Updated March 2016 

why exercise?

Why exercise to relieve lower back pain?

Will it aggravate your present pain?  Should you avoid it?

Our Beliefs about Exercise

At first, it may seem hard to believe for some, that exercise would be a recommended option.  This can be due to a fear that it may exacerbate or prolong the pain already present.   We tend to visualize ourselves moving around in an exercise room frantically at a fast pace or even at an especially uncomfortable one.  We may picture ourselves being told to perform some extensive, unexciting, painful and boring movements that don’t really help.  Perhaps, it may only add to our busy lives and cause us to feel worse afterwards.

If you already have this in mind when you think of exercise for your back,  then you have already failed at finding the appropriate treatment before even starting.  Maybe, your gut instinct is telling you that the exercises are simply not practical or relevant to your pain.   Maybe, it is because you have done it before and don’t want to invest any more time and energy with something that might be unproductive.  Perhaps the plan was not appropriate to begin with in the first place.

It is important that you want to protect yourself from further pain and injury to your lumbar spine.  Vigilance is important and with your lumbar vertebrae and disc health at stake, you cannot afford to take another chance with the wrong treatment or even an unnecessary one.

Assumptions

When exercise is recommended as a treatment, there are some assumptions or conditions already made.

The first is that your back condition has been assessed to be muscular and NOT something more serious in nature with respect to your back, hips and legs.  The second is that you are physically healthy enough to exercise.  The third, is that you are not properly conditioned in these muscle and joint groups and possibly not even aware of it.

It is important that these assumptions or conditions are true before you commit to an exercise plan.

What should not be assumed is that the exercises are either not relevant, may cause further pain, may be difficult to perform, performed at a pace beyond your desire or worst of all, time consuming and boring.

In order to change this assumption or perception, we must learn why the exercises should be relevant, comfortable, easier to perform and at your pace, and will not consume your time and bore you.

Areas of Concern with Exercise

1) Relevance

You can tell someone to perform an exercise to help with lower back pain, but if they don’t understand why, then they may not care to do it or continue to.  They won’t see the value or importance and will only associate it as a chore and possibly lose interest.

When they learn: the ‘functional value’ to the exercise, how it affects the muscle group and joint, and why it is done to relieve pain, they will value it.  They will want to perform the exercise to help protect themselves from further pain.  They may become more self-aware of the importance and why it should be done.  Transferring their need to protect themselves from potentially harmful exercise to one that provides protection to the injured area is key.   A relevant exercise is one that you will want to perform and will enjoy performing long term.

2) Comfort 

Since a sufferer is already in pain,  they are naturally apprehensive to any movement that will worsen it.  Some are actually not apprehensive and are very willing to perform the exercise as the better of the two forms of pain.   However, both will still have the same recurring back pain issue (any may even worsen it)  if an appropriate level of comfort is not considered during the exercise.

Everyone’s level of pain is different with respect to severity,  muscle groups involved,  vertebral and disc wear, mobility, pain tolerance and certainly many other factors.  Therefore, they should be able to perform the exercises at their own comfort level and pace.   Whether or not it takes one minute or one month to progress through a particular exercise, they know that it is relevant to their recovery and important to do.  Exercises and stretches are not always comfortable.  If you control it at your chosen pace with the goal in mind to progress, then the pain will subside as you are carefully reconditioning your body in to a healthier state to achieve less pain.   If you discontinue an exercise due to pain,  then there are some factors to consider.  Is your pain tolerance very low and your sensitivity an issue?  Are you performing the exercise correctly?   Is it the proper one to perform?  Do you have a more serious condition presenting as back pain?   Comfort is vital but is only useful provided that you are making progress with the exercise.

3) Difficulty

It helps that the exercise is easy to perform.  However, lower back pain makes everything feel difficult and rarely easy.  Proper exercise for should not physically take more that a few movements at most to perform.  One or two movements at best initially and more as your pain subsides.

Try not to see exercise as an on-going and difficult chore to perform everyday.  You are not trying to perform an exercise to qualify for a marathon.  The goal of the exercise is to properly condition a specific muscle group so that in functions as it is intended to in the first place.  When your muscle is not performing its functional and relevant movement properly,  other muscles will compensate but will not perform it as well.

A good example of this would be in the case of excessive sitting.  Sitting for extended periods of time will cause your gluteal muscles to become weaker, shut down and lose their natural ability to activate primarily upon standing.  As a result, the quadriceps compensate when the glutes don’t.  This places more stress of the knee joint and patella, resulting in knee pain.  The quadriceps also become overused and tighter.  This affects pelvic tilt and then lumbar imbalance.  The imbalance presents as lower back pain.

The pain is a signal to you that something is either injured or not working properly.  Transferring the responsibility back to the appropriate muscle groups will relieve this pain.

Target and specific exercises that recondition the glutes to activate primarily will relieve both knee pain and lumbar pain.  The exercises as offered in the ebook are really short movements than full exercises.   This reduces the intimidation factor of exercise and make it easier to perform.

4) Time

When you are afflicted, your time is already consumed and in very short supply.  A targeted exercise program is not easy to squeeze in between.  It is very daunting to want to add anything to your day when all you feel is that you want to rest and do anything but exercise.

Think of the time your will have to put aside to exercise as an investment in freeing up future time that may be spent resting and recovering from lack of exercise.   A proper exercise program should improve your body so that it is protected from pain and not worsen it.  The exercise may require an initial investment of time but should become less demanding over time.  This allows for more time due to effective recovery, healing and less pain.  You should be able to perform the exercises LESS because they should condition the muscle back to required level of functioning prior to back pain.  Exercises designed to treat such pain should be used less often as you improve.  Only ‘maintenance’ type exercises should be needed afterwards to keep your muscles fit and properly functioning, requiring less overall time.

5) Boredom 

This is a personal opinion. If you are dealing with back pain, your concern about whether or not exercises is boring or not is secondary.

Do not focus on whether or not the exercise is boring or not, more than if it is practical, meaningful and important to your recovery.  If these factors are prioritized, then the reward will come naturally and you will not feel bored.  In fact, you will feel relieved and have a greater sense of accomplishment and satisfaction with the exercise.  With less, pain, you can participate more often in activities that you prefer and that will satisfy.  Whether or not you may find them boring is actually up to you and may depend on your progress in the exercise program.