby.

Please also see Ante natal Care section.

Case study:

One story illustrates the effects of muscular imbalance. Ali had been a keen footballer until an unfortunate knee injury. His knee was so painful that he was unable to play football at all, and after consulting with an orthopedic surgeon, he underwent surgery for a cartilage tear as well as repair of the Anterior cruciate ligament. After surgery, Ali was advised by his surgeon to undergo extensive rehabilitation for his knee, so that he could strengthen the muscles that supported his knee joint. Once his muscular strength had improved, there was a chance for him to return to playing football. However due to the arrival of a new baby in the family, he became involved with family, and gave up football. As a result, he stopped going for his rehabilitation exercises. Four years later Ali started to suffer from a dull and recurring pain in his back. On examination we discovered that the muscles of his right leg had wasted considerably. He had unknowingly favoured the use of his left leg after surgery, and as a result had developed a gait where his body weight was not equally distributed. As a result, his back supporting muscles had been compensated, and after four years the accumulated muscle tension and imbalance manifested as back pain.

Treatment included showing Ali how to regain strength in his right leg, and to rebuild balanced strength in the muscles of his back and abdomen. As he grew stronger he began to feel better. The last I heard of him, he was kicking a ball around with his four-year-old son.

Case study:

An example of a work related injury

An assistant on a dive trip found that after lifting several heavy oxygen tanks, his back began to ache. Hoping that the pain would go away, he continued lifting tanks all day. By evening he was in considerable pain, and found it difficult to stand or sit. Pain was radiating into his buttock and the back of his thigh.

By the time the osteopath saw him on the following day, his back has stiffened considerably, and he was unable to stand up straight without a compensating lean to the left side . When the osteopath asked him to describe his lifting pattern, he said that his lifting pattern had been to lift the heavy oxygen tanks from the floor on his right and to lift and place them onto a counter directly in front of him about waist high. This repetitive strain of bending and lifting throughout the day resulted in the discomfort that he was feeling.

On examination, the osteopath found that he had strained the sacroiliac joint on the right side of his lower back. As a result, there was a considerable amount of muscle spasm, nerve entrapment and movement restriction.

Treatment involved first relaxing the soft tissue that had tightened and was in spasm. A combination of heat and neuromuscular massage allowed the muscle to relax . Osteopathic manipulation followed, releasing the restricted joint.

This patient reported an immediate reduction in symptoms after the first treatment, and was symptom free after two weeks of treatment.

Case study:

An example of poor ergonomics

A student working towards her Masters degree found herself spending up to 7 hours a day at the computer typing. She noticed as she typed that the left side of her neck began to ache after a while. After a week, the discomfort started to inhibit her study time. When she came for treatment, in the initial assessment the osteopath noticed a muscular imbalance in the muscles of her neck. It seemed as if her neck was twisted slightly to the right. The osteopath asked her to demonstrate to him her sitting position at the computer. Her demonstration of her position confirmed that although her keyboard was placed directly in front of her, the computer monitor was placed on a shelf to the right, causing her to twist her neck to the right for extended periods of time. Over time this had created a muscular imbalance, and this manifested as pain with restricted movement in the neck.
This patient was treated with neuromuscular massage to relax the tension in her neck. This was followed by passive mobilisation of the neck ,and stretching of the muscles. When the muscles were sufficiently relaxed, osteopathic manipulation was used to release the restricted joints of her neck, and she began to regain her full range of movement.
Once this patient was symptom free, she was given a series of simple exercises to do to maintain balance and strength in the musculature of her neck.
She was also advised on how to change certain aspects of her position at work so as to avoid any future painful episodes.