Concerns About Exercise for Lower Back Pain. Part 2
Updated August 18, 2016
For Part One, see “Worried About Exercise to Relieve Back Pain?”
Many questions and concerns we have about the practice of exercise to relieve back pain are valid and should be respected.
When someone is already suffering from pain, they are faced with many limitations and many questions. Their options are limited and many conditions must be met to convince someone with back pain to adopt a lifestyle that includes exercise.
Some of the most common and important questions include:
- Is it safe to exercise when I am in pain?
- Do I risk further injury or increasing my pain?
- Will my current recovery be lost or set back if I exercise?
- What type of exercises do you recommend?
- What exercises are safe for me to perform?
- If the exercise causes me pain, should I stop?
- Is there an alternative to exercising?
For answers, scroll down.
Suggested answers to these concerns are:
Is it safe to exercise when I am in pain?
Yes and No
It all depends on the type of exercise that you perform. Some exercises are designed to reduce pain while others merely contribute to it. Initially, you must be selective of the nature of the exercise and whether it will stabilize your lower back or not.
When you are already in pain, any movement that you perform will contribute to further pain. It is normal to avoid any movements and opt for rest instead. Rest is essential to recovery and healing. The problem however, is that as you are resting, the muscles and joints that affect your back are becoming progressively weaker, shorter and stiffer. Some muscles are tightening as a way to immobilize the area as a protective mechanism from further pain. It is important to avoid this during rest as it risks further injury to your back. This creates a cycle where rest and recovery do not help but worsen matters. Muscle do not relax as well as they contract. This becomes more evident with age. They require stretching to counter this effect. In the event of an injury when a muscle is contracting to prevent further injury (muscle guarding and back spasm) this effect is even more pronounced.
It is only safe to exercise when:
- There is adequate rest recommended from your doctor.
- Your doctor advises exercise for your recovery.
- You are aware of where the source of pain is from (ex. muscular, nervous or skeletal)
- The exercises are controlled, safe and intended specifically for low back pain
Do I risk further injury or increasing my pain?
Yes. This depends on the type of exercise.
When you are beginning an exercise routine, avoid any exercise that involves the following movements:
- excessive upper body movements that involve leaning, bending and twisting
- upper body movements that require more than your normal body weight
- movements that place more effort on the upper body than the lower
- exercises that don’t focus on the hip and leg muscles (specifically the gluteal muscles)
- exercises that require sudden or ballistic type movements or stretches
Will my current recovery be lost or set back if I exercise?
This is also dependent on the type of exercise that you choose.
If your current recovery becomes compromised then that is a sign that either you are performing the wrong exercise or that you are over exercising and should allow more recovery time in between. Without a specific exercise plan, then you are not allowing your back and the muscles that protect it to become proactive in the recovery. This causes either your current recovery to move inefficiently and slowly or to be ineffective when your body is required to perform under stressful conditions.
What type of exercises do you recommend?
The conditions recommended above in the previous answers help to determine the type of exercises needed.
At first, you should be performing exercises that you would find given in a rehabilitation setting. Slow, controlled, safe and specific. Avoid any exercise that does not meet this criteria. The exercise must also incorporate movements to generate more flexibility, range of motion, strength conditioning and stability. There is a wealth of exercises available and also offered on this site.
What exercises are safe for me to perform?
This depends on your level of back pain and degree of injury.
This site recommends a specific order that should be followed in priority for the types of exercise to perform.
The order is as follows for lower back pain.
- Protect the lower back from injury
- Specifically target lower back, hips, leg muscles and joints
- Address your initial, tightness, stiffness, and mobility
- Engage weak and poorly functioning muscles and joints
- Strengthen weak and imbalanced muscle groups over specific levels and time
- Incorporate different methods of conditioning for each muscle group
- Place a significant degree of effort on the muscle group progressively
- Help the muscle group and joints to naturally engage and function at ALL times of any activity
If the exercise causes me pain, should I stop?
If it doesn’t pass the above criteria.
Is there an alternative to exercising for lower back pain?
There are alternates to exercising. Many of us recover with little intervention other than rest. There are many alternatives out there and many success stories to reflect their value. It must be noted that, even though there can be recovery without exercise, there is no protection from the return of issues that exercise can provide.
You many find that some of the alternatives do incorporate a required amount of exercise but they do not necessarily promote it as well or often as what it offered here.
It is important to keep in mind that your lower back is dependent on balanced, strong, and flexible muscles that require specific exercises. Wherever you go to find your solution to your pain, you will find this advice will be very helpful to you recovery.