What is the best type of exercise for someone with lower back pain?
Your question is very generic because lower back pain can have very many causes.
When I am approached to train somebody with low back pain, I always require a physician’s approval. This person should have seen a physical therapist, and it is a good idea to connect with the therapist to find out what type of exercises have been done. Sometimes the client has illustrations of exercises from the PT clinic. I then start with those exercises but still try to talk with the therapist to find out more. Be mindful that the client needs to give the okay to such a conversation.
If I get a physician’s approval but the client never went to PT, I go through a lengthy question and answer session to find out more about the history. When does the pain occur, what makes it worse, what makes it better? How long has it been?
In the event of the occasional back pain which does not appear to have any cause, I usually start with exercises lying down to minimize pressure on the lumbar spine. I encourage the client to be very interactive and always let me know if something causes discomfort. Strengthening the core with true beginner exercises like pelvic tilts and very entry level Pilates is a good starting point. As you get to know the client better your can add on from there.
Low back problems and poor posture often go hand in hand. Educating the client about posture is a key element. I firmly believe that bad posture starts initially with bad habits, and – depending on the age of the client – can be reversed to a point. Awareness is the first step in that direction.
It can vary depending on what’s causing your low back pain. In general for many it’s due to week abs & tight lower backs & poor posture.
Work on strengthen both your abs/back (your core muscles) while also stretching your back & probably glute & hamstrings are tight too.
Start standing straighter & use your muscles (not joints) to hold your body upright. We tend to allow our joints/bones to do the work & not our muscles which is what they are ment for.
Pilates & yoga are great places to start to learn to work from your core.
both answers are great! depending on the client and the age i prefer doing back bridging. Start of simple and progress by placing both legs to one another, adding weight or even one legged back bridging to show progression. Important thing is to go slow, making sure the client feels the pull in every motion.
Once the client becomes accustomed, i would strengthen the hamstrings. The reason being is due to the muscles attached from the erectors to the hamstrings. When someone gets LBP, they compensate on hamstrings for the lift, so strenghtening them would help mucho!
Weak back, can also be from a strong core. Always train the antagonist muscles, never overtrain a body region without doing the opposite.
Angela, I like the way you phrase your question, particularly the fact that you used “lower back pain.”
The American College of Sports Medicine uses the same terminology–“Lower Back Pain Syndrome” in their Third Edition of “Exercise Management for Persons with Chronic Disease and Disabilities to describe this clinical condition.
The guidelines for exercise testing and prescription include:
1. Isometric trunk testing to measure isometric strength in multiple positions to find true peak torke
2. Flexibility utilizing straight leg stretch inclinometry up to an angle that elicits pain or radiating symptoms.
As far as exercise programming is concerned the guidelines include:
Strength
Resistance: abdominal strengthening, back extensions
Goals: Increase abdominal strength; increase lumbar extensor strength
Intensity/Frequency/Duration: Under the age of 50: 10-15 reps/day; Over age of 50: 8-12 reps two or more times a day per week.
Time to Goal: 2-4 weeks
Flexibility: Any standard flexibility that does not increase LBP
Goals: Increase trunk and hip flexor and extensor ROM
Intensity/Frequency/Duration: 2 min/muscle group; hold position for three reps, 10s/stretch
Functional: 5 min walk – 1 min chair sit to stand
Goal: Increase/maintain ADLs
Intensity/Frequency/Duration: Brisk walk, 3-5 days/week; chair sit and stand, 2-3 days/week
Time to Goal: 2-4 weeks.
