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The key to preventing lower back injury and pain (LBP), whether work-related or not, is physical conditioning. "Getting into shape" involves the overall conditioning of the body and the cardiovascular system. Aerobic exercise plus the exercising of the core muscles (those of the spine and the abdomen that are responsible for stabilizing the spine), are both critical for developing healthy and pain-free backs.
Traditional beliefs among exercise practitioners and even rehabilitation professionals that strong back and abdominal muscles alone protect the back and reduce LBP episodes have never been validated by research or experience. It's time to debunk that myth.
Mobility and flexibility of the lumbar region seems to be another fallacy. However, that doesn't mean that strong and supple back muscles, if you have them, are a bad thing. Nevertheless, developing them by using exercises that are conventionally prescribed for a strong and flexible back sometimes inflicts injury. So, if neither strength nor lumbar flexibility guarantees a healthy back, then what does?
Studies on the biomechanics of the back suggest that muscle endurance is more protective than mere strength.
Stuart McGill, a world-renowned lecturer and expert in spine function and injury prevention and rehabilitation at the University of Waterloo, Ontario, suggests instead, in his book Low Back Disorder, Evidence-Based Prevention and Rehabilitation (Human Kinetics, 2002), that stabilizing the spine seems to be the answer.
The way to achieve and maintain spinal stability is to:
"Sparing" means exercising with the spine in a line with no additional load.
The focus of this document is on selecting the most appropriate types of exercises and the best way to conduct them to make you fitter without injuring yourself. Ideally you should have a set of exercises tailored to your individual objectives and ability. Because we are unable to satisfy every individual's needs, we can suggest only a rather generic set of exercises that we hope will suit the majority of working people.
The other objective is to present exercises that everyone can do and eventually benefit from doing regularly, regardless of how deconditioned one might be at the outset.
Always consult with a doctor or medical professional before beginning any type of exercise program.
Every session should begin with the "Cat-Camel" exercises (Figures 1A, 1B, and 1C)
The so-called "Birddog" exercise is suggested for improving the back extensor muscles without overloading or straining them. The degree of difficulty of this exercise can be customized to the starting ability of the person attempting them.
A. For people with a seriously deconditioned back:
B. For the average person:
From the "all fours" position (Figure 1A):
We suggest starting with the arm exercises because they are easier and less challenging for maintaining your balance. When you can do that easily, progress to the next step that involves raising a leg.
From the "all fours" position (Figure 1A):
After mastering the alternate leg raises add another motion:
A common exercise for abdominal muscles is the curl-up. However, there are many ways of performing this manouevre and some of them can be harmful and injurious, especially those which involve excessive bending and twisting. One example is the exercise where additional weights are used in order to speed up the development of the impressive so-called "six pack".
Based upon the concept of "sparing the back" endorsed by Stuart McGill we suggest the following:
Starting position (Figure 5A)
These muscles are also important in stabilizing the spine and thus preventing episodes of low back pain.
The Side Bridge - a version for the deconditioned:
Starting position (Figure 7A).
Figure 8A and Figure 8B show more challenging versions of the side bridge.
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Although every effort is made to ensure the accuracy, currency and completeness of the information, CCOHS does not guarantee, warrant, represent or undertake that the information provided is correct, accurate or current. CCOHS is not liable for any loss, claim, or demand arising directly or indirectly from any use or reliance upon the information.