Monday, June 4, 2012
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Doing specific back exercises is championed by any number of back gurus. However, most people do not need to strengthen their backs. They need to become active. Aerobic activity by itself can decrease back problems. As an Atlanta neurosurgeon says, “Motion is the lotion.” Immobility leads to increased pain.
In his research, as reported in his book Low Back Disorders, exercise physiologist Stuart McGill makes a good case for not doing a number of exercises. These are frequently the same exercises doctors tell their patients with low back pain to do. Don’t do them!! They are listed below. He also shows why certain exercises are better at rehabilitating an injured back than others. He compares the back to a tall tower with supporting guy wires. The tower supports itself against gravity by the way it is constructed, i.e., it isn’t easily compressed. The guy wires keep the tower from buckling or falling over. The tower is your vertebral column. The guy wires are your back and abdominal muscles.
If you think you need specific exercises or think they may help your back, take the following advice from McGill into account: there are some specific exercises to avoid. Any exercise that increases intra-abdominal pressure increases compression of the discs and the facet joints, increasing the likelihood of injury or irritation of these structures. Even though strong abdominal muscles contribute to back stability, true sit-ups and bent leg sit-ups can be injurious. They increase the compressive force between vertebrae to unacceptable limits. Unless you are an athlete bent on competition and willing to take that risk in order to improve your performance, avoid doing them. For the rest of us, endurance in those muscles is more important than strength. Pull-ups, believe it or not, also compress your discs. Most extension exercises are a bad choice.
All exercises should be done with the back in a neutral position, including any stretching such as hamstring, quadriceps, and psoas stretches. McGill also goes over nerve flossing (a way of decreasing the compression on segmental nerves), but it has the potential to worsen pain. It is best to receive specific instructions from a physical therapist who has a lot of experience with the technique.
Back exercises that are acceptable include the cat-camel, partial squats, curl-ups, side bridge, plank, push-up, and bird dog. These increase core strength and back stability by strengthening the rectus abdominis, obliquus externus abdominis, and obliquus internus abdominis muscles (the guy wires to your towering vertebral column). Aerobic exercises, like brisk walking, jogging, swimming, and – depending upon your posture – riding a bike are also good for your lower back. They increase your overall stamina and the stamina and strength of the muscles in your back.