If you’re in the 80% majority of Americans that have had back pain at some juncture in your life, it can be tempting to lie in bed all day. Resist the urge! While bedrest was once prescribed for back pain, it rarely provides any therapeutic benefit and is more likely to make things worse.
In fact, research indicates that people who exercise and stay flexible manage their pain much better than those who don’t. Exercise improves your pain threshold. With chronic pain, your pain threshold drops – meaning it takes less pain to make you feel more discomfort. With cardiovascular, strength training and flexibility work, you can actually improve your own pain threshold.
Men in particular benefit from incorporating a flexibility routine into their wellness strategy, perhaps because they are less likely to have one of their own accord. The body will develop compensation patterns at all costs, and inflexibility in the posterior chain (think gluts, hamstrings, calves) will overstress the pelvis and low back, leading to pain and injury. Incorporating massage therapy to address existing tightness and tension is advisable in this case as well; stretching is preventative in nature and will work effectively to allay future injuries.
There’s no “one size fits all” approach to fitness or stretching. Know that an exercise or stretch that works for 75% of people may not work for you. Considering your activities of daily living (ADLs) as well as doing a postural assessment are good places to start. For example:
- Do you sit or stand all day, or a combination of both?
- Are you frequently traveling in a car or plane?
- Are you caring for little ones? Breastfeeding?
- Where is your fitness level at the moment?
- Are you looking down at your phone all day?
- How does your head relate to your shoulders?
- Do you have a lumbar (low back) or cervical (neck) curve? (an x-ray is diagnostic here)
- Are your feet flat? Do you pronate? Supinate?
- How level are your hips? Shoulders?
- Do your Achilles bow either way?
Variations of these answers will all help determine the most appropriate routine for you. That being said, there are common patterns of weakness and imbalance due to the prevalence of seated postures and forward head carriage. The value of having a strong core cannot be overstated. No matter what the cause of your back pain, balanced and strong core muscles will improve symptomology and reduce pain.
Benefits of a Strong, Flexible Back
Our body was engineered for efficient movement. The organization of our bones in combination with the way our soft tissue structures like ligaments, tendons and muscles are linked together in a connected system that is able to execute the functional movements we perform every day. By strengthening the muscles in our back with targeted lower back exercises, we will not only reduce pain, but improve the structural stability of the spine as well as overall posture.
1. Improved posture and spinal stability
The erector spinae, or the muscles that line the spine, assist your abdominals, hip flexors (deep muscles that allow you to flex your thighs – think cycling, stairs and running) and obliques (your “side abs”- crucial for stability) in holding the body in an upright position. By strengthening these muscles groups, you improve posture and stability by increasing muscular endurance and engagement.
2. Improve balance
Balance is a critical tool for us as humans. Learning to walk upright allowed us to better adapt to our environment and helped guide us into a new era of human existence. We have been able to expand on the capabilities of the human body through sports. And though these activities might not be for everyone, they do show the type of balance that comes from a strong core and back. This is also why performing a variety of exercise is crucial; many workout routines and sports are asymmetrical and utilize some muscles over others.
3. Build lean muscle
The saying goes, muscle weighs more than fat. It’s true! Additionally, as you build more muscle through strength training, your body will need more fuel to sustain itself. Combining strength training with proper nutrition will not only help build lean muscle but will encourage weight loss as well.
4. Reduced back pain
We know that a lack of exercise can cause lower back pain through muscle strains and tight muscles. So when we incorporate exercise into our day, we not only will improve our overall health and well-being but significantly reduce our chances of developing back pain.
Five Back Strengthening Exercises
Start on your belly with your legs straight and arms extended overhead. Lift your legs and your chest to create a slight arch with your body. Focus on staying long and stretch your arms by your ears extend your biceps by your ears. Squeeze your rear to create strength along the back body. Hold this position for 30 seconds, rest and then repeat 3–4 more times.
2. Swimmer Kicks
From the superman position, begin to make small “kicks” with the arms and legs. This exercise adds dynamic movement and engages ancillary, supportive muscles. “Swim” for a minute.
3. Forearm Plank
From the top of a push-up, or plank position, drop down to your forearms. Drive your forearms down into the floor as you pull your belly button up towards your spine. Engage your legs by pressing your heels back. Hold this position for one minute, rest, then repeat two more times for a total of three minutes. Work up to five.
4. Bird Dog
From the top of a push-up with your hands underneath your shoulders and your legs strong and core tight, extend your right arm forward as you lift your left foot off the ground. Return to planks and then extend your left arm forward and lift your right foot up. Return to plank. Continue to alternate back and forth between sides for one minute. Rest, and then repeat two more times.
*Alternatively – perform this exercise on all fours. This is a good modification for beginners.
A proper squat is a functional movement that requires ankle and hip mobility as well as core, back and glut strength. The better our squat, the stronger, more coordinated and healthier our bodies will be.
Start with your feet shoulders distance apart. Turn your toes forward (if ankle mobility is an issue, turn your toes out slightly). Pull your belly button in towards your spine and widen your shoulders. Keep your heels firmly planted on the floor as you bring your hips back and down, and then below the line of your knees. Complete three sets of 20 reps.
Five Back Stretching Exercises
While strengthening exercises are key to a strong back, it is equally important to stretch. Flexibility is a major component of a healthy and pain-free body. Tight muscles can shift the alignment of the joints and over time can lead to pain. While the chiropractic adjustment restores motion to these joints, maintaining flexibility reduces stress on joints and provides fluid motion. For each posture, try to hold the stretch for at least one minute and no more than two.
1. Seated Forward Fold
Sit tall with your legs straight out in front. Flex your toes towards your shins. Reach your arms straight overhead, growing taller, and hinge forward from the waist, leading with your chest. Continue to extend your chest toward your toes. You should feel a stretch in the backs of your legs and/or the lower back.
2. Head to Knee Forward Fold
Sit tall with your legs straight out in front. Bring your right foot to your inner left thigh or knee. Reach your right arm up overhead. Turn your torso to face your left knee and bow forward, reaching your arms on either side of your foot. Continue to reach your chest over your left thigh while pressing your right hip into the floor. This pose will target the right lower back and the left hamstrings. After one minute, switch sides.
3. Cat and Cow
Start on your hands and knees. Press through your palms as you round your upper back toward the ceiling, drawing your belly button to spine. Draw your chin to your chest as you widen your upper back into cat pose. Then, draw your belly button down towards the floor as you draw your shoulder blades together to come into cow pose. Move back and forth between these two poses 10 times.
4. Seated Crossed Leg Forward Fold
Sit with your legs in a comfortable crossed leg position. Sit up tall, reach your arms overhead and then hinge at the waist, bringing your hands to the floor. Continue to reach your hands forward as you hold this position for one minute. Then, switch the cross of your legs and repeat.
5. Figure Four Stretch
Sit on a chair with your feet on the floor. Bring your right foot over and above your left knee. Press your right knee away from your chest and sit up very straight. Lean forward with you chest leading. Hold this position for one minute, then switch sides.
If you have a chronic pain condition, it’s always a good idea to proceed under the guidance of a medical professional. As a chiropractic physician, master trainer and fitness enthusiast, Dr. Doyle is happy to help you modify your exercise regimen to suit your body’s structural needs, and does so for her wellness challenge groups each and every month. She utilizes a digital library of over 600 workouts from tai chi to HIIT workouts to dynamic strength training and stabilization, and can make recommendations for your specific needs and challenges.