Low back pain can be the result of many different things. Pain can be triggered by some combination of overuse, muscle strain, and/or injuries to the muscles, ligaments, and discs that support the spine. Over time, a muscle injury that has not been managed correctly may lead to an overall imbalance in the spine. This can lead to constant tension on the muscles, ligaments, bones, making the back more prone to injury or re-injury. Since low back pain can be caused by injury to various structures in the spine and its supporting structures, it is important to consult your physician or athletic trainer if you have had back pain lasting longer than 1-2 weeks. Your physician can provide a diagnosis and explain what structure is injured so that your physical therapist or athletic trainer can guide you as to which exercises are appropriate for your specific injury. Each diagnosis is treated with different protocols, therefore it is important that you consult a medical professional before beginning any strenuous rehabilitation program. Low back exercises and flexibility can be the best treatment option for almost all types of back problems as it is likely to help restore balance in the spine. Low back exercises concentrate on strengthening with the abdominal muscles, to be able to give stabilization of the spine. Rehabilitation programs or preventative rehabilitation programs that focus on strengthening lumbar muscles combined with core stability and proprioception will reduce the risk of low back pain if exercises are done correctly, and on a regular basis.
The Lumbar/Core Strength and Stability
The program below can be utilized as a preventative rehabilitation program or if you are recovering from an injury. The program includes a flexibility and strengthening section. Flexibility should be done at least 5 times a week, and the strengthening section should be done 3-4 times a week. The program is divided into levels “Easy”, “Medium”, and “Difficult”. It is recommended to start with the “Easy” exercises, and perfect them before moving onto “Medium” or “Difficult”.
Please take the time to overview the information below before beginning the Lumbar/Core Strength and Stability Program. It is important to understand the way certain muscles work, and how the exercises should feel in order to know if you are doing the exercises correctly.
What is my “core”?
The “core” is comprised of several groups of muscles including the transversus abdominus, multifidus, diaphragm and pelvic floor muscles. These muscles work together to produce maximum stability in theabdominal and lumbar (lower) back region, as well as coordinate the movement of the arms, legs, and spine. Engaging these muscles is not something that most people do consciously, therefore it is important to learn how to effectively co-contract these muscles while performing these rehabilitation exercises.
How do I engage my core?
Place two fingers on the bones on the front of your hips (ASIS). Move your hands in an inch towards your belly button and down an inch towards your toes. You should now be directly over the transversus abdominus muscle. When you contract your core correctly, you should feel a gentle tightening under your fingers, as if you took in your belt one extra notch. If the muscles under your fingers start to “dome”, then you are contracting too much and compensating with larger muscle groups. It is important to learn how to engage your core in various positions and well as during activity to provide maximum stability for your spine.
A lack of flexibility through the hips (hamstring, hip flexors, gluteus muscles) can contribute to low back pain, therefore it is important to work on this if you are experiencing back pain. Please make sure all stretches are “pain free”. If you feel discomfort, you may not be ready to do that specific stretch.
1 – Quadriceps Stretch
Using a towel, or band, lie on your stomach, attach the band to affected foot and pull your heel to your butt. Hold this stretch for 1 min. Repeat 3 times.