Stop Low Back Pain (Part 3)

By Brian Schiff, The Fitness Edge

Many people suffer from the effects of osteoarthritis. For the purposes of this newsletter, I am sticking to that and will not be addressing rheumatoid arthritis. OA is a natural degeneration of the spinal segments and associated structures. It is commonly associated with joint space narrowing, bone spurs, calcification, narrowing of the foramen where nerve roots exit and of course stiffness/limited motion. Some people even experience nerve related problems due to excessive joint space narrowing known as spinal stenosis.

The treatment of choice is typically exercise. Whether you see a chiropractor or physical therapist, they will likely recommend stretching and strengthening exercises for long term management of the problem. Finding a balance between appropriate loading of the spinal column and adequate rest in combination with activity modification is the key to minimizing pain. Joint health can also be preserved with proper diet and nutrition as well. My primary aim today is to focus on exercise - what to do and what to avoid.

If you find the following information valuable and know of someone else who may benefit from it, please feel free to forward it on to them. In addition, send us your questions about training or specific topics of interest. I will attempt to address them in upcoming newsletters.

Proper Program Design for OA

First, let me start by addressing some general precautions I follow when working with a client experiencing pain or dysfunction related to OA.

Never force a joint through painful range of motion Avoid high impact activities (jumping, skiing, etc.). Minimize ballistic movements. Utilize low to moderate weights or loading during exercise. Minimize positions that close down the joint space for prolonged periods of time (typically excessive extension, side bending and rotation).

So, how do you know what is safe to do? The key is starting with a proper assessment from a trained medical professional or fitness trainer with experience in this special population. Understanding the progression of OA and carefully evaluating range of motion, flexibility, and strength will provide a good starting point. Beyond this, it is necessary to look at pain levels and personal activity goals. The training program must be set up to help you increase your activity levels or assist you in better performing your desired task - whether it be golf or gardening.

If you read and absorb nothing else, please read this: learn to monitor your pain in response to activities and exercise! I am not talking about muscle soreness, but rather joint soreness. I am sure most of you can tell the difference. Joint pain or soreness that persists greater than 24 hours after activity means you overdid it. Plain and simple - the body needs more recovery and less intensity/volume. If you fail to observe this rule, the pain and stiffness will progressively worsen with continued activity until it begins ruining your life. One other important note - pain during activity is even worse. This is a signal to stop (by pain I mean more than the normal discomfort you may have grown accustomed to).

To alleviate pain, my favorite remedy is ice. I know you are thinking to yourself that heat feels much better, but the ice treats the cause of the pain (inflammation) whereas the heat serves to interrupt pain signals temporarily and does not generally reduce the inflammation.

5 Effective Exercises for Back Arthritis

The following exercises are not intended to serve as medical advice and are not intended to treat a medical problem. If you suffer from back pain, please seek the advice of your doctor prior to trying these exercises. They are general exercises I use with my clients that have worked well, but keep in mind they are applied differently depending on each client's particular case.

Double knees to chest stretch - Lying on your back, bring both knees toward the chest by placing the hands on top of the shins or behind the thighs. Hold 20 seconds and repeat 2 times. This serves to stretch the lower lumbar spine and open the joint space a bit.

Lower trunk rotation - Lying on the back with the shoulder blades flat against the floor (knees bent to 90 degrees and feet flat on the floor), gently rock the legs to one side and hold for 20 seconds. Repeat twice on each side. Do not allow the shoulder blade to come off the floor as this signals compensatory motion from the upper torso/thoracic spine.

Abdominal bracing or drawing in - Lying on your back (knees once again bent to 90 degrees with the feet flat on the floor) slowly draw your belly button in toward the spine and tighten your abdominals. Hold 5 seconds and repeat 10 times. Do 1-2 sets. This exercise will help facilitate a neutral spine position and activate the transverse abdominus.

Standing ball squats - Using a stability ball, place the ball in the small of the back and against the wall. With the feet shoulder width apart, slowly lower your body down into a squat (knees do not go beyond the toes). Hold for 2-3 seconds and return to upright. Perform 2 sets of 10-15 reps. You may add weight or lengthen the hold to increase the difficulty. This exercise is good for loading the spine safely and will also strengthen the thighs to assist with proper lifting technique and functional activities.

Quadruped arm & leg raise - Begin on all fours on the floor (hands and knees on the floor). Next straighten out the right arm and left leg at the same time. Pause 1-2 seconds and slowly return to the starting position. Now repeat the sequence with the left arm and right leg. Do 1-2 sets of 10-15 reps. To test your core stability,place a small dowel rod on the small of the back and try to keep it straight and steady. If tilts significantly or rolls off, you have poor core stability.

Doug's Note: Brian Schiff is both a friend and a professional I trust. Over the last couple years, he's taken a leadership role in helping Americans alleviate pain through his books on injury prevention and rehabilitation which can be found at:The Ultimate Rotator Cuff Training GuideClick Here!

The Ultimate Frozen Shoulder Therapy GuideClick Here!