Training a Client with a lower back issue
I have a client that is looking for a trainer to help him build strength in his lower back after a discectomy (removal of a disk in his lower back). I have been researching different helpful exercises for him. Any suggestions on exercises, research spots, etc?
on the assumption that you have clearance from his physician, I would suggest that you contact his physical therapist and ask for advice there. Web sites can give you a lot of general information but the PT should be more familiar with his particular situation and ought to know the history of the back problem.
When I have a new client in a similar situation, I always do my own assessment and share this with the PT. I then start with the PT exercises that are familiar to the client and add only those of general conditioning that get the PT stamp of approval. As you continue to work with the client you'll get a better feeling for his abilities.
Getting started with a client with such issues is always tricky because you do not know him yet. Always err on the side of safety.
Dr.Susan Klein-Vogelbach, a founding director of a physical therapy school in Basel, Switzerland, was the first to use Swiss balls with adults who had orthopedic or other medical problems.Many back pain sufferers find the ball invaluable in rehabilitation.
I had citated from the wanderful book, written by Maureen Flett "SWISS BALL" for Strength, Tone, and Posture. Author had covered Neutral Alignment and Posture Positions, and also had covered Core Stability Exercises /Beginners' Level /
Author also had recommended not be rushed and can take anything from an hour to a few weeks to perfect following exercises:
Bridge with Legs Lifts
Bridge and double Knee Flex
Side Walk /lay with the ball between your shoulders in the reverse bridge position/
Hip and Knee Flexion /lay with ball under your shoulders and your feet shoulder width apart/
Reverse Bridge with Leg Extention.
Adductors /lay on the exercise mat with the ball placed between your knees/
With regards, Miroslava.
I hope that this helps.
I agree that you want to work with the physical therapist and doctor. Then do your own consultation to get to know the person. Erring on the side of caution is also my motto.
Some great posts here already, I also would consult their PT and physician, stay within your scope and follow their recommendation/s.
I also was impressed with Miraslava's thoughts and ideas regarding working with the Swiss ball. She gave some excellent exercise ideas. As long as your client's PT approves, give it a try. I know the results for many orthopedic patients, including those with low back issues, have proved to be excellent.
It is very important that people with back issues avoid long periods of sitting. If their job is at a desk, they would benefit greatly from a treadmill desk or a desk that could go from sit down to standing heights. And sitting on a fit ball and then their regular chair in turns will also help. And getting up and at minimum pacing if a treadmill desk is unavailabe (and if they have a TD) frequently is good.
Stretching is absolutely necessary. A good general series is advisable, but specific stretches for the major culprits (hams, hip flexors, quads, spinal rotators/flexors/extensors, etc.) are most important.
Myofascial release can be amazing.
Work on posture and stability (what most are calling core) is absolutely necessary.
Aquatic exercise is very helpful.
Each client will have similarities and differences. It takes a bit of detective work to get all the answers, but most can be helped.