low-back-pain-frazier Low Back Pain Rehabilitation Exercises

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THE SPORTS MEDICINE PATIENT ADVISOR 151

Low Back Pain

What is low back pain? connective tissues of the back gling or numbness in the calf
become inflamed as a result of or foot mky indicate a herniat-
Low back pain is pain and
an infection or an immune sys- ed disk ot pinched nerve. Be
stiffness in the lower back. It is
tem problem. Arthritic disor- sure to sJe your doctor if you
one of the most common rea-
ders as well as some congeni- have weJmess in your leg,
sons people miss work.
tal and degenerative condi- especiallt if you cannot lift
How does it occur? tions may cause back pain. your foo~,because this is a sign
Back pain accompanied by of nerve tlamage. New bowel
Low back pain is usually
loss of bladder or bowel con- , or bladd~r problems related to
caused when a ligament or
trol, difficulty in moving your . your back pain may indicate
muscle holding a vertebra in

t
legs, or numbness or tingling severe injury to your spinal
its proper position is strained,
in your arms or legs may indi- cord, and you should see your
Vertebrae are bones that make
cate an injury to your spine doctor. that in~eases
up the spinal column through
and nerves, which requires
which the spinal cord passes.
immediate medical treat-
When these muscles or liga-
ments become weak, the spine
ment. I
Low Back Pam
.
loses its stability, resulting in What are the I
pain. Because nerves reach all symptoms?
parts of the body from the
spinal cord, back problems can Symptoms include:
lead to pain or weakness in - pain in the back or legs
__ - stiffness and limited
~lmo~ any.R~2i..Jhe b..:::o.::d:J...y.:..--
-----.- - Low back pain can occur if motion.
your job involves lifting and The pain may be continu-
carrying heavy objects, or if ous or may occur only in
you spend a lotof time sitting certain positions. It
or standing in one position or may be aggravated by
bending over. It can be caused coughing, sneezing,
by a fall or by unusually stren- bending, twisting, or
uous exercise. It can be straining during a
brought on by the tension and bowel movement. The
stress that cause headaches in pain may occur in only
some people. It can even be one spot or may
brought on by violent sneez- spread to other areas,
ing or coughing. most commonly down
People who are overweight the buttocks and into
may have low back pain the back of the thigh.
because of the added stress on A low back strain
their back. typically does not pro-
Back pain may occur when duce pain past the knee
the muscles, joints, bones, and into the calf or foot. Tin-
Rear view of body
I
Low Back Pain -. Page 1 of 5
152 THE SPORTS MEDICINE PATIENT ADVISOR

Low Back Pain ---r-I I -------.....

I
despite treatment indicates a • Having traction, if How lolng will the effects
more severe problem, which recommended by your last? I
should be evaluated. doctor.
The effeJts of back pain last as
• Wearing a belt or corset to I •
long as the cause exists or
How is it diagnosed? support your back. until yoJr body recovers from
Your doctor will review your • Talking with a counselor, if the strain, usually a day or
medical history and examine your back pain is related to two but ~ometimes weeks.
you. He or she may order x- tension caused by emotional
rays. In certain situations a problems. How cbn I take care of
myelogram, CT scan, or MRI I

• Beginning a program of myself{
may be ordered.
physical therapy, or In additton to the treatment
exercising on your own. describ~d above, keep in mind
How is it treated?
Begin a regular exercise these suggestions:
The early stages of back pain program to gently stretch
with muscle spasms should be • Use ~ electric heating pad
and strengthen your muscles
treated with ice packs for 20 to on a low setting (or a hot
as soon as you can. Your .
30 minutes everyl'!t\t06 hours wate~ bottle wrapped in a
doctor or physical therapist
for the first 2 to 3 days. You to
towe~1 avoid burning
can recommend exercises
may lie on a frozen gel pack, yourself) for 20 to 30 minutes.
that will not only help you
crushed ice, or a bag of frozen Don,J let the heating pad get
. feel better but will I
peas. too hot, and don't fall asleep
strengthen your muscles and I

