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How to Have a FABulous Back Following an Injury

Following a back injury, most people are anxious to return to work or resume activities of normal living, After the acute phase, which can take anywhere from 48 hours to two weeks, it is time to start thinking proactively to prevent a recurrence of your back pain. By following this simple plan you can design your own rehabilitation program to keep your back feeling FABulous:

Flexibility: Think of flexibility like creating shock absorbers for your spine. Just as you would buy shock absorbers to make the ride smoother in your aging car, flexible joints and muscles make the ride smoother for your aging body. As joints and soft tissues like muscles and tendons become less flexible over time, normal daily activities become stressful simply because there is less elasticity. Through a consistent flexibility exercise plan you can decrease the strain on your back and restore elasticity to the tissues. Here are five excellent flexibility exercises for maintaining a healthy spine:

  1. Knee to chest stretch: Lie on your back and pull both knees to your chest. Hold 30 seconds taking pressure off every five to ten seconds.
  2. Hamstring stretch: Lie on your back, pull one knee to your chest, grasping behind the knee. Hold 30 seconds and repeat on the opposite side.
  3. Knee rocking: Lie on your back, with your hands behind your head and elbows on the ground. "Rock" both knees as far as you can to the right side, while keeping your shoulder and elbows on the ground. Hold five seconds and repeat on the other side. Perform this exercise three times on each side.
  4. Press up: From your stomach, place your hands under your shoulders and press up your torso until your elbows are straight, while relaxing your hips and trying to keep your pelvis on the ground. Relax the buttocks. Hold five seconds for three to five repetitions.
  5. Doorway stretch: Stand in a doorway, with one foot forward and place your elbows on the door jam. Bend the front knee as you lunge forward. This leads to a stretch in the pectorals, thoracic spine and the calf. Lead with your chest and not your back. Hold 15 seconds, then repeat with the other leg forward.

Abdominal strength: Think of your abdominal muscles as a rigid cylinder that protects your internal organs and your skeleton - somewhat like wearing a girdle of armor. Developing muscles in your abdominal region, contributes to a stronger cylinder or "core" in popular terms.

Here are four outstanding strengthening exercises for your core:

  1. Upper abdominals: These muscles are the most commonly exercised by most folks in the gym. Typical crunches and Pilates "100" are examples.
  2. Lower abdominals: These muscles are targeted through such exercises as leg drops, and jack knifes.
  3. Obliques: These side muscles are targeted through such exercises as side crunches, bicycles, or side plank exercise.
  4. Transversus abdominus: These pelvic floor, deeper muscles are targeted by such exercises as pelvic tilts, all fours pelvic tilts and plank.

These exercises are more difficult to describe on paper than the flexibility exercises. If you Google them by name, you will come up with many variations from beginner to advanced.

Back Strength/Body Mechanics: Think of your back strength and body mechanics as another way to reduce stress to your back, and protect it from injury with normal everyday activities. By developing back strength and using good body mechanics you are increasing your ability to perform lifting tasks without injury.

One of the best back strengthening exercises which targets the back extensors is lumbar extension exercises like arm and leg lifts from a stomach lying position. There are also several machines in the gym that provide strength for these muscles in the gym if performed correctly. These include the Roman Chair or the Lumbar Extension machines.

The basic rule with body mechanics is to maintain the "neutral spine" for your activities. Neutral spine posture requires a balance of your head, neck and shoulders over your hips and pelvis, maintaining the normal structural curves that are part of normal spinal anatomy. For example, it is normal for the lumber curve to have a slight sway or arch in standing. Maintaining this arch when sitting and lifting protects the back from injury. If you Google "good body mechanics" you can get a great deal of information on this topic. For the sake of simplicity maintain a neutral spine for your daily activities and avoid tasks which repeatedly require you to move out of neutral spine postures, especially if they involve lifting.

Consistency is the key. Complete these exercises daily. Do not wait until you have an injury or are in pain - this proactive approach will keep your spine healthy and less likely to sustain injury!

It is possible to "treat your own back" effectively. Start with "RICE" in the acute phase, and when you have recovered with minimal symptoms, you can begin your long term "FAB" approach.

Jim Flood, MSPT is co-owner of Personally Fit, a fitness/physical therapy center located in Rancho Bernardo. He has been in clinical practice for over 20 years. He can be reached at jflood@ personallyfitonline.com


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