DEAR DOCTOR K:
My lower back has been giving me trouble. Could you describe some exercises to strengthen it?
If misery loves company, you’ll be glad to hear that there are many people who have back problems. One large survey conducted by the government found that about one out of every four adults had suffered from back pain lasting at least a whole day in the previous three months.
The good news is that an exercise program designed to stretch and strengthen your back and core muscles can help you heal from back pain and help prevent a repeat episode.
Both strengthening exercises and stretching are essential. The bones of your spine (the vertebrae) hold you upright. They are stacked on top of each other like a roll of dimes. That stack is like a column, but the bones in that stack stay on top of each other only because the muscles attached to those bones keep them in proper position.
When those muscles are weak, changes in the position of the bones can cause pain. Nerves that run between the bones can be pinched, and ligaments that attach the bones to each other can become strained.
Stretching is important because sometimes the pain comes from the muscles themselves. As we get older, our muscles tend to stiffen up more. When a stiff muscle is suddenly asked to work, it can cause pain. If the muscle is gently stretched, it becomes more ready to work. Supple, well-stretched muscles are less prone to injury. Stretch gently, without bouncing. If you aren’t used to stretching, start by holding a stretch for a short time. Gradually build up to roughly 30-second stretches.
It’s not just your back muscles that need strengthening and stretching; other muscles also are important in keeping your back straight. Specifically, a stretching and strengthening regimen should target your back, abdominal and buttock muscles. Together, these muscles help maintain an upright posture and support the back during walking, standing and sitting.
The muscles of the upper legs also need to be strong and flexible. When they are weak and tight, they can strain the supporting structures of the back.
If you were exercising before your back pain and had to slow down or stop because of it, don’t resume exercising at the same level as before the episode. If you try to pick up where you left off, you might hurt your back again. Gradually build back up to where you were before.
I advise working with an expert to develop a suitable exercise program. Ask your doctor to recommend a physiatrist (a doctor who specializes in physical medicine), a physical therapist or a reputable personal trainer. The right exercise program will help you build strong, flexible muscles that will be less prone to injury.
To get you started, I’ve put descriptions and illustrations of several back-strengthening exercises here:
1. Lie on the floor on your back. Bend your knees and keep your feet flat on the floor. Squeeze your buttocks and pull your abdomen in toward your back. Your lower back should be pressed flat on the floor. Now raise your buttocks about an inch off the floor. Your lower back will lift slightly off the floor while your upper back remains flat. Hold for a few seconds before relaxing. Repeat 10 times.
2. While lying on the floor on your back, with your head and neck supported, grasp your leg just below your knee. Pull your leg gently toward your chest. Hold for 20 seconds. Repeat on other side. Repeat 10 times.
3. Stand with your feet slightly apart and your hands on the top of your buttocks. While looking up, push your hips forward slightly and gently bend backward. Keep your knees straight. Hold for 10 seconds. Relax. Repeat 10 times.
4. Lie on your back and bend your knees. With your arms crossed in front of your chest, slowly lift your shoulders a few inches off the floor as you pull your abdomen in and tighten your buttocks. Lower your back gently to the ground. Repeat 8–20 times.