The following are ways to with it.You could get a burn.
help avoid back trouble later. I
treat low back pain: • Try Pftting an ice pack
When the pain subsides, ask
• After the initial injury, your doctor about starting an wrapped in a towel on your
applying heat from a heating exercise program such as the back ~or 20 minutes, one to
I

pad or hot water bottle. following: four times a day. Set an
• Resting in bed on a firm alarni to avoid frostbite from
• Exercise moderately every
mattress. Often it helps to lie using the ice pack too long.
day, using stretching and
on your back with your warm-up exercises 1 I

• Put pillow under your
knees raised. However, some suggested by your doctor or knees when you are lying
I
people prefer to lie on their physical therapist. dowt·
side with their knees bent. • SleeR without a pillow
• Exercise vigorously for
• Taking aspirin, ibuprofen, or about 30 minutes two or under your head.
other anti-inflammatory three times a week by • Loselweight if you are
medications; muscle walking, swimming, using a overreight.
relaxants; or other pain stationary bicycle, or doing • Pracfce good posture. Stand
medications if low-impact aerobics. withlyour head up, shoulders
recommended by your
Participating regularly in an straight, chest forward,
doctor.
exercise program will not only weight balanced evenly on
• Having your back massaged help your back, it will also help bothlfeet, and pelvis tucked
by a trained person. keep you healthier overall. • I
m'
l
I
!
Low Back Pain - Page 2 of 5
THE SPORTS MEDICINE PATIENT ADVISOR 153

Low Back Pain ---------

Pain is the best way to judge be able toha\T~,thesame range • Lie on your side with your
the pace you should set in of motion that1iyouhad before knees bent when you sleep
increasing your activity and your injury.ygu'Inustbe able or rest. It may help to put a
exercise. Minor discomfort, to run, jwitpan.c:i'twist without pillow between your knees.
stiffness, soreness, and mild . p-ain. ~~" :.;:.~:,<,.i.:.,.
.- ',,-. • Put a pillow under your
aches need not interfere with knees when you sleep on
activity. However, limit your What can {do to help your back.
activities temporarily if: prevent low back pain? • Raise the foot of the bed 8
• Your symptoms return. You can reduce the strain on inches to discourage
• The pain increases when you your back by doing the follow- sleeping on your stomach
are more active. ing: unless you have other
• The pain increases within 24 • Don't push with your arms problems that require that
hours after a new or higher when you move a heavy you keep your head
level of activity. object. Turn around and elevated.
push backwards so the strain To rest your back, hold each of
When can I return to my is taker(byxpo/legs. these positions for 5 minutes
:'.,,1:'111(' ;' -.
sport or activity? • Wheneyer Yi9t1i~it, in a
sit or longer:
The goal of rehabilitation is to straight'"ba.q<~<;lchair and • Lie on your back, bend your
return you to your sport or hold yourspifl~against the knees, and put pillows
activity as soon as is safely back of the Chair: under your knees.
possible. If you return too • Bend your knees and hips • Lie on your back, put a
soon you may worsen your and keep your back straight pillow under your neck,
injury, which could lead to when you lift a heavy object. bend your knees to a 90-
...
----- .....
---------
----permanenniamage~-EveFyone-. Avoidllffing heavy objects --"-de-greeangle, anapuryour--------- -----
recovers from injury at a dif- higher than your waist. lower legs and feet on a
ferent r~te. Return t~ your • Hold packages you carry chair.
sport WIllbe determined by close to your body, with • Lie on your back, bend your
how soon your back recovers, your arms bent. knees, and bring one knee
not b y ~ohwmban y~ays or • Use a footrest for one foot up to your chest and hold it
wee k It as een smce your
s '. . there. Repeat with the other
., . d In al th when you stand or SItmane knee, then bring both knees
mJury occurre. gener, e f' 1; . Thi
longer you have symptoms skPot ora' °tg:ne.. :- to your chest. When holding
before you start treatment, the a
eeps your ,;' ckstraigh . your knee to your chest,
longer it will take to get better. • Bend your knees when you grab your thigh rather than
It is important that you 'bend over. your lower leg to avoid
have fully recovered from • Sit close to the pedals when overflexing your knee.
your low back pain before you you drive and use your seat
return to your sport or any belt and a hard backrest or
strenuous activity. You must pillow.

