Back pain can develop at any point of the spine and is often caused by stresses on the muscles and ligaments that support it.  The most common site affected is the lower back because it bears the most weight and physical stress. The back pain is characterized by a range of symptoms including pain, muscle tension or stiffness, weakness in the legs or feet, and a possible tingling or burning sensation, often travelling down the legs (sciatica).

Some interesting facts:

• One-half of all working Americans admit to having back pain symptoms each year.

• Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

• Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

• Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.

• Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives   (as referenced in amerchiro)

 Risk factors for developing low back pain

There are numerous reasons for developing low back pain, including but not limited to:

• weak abdominal muscles (especially the deep transverse abdominus)

• poor back extensor muscle endurance

• decreased flexibility and/or strength of muscles and ligaments surrounding the hip joint

• being overweight   

• lack of physical exercise

• nutritional deficiencies – examples may include omega 3, vitamin D, calcium, water… click here for other options

• psychological stress

It is important to note that chronic low back pain is not always attributable to one single factor and should be carefully evaluated by a qualified health professional for correct diagnosis and to rule out any dangerous complications (i.e internal organ, neural and/or metabolic pathology).

Core Exercises =  Low Back and Abdominal Exercises

Rehabilitation programs to treat low back pain include exercises for the abdominal, lower back and leg muscles. These include stretching, strengthening, and aerobic type exercise to increase movement and encourage the body to heal. The abdominal muscles and back muscles (also called core muscles) are key components to back fitness as they provide the strength to keep our body upright and for movement. When these muscles are in poor condition there’s additional stress placed on the spine and low back injury or back pain is more likely.

 Stretching Exercises

Key muscles to target are:

• Hamstrings- aid in good posture while standing/ sitting, as well support the function of hip flexors and gluteals Minimize stress on the low back if not tight and in good shape.

• Piriformis – the dancers “hip turn out” muscle; may cause sciatic like pain if tight

• Psoas Muscles- hip flexors; greatly limit low back mobility if tight

• Gluteal Muscles - support hip joint and back stability, i.e as in walking; linked to low back pain if weak/tight 

Stretching should be done after the muscles have been warmed up through aerobic or strength type exercise.

It should be done daily (4-7x wk) to ensure flexibility. Avoid fast, bouncy or jerky movements as to allow the muscles to lengthen and relax.  Remember to breathe in a natural rhythm, no breath holding. Hold each stretch for a minimum of 10 breaths.  See our stretching tips for beneficial low back stretches.

Strengthening Core Exercises

Developing strong core muscles in the abdomen, lower back and gluteus is crucial to decreasing the stress placed upon the low back.

   “Bushmen’s glutes” vs. “Westerner’s”

Notice the sway back posture prevalent in approx. 40% western males.

_______________________________________________________________________________                               These exercises are great to get you started. Contact us for more advanced version of these old-time favourites. Please consult with your physician if experiencing numbness, tingling, excruciating pain and/or other symptoms in the low back that may be aggravated by starting out a new exercise program. Some of these exercises are best learned from a qualified fitness professional as many of us don’t really know how to engage our deep abdominal and back muscles.Our body is simply sluggish at getting these muscles to fire….. “On your marks get set GOooooo…“ 

—start with a 5-10 min warm up on a bike/cross-trainer/ walking                                                                            

1. PelvicTilt  - 5-8s X 8-10 reps                                                                                                                                                                   Advanced:  perform the pelvic tilt + with legs up in the air; knees slightly bent; toes towards you. Don’t   allow your low back to arch; press it into the floor by drawing belly button in; use your breath.  5-8s hold X 6 reps
2. Plank – hold position for approx. 30 seconds – up to 1 min 
3. Superman Exercise – 10-15 reps
4. Single hip ups – 10-15 reps/leg      
5. Elbow to knee crunch– 10-15 reps /side             

— repeat this circuit 2-3 times —- stretch for 5-10 min at the end —                                      

Notes:     

• Listen to your body and stop if experiencing bad pain
• Start off with 1-2 sets if new to these exercises
• Check your form and never hold your breath
• Engage your deep abdominal muscles by pulling your belly to your spine on the inhale and keeping your back flat. This will prevent your back from arching and causing unnecessary strain/injury
• NEVER ARCH your back……keep it in neutral….refer to pelvic tilt exercise
• Keep hydrated and have fun =)  

_____________________________________________________________________________                                                                                                                                                                        Aerobic Exercises 
As the old saying goes…” if you don’t use it, you’ll lose it.” Engaging in a cardio exercise program specific to your health and low back fitness will aid in rehabilitation and maintain everyday functionality. While some back pain patients can engage in running and other types of moderate to high impact cardio exercise, for many with more serious back discomfort it is more comfortable to engage in low impact cardio conditioning that is easier on the joints and the muscles of low back. Some examples include:

2. The Canadian Physical Activity, Fitness & Lifestyle Approach (CPAFLA): CSEP- Health & Fitness Program’s health-Related Appraisal and Counselling Strategy (3rd edition)

3.  American Chiropractic Association http://www.amerchiro.org

4. Leinonen at al, 2000. Arch Phys Med Rehab, 81, pp 32-37