Hip or knee replacement surgeries are no longer exclusively performed on older persons and are now not uncommon procedures for many patients with persistent, significant hip or knee pain. Good out ...View Article
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This section contains a printer friendly version of the Acute Low Back Exercises. ONLY the exercises and a brief description is offered on this page. For a complete explaination please go to the Acute Back Pain page.
Place the hands on your stomach with one hand on the upper abdominal area and the other on the lower abdominal area. Now raise your head off the ground so that you are looking down toward your feet. You should feel the rectus abdominis (stomach) muscle tighten up. Try this several times, feeling the muscle flex.
Once confident you can flex the stomach muscles while raising your head, try to tighten the rectus abdominis with the head resting on the floor. Learning to control the abdominal musculature is the goal of this exercise. If you cannot feel the muscles flex without raising your head, close your eyes and concentrate on what happens to the body as the head rises off the floor.
Repeat several times, then test yourself by keeping your head on the floor while flexing the stomach muscles. If you still cannot get the abdominal muscles to flex without raising the head, do not get discouraged, this exercise is harder than it seems. Mastering this activity is very important as it forms the foundation which you will build upon for a healthy back.
FLATTENING THE BACK
The next step on the journey to spinal wellness is an exercise called FLATTENING THE BACK. This exercise builds on the abdominal flexer activity by developing awareness of pelvic movement which will improve coordination and flexibility.
To learn this skill, lie on your back with knees bent so the feet are flat on the floor. Practice a few abdominal flexes in this position. Now that you are warmed up, try rolling your pelvis so the small of your back rests flat against the floor.
Once you can successfully roll the small of the back tightly to the floor, try holding the position for several seconds. For the second part of this activity, lower your legs until they are resting on the ground (knees straight). Now perform the flat back exercise, practicing until you can firmly hold the back to the floor for several seconds. Check to make sure the back is snug against the floor by trying to insert your fingers between the floor and the small of your back. If the fingers can get in, then you are not performing this activity properly. Go back to the bent knee position and practice.
The abdominal flexor and flat back exercises are building blocks of the pelvic stabilization exercises which will form the foundation of the better back program.
Pelvic Stabilization Exercises
These exercises build on the abdominal and pelvic control activities covered in the previous section. To perform these exercises, lay on a firm supportive surface. Practice the abdominal flexion and flat back activities. While laying on your back in the flexed knee position flatten your back and flex your abdominal muscles at the same time. If you have trouble doing this, try raising your head. This will help the abdominal muscles to contract.
Breathing -- When performing any exercise, be sure not to hold your breath. Each exercise will require a different rate at which you inhale and exhale. In general, breathe in as you prepare for movement and breathe out as you move.
THE BASIC POSITION
When the back is flat against the floor and the abdominal musculature is flexed, this is called the basic position. The basic position is what will build low back strength and endurance. Practice holding the basic position for a few seconds at a time. The goal is to build endurance until you can hold the position for a minute or two. Once this is achieved it is time to move on to the mastery of the next exercise.
The next series of exercises will help to imprint the basic position into the subconscious. One of the goals of the Acute Back Program is to be so thoroughly conditioned by performing the pelvic stabilization exercises in a variety of ways that the back becomes solid as a "brick wall".
BENT KNEE LEG RAISES
Once the basic position can be sustained for periods longer than two minutes performing the Bent Knee Leg Raises are the first step in challenging these newly developed skills.
To begin, assume the basic position (flat back and flexed abdominal musculature). Slowly raise the right leg (bent knee) at the hip until the thigh is approximately 90 degrees from the floor. Lower the leg slowly back to the foot flat on the floor starting position. Repeat with the opposite leg.
This exercise of alternating leg lifts in a bent knee position should be repeated until the basic position (back flat to the floor, stomach muscles contracted) can no longer be sustained. When this occurs simply relax. Stop and rest. Make sure there is not any increase in pain.
BENT KNEE LEG RAISE
WITH EXTENDED ARM
Performing the knee leg raise with the arms extended, working in tandem and in cross-over patterns are advanced steps in the pelvic stabilization exercises. So far, you have learned to perform bent knee leg raises which challenge the flat back/tight abdominal combination (pelvic control). If you have mastered the ability to perform this exercise continuously without losing the tight abs and flat back longer than 5 minutes, it is time to go to the next level.