---- Low Back PainRehabi/~t,at;on Exercises ----......

.u. .

The goal of these exercises is to strengthen your abdo~~muscles, stretch your lower back, hip
flexors, and hamstrings. These exercises may help reduce lower back pain by correcting muscle
imbalances in strength and flexibility of the trunk andhips.

1. Hamstring stretch: Place the heel of one leg on a stool about 15 inches
high. Lean forward, bending at the hips until you feel a mild stretch in
the back of your thigh. Make sure you do not roll your shoulders and
bend at the waist when doing this or you will stretch your lower back
instead. Hold the stretch 30 to 60 seconds. Do the same exercise with the
other leg. Repeat 3 times.

2. Cat and camel: Get down on your hands
and knees. Let yourstomach sag, allowing Hamstring stretch
your back to curve downward. Hold this
position for 5 seconds, then arch your back.
Repeat 10 times. D02 sets ..

Cat and camel 3. Pelvic tilt: Lie on your back with
your knees bent and your feet
flat on the floor. Tighten your
stomach muscles to flatten your lower back against the floor.
Hold for 5 seconds, then relax. Repeat 10 times. Do 3 sets. Pelvic tilt

4. Partial curl: Lie on your back with your knees bent and your feet
tl}e
_____ .__ flil..t..9n flggr. Tighi~!lY.9_urstOl!!~cb.}.!lusc~~9DgJ].atten your
back against the floor. Tuck your chin to your chest. With your
hands stretched out in front of you, curl your upper body for-
ward until your shoulders clear the floor. Hold this positiori for 3
seconds. Don't hold your breath. It helps to breathe out as you Partial curl
lift your shoulders up. Relax. Repeat 10 times, Build to 3 sets of
10. To challenge yourself clasp your hands behind your head
and keep your elbows out to the side.

5. Prone hip extension: Lie on your stomach with your legs
straight out behind you. Tighten your buttock muscles
and lift your right leg off the floor, keeping your knee
straight. Hold this position for 5 seconds. Then lower your Prone hip extension
leg and relax. Repeat the same with your left leg. Hold 5
seconds and then lower the leg and relax. Repeat 10 times
on each side. Build up to 3 sets of 10.

6. Single knee to chest: Now do a pelvic tilt and pull one knee up
to your chest. Hold for 5 seconds and return to the starting
position. Alternate sides, and repeat it 10:-20 times.
Single knee to chest

Low Back Pain -pag~;~;)bf5
r
THE SPORTS.MEDICINEPATIENT ADVISOR 155
~
'.;~;~

---' Low Back Pain:Rehabilitation Exercises ---......
. '~,: ·;b--·· "
..:~! ; .. ,
i[';
/.:.
,. . );~~~.<
7. Double knee to
chesfAgam; doa
pelvic tilt and now p@poth
knees up to y~~iche~t Hold for
5 secondsandrm.e~~:tti~~tO .'
.':
times.Y01.:(may;~~~ti~f\9:.llit:!on~

Doubl. knee W FOesI .
~~:.1tf~~f;~~:~&-;
8. Lower trunk rotation: Do a pelvic tilt.Keepi?g~p:6Ulders
down flat, gently rotate the knees to one side, tli~nthe other,
as far as you can. Repeat 10-20 times. ;:: .

Lower trunk rotation
.. .

9. Pirif~rmis stretch: Lie on your back as shoin. Pull
..one;~l:!e up and across your trunk so you feel a
. ..>!~p~p'#.b~estr~tch in the top buttocks and back.
and
.: ::-·1f:Iolp.:;.to,(~~J5s~conds repeat 5-10 times on

,[~~~~~r""iiiii'i'
:.,.;\,lX9yJ, ;, ..
,p~this exercise by reaching for your
.
·····'··ll':~;'"iII-i··''".·''·.'''···I. .
.·.'~~I~~~llWW·Weopposite hand and keeping your
...·.....,;!shomflendlat on the floor. Pull your knee over as
-----f---------l"ir~formls-stretch
'far'ils'you can allowing your trunk to rotate. --------