This time, while performing the bent knee leg raises in the controlled pelvic position, hold both arms (elbows straight) up at 90 degrees (perpendicular) to the floor.
BENT KNEE LEG RAISE WITH
EXTENDED ARMS MOVING IN TANDEM
With this exercise, perform the bent knee leg raise with the arms extended. Move the arms in tandem with the legs. For example, raise the right leg and bring the right arm up, over the head while keeping the left leg and arm stationary. Then raise the left leg and bring the left arm up, over the head while keeping the right leg and arm stationary. Remember to keep your back flat on the floor and stomach tight during this activity. When you canot keep flat and tight it is time to rest.
BENT KNEE LEG RAISE WITH
ARM AND LEG CROSSOVER
The next level of difficulty requires a cross-over movement. While maintaining the stable pelvis position, raise your right leg in the bent knee position while moving the left arm towards the head. Return to starting position and repeat on the opposite sides.
With this exercise, perform the bent knee leg raise with the arms extended. Move the arms in opposition to the legs. For example, raise the right leg and bring the left arm up, over the head while keeping the left leg and right arm stationary. Then raise the left leg and bring the right arm up, over the head while keeping the right leg and left arm stationary. Remember to keep your back flat on the floor and stomach tight during this activity. When you canot keep flat and tight it is time to rest.
The goal of this exercise is to increase strength, coordination, and movement to the lower back and hip region through rotation of the leg from the hip, while maintaining a stabile pelvis.
To perform this activity, maintain the stabile pelvic position (tight abdominals and flat back) with straight legs. To start, place the right hand on the right hip joint, softly point the right foot, then slowly turn-out your right leg from the hip joint.
As your leg rotates outward you should feel the joint moving under your hand. Be sure the movement comes from the hip and is not a forced knee or foot movement. You could end up with a secondary injury.
The movement of the hip should not be forced and kept within a pain-free range. Slowly roll the leg back to neutral and repeat on the left. Repeat with each leg five times.
Keep in mind, if you try to progress faster than the body is healing, you will end up flaring-up your condition, resulting in more pain. If you do get pain during an activity, stop. If you are sore after exercise, next time perform fewer repetitions or go back to the basics until the flare-up calms down.
To perform Crunches, lie on your back in the bent knee position. Support the neck by placing your hands behind it or on the back of the head. Be sure not to pull on the head or neck during the activity. Next roll the pelvis so the back is flat to the floor and the stomach muscles are tight. Gently press your knees together so the inner thigh muscles are slightly contracted (tight). Be sure to hold the stable pelvis and tight knee position throughout the exercise.
Breathe in to prepare for movement and breathe out as you slowly roll the shoulders off the ground. When the shoulder blades are off the ground, hold for a moment and slowly lower back down breathing in as you go down. Start with five repetitions with a goal of reaching 20 per set over time.
HIP AND THIGH STRETCH
The Hip and thigh stretch is designed to increase flexibility of the lower back, hips, and thigh musculature. As you progress through the basic exercises, this activity can be a great warm up to the intermediate and advanced workouts.
Lie on your back quietly resting. Grasp one of you thighs with both hands and gently pull the leg towards the chest. This should be a pain-free stretch. If you experience any pain, back off on the pressure.
The Hip and Thigh stretch helps increase flexibility of the hip and leg muscles. Hold the stretch for 3 to 5 breaths. Repeat with the other leg. Each leg should be stretched three times.
Next grasp the right thigh with the right hand and the left thigh with the left hand. Gently pull both thighs toward the chest, hold for 3 to 5 breathes, then slowly lower back to the resting position. Repeat 3 times.
THE CAT STRETCH
The Cat Stretch is a great warm-up and is helpful in learning to use the abdominal and hip muscles when performing the pelvic tilting component of the stable pelvis activities.
To start-kneel on all fours with the hands placed slightly wider than the shoulders. If you have wrist problems, rest on your knuckles. If not, the fingers should be pointing straight ahead. The knees should be spaced about as wide as the hips and the toes should be pointing backwards. The back should be flat, like a table.
Part One -- roll the pelvis up and back like a Halloween Cat. Contract your abdominal muscles, breathe out, and bring the head to your chest as you complete the initial part.
For the second part of the Cat Stretch, return to the starting position. This time, roll the pelvis down and forward, so the mid-section hangs like an old horse, raising the head so you are looking forward. Breathe out as you move. Repeat this five times.