Non-Specific Low Back Pain Exercise Therapy

As often discussed in my research reviews, pain in lower back remains an enigma in modern day health care. It is a common, disabling, and costly condition that we know relatively little about in terms or pathoanatomical causes and effective treatments.

This study was reported in the print and television media, so I felt it important to review here. As always, if you have any questions about this or any of my other reviews, please feel free to contact me.

The goal of this large meta-analysis was to evaluate the effectiveness of exercise therapy in the treatment of low back pain in adults. Exercise therapy was intentionally defined in this study as a heterogeneous group of interventions from general physical fitness interventions to various types of stretching and aerobic exercise protocols. 61 published reports of completed, randomized controlled trials comparing an exercise intervention to placebo, no treatment or other conservative treatments were included in the analysis. Patients suffering acute ( 12 weeks) low back pain were included in the studies (most of the studies involved chronic patients).

The trials evaluated provided the following insights:

there is clear evidence that exercise therapy is at least as effective as other conservative therapies for chronic low back pain, despite conflicting evidence that it is any better
for acute pain in lower back, exercise are not more effective than other conservative therapies (note that exercise therapy is not the same as advice to stay active, which is currently a recommended, evidence-based intervention for low back pain)
there is some evidence to support a graded-activity exercise program for sub acute low back pain in occupational settings

Conclusions & Practical:

This study concludes that evidence from randomized, controlled trials demonstrates that exercise therapy is effective for reducing pain and improving functional outcomes in patients with chronic low back pain. It appears that clinically important improvements are more likely to be seen in healthcare environments, meaning that exercise therapy may work better when supervised by a healthcare provider (see companion article regarding strategies for implementing exercise therapy for low back pain).

It seems intuitive that exercise would be an appropriate intervention for low back pain, provided that it is administered by qualified professionals in a safe, supervised environment. This seems to be a situation where the literature still needs to catch up to clinical practice. To this end, I feel more research needs to be directed toward the effectiveness of combining physical and clinical interventions commonly used in practice. I feel the absence of clear data on the treatment of low back pain is due to the lack of "clinical reality" of most randomized trials.

Most manual medicine practitioners combine a number of interventions in addition to exercise to treat these patients. In order to studies to reflect the benefit of such treatment regimens, more large-scale trials need to be performed with this type of design.

How to Relieve Lower Back Pain - 6 Simple Tips For Your Back Pain

How to relieve lower back pain is the use of interventions and therapies which involve blocking the conduction of nerves between specific areas of the brain and the body to alleviate pain, medications for short- term relief, exercises for strengthening and pain relief, surgery for relief of chronic pain and other disabilities.

Low back pain is very common among adults and it is often caused by overused of muscles causing strain or injury. Long hours of sitting and standing can also aggravate the condition. Since the lower part of your back makes the most of your movement in everything you do, it can also be the most affected when stressed and injured. As such, when people have such condition, they feel as if they want that pain to disappear in a second.

In the advance of technology these days, there are treatments to help relieve pain in the lower back that varies depending on the severity of the case. There some key points that we have to remember when dealing with the treatment options:

• Different treatments can help you stay as active as possible as it will help you understand that some continued or repeated back pain is not surprising or dangerous at all. Most low back pain can get better if you stay active, you avoid positions and activities that may be exhausting to your lower back, use ice for pain and inflammation, and take nonprescription pain relievers when you need them. Doctor's advice is necessary.


• When pain is no longer severe, you may be ready for gentle strengthening exercises for your back, necks, legs and to some different areas of the body.. Exercise may not only help decrease low back pain, but it may also help you recover faster, prevent recurrence injury to your back, and reduce the risk of permanent disability.


• Exercises to reduce low back pain may not be complicated and can be done at the comforts of your home without any special equipment.


• Don't be afraid of the pain and let it stop you from trying gentle activity. You should try to be active soon to prevent pain recurrence and other disabilities. Remember, too little activity can lead to loss of flexibility, strength, and endurance, thus causing more pain.

How To Relieve Lower Back Pain

1. Introduce lower back pain stretching exercises

Some relief from the early stages of lower back pain can be accomplished by performing simple stretches which are often advised by your therapist. Lower back strengthening exercises, along with cardio training exercises are keys to get rid of lower back pain. These will enable your body to become stronger and increase movement and flexibility.

The gentle motions of aerobic exercises such as swimming or riding a stationary bicycle will encourage blood flow through the muscles, increase your flexibility, and enable your body to release natural pain killers of the body into the blood stream thus relieving pain. Aim for 20 to 30 minutes of these exercises each day and you'll notice a significant difference in not only your lower back, but you'll feel better overall.

• Aerobic exercise - this is done to condition your heart and other muscles, maintain health, and increase oxygenation to the different parts of the body


• Tread milling, swimming, riding on a stationary bike, brisk walking, jogging, aerobics.


• Strengthening exercises - this focuses on your back, stomach, and leg muscles.


• Prone hold, chest life, opposite arm leg raises, roll outs, super man.


• Stretching exercises - this is done to keep your muscles and other supporting tissues flexible and less prone to injury.

If you have low back pain, avoid:

• X Straight leg sit-ups.


• X Lifting both legs while lying on your back (leg lifts).


• X Lifting heavy weights above the waist.

2. Hot and cold treatment

The early stage of lower back pain can be treated with Alternate hot and cold compress. You have to try out whether ice will work better for you than heat. Experiment to determine which one do you prefer and which one is more effective for you. Try to use ice pack for pain and inflammation for at least 10-15 minutes. Once the pain has subsided, apply some hot pack and do it for another 10-15 minutes.

3. Medications

The most common medications for back pain is the over the counter pain killers and non-steroidal anti-inflammatory drugs (NSAIDs). These are highly recommended to alleviate back pain. They both work differently so they usually are taken at the same time. Prescribed drugs such as muscle relaxant, anti- depressants are used for prolong relief of pain.

• Pain killer such as Acetaminophen (Tylenol) is the single most effective non prescription drugs for lower back pain and it has fewer side effects. It relieves pain by working its action into the brain to turn off the pain perception.


• NSAIDs such as Aspirin decreases swelling on the affected area. However, aspirin is not usually taken because of its life threatening effects.


• Prescribed Steroids which are effective in treating swelling; however, these drugs have a lot of adverse effects so the dose should be exact and be given regularly and on time.


• For the dose, frequency and duration of the drug, consult your health care provider for safety.

4. Transcutaneous electrical nerve simulation is a method employed to bring lower back pain relief. A battery-powered device is used to send mild electric pulses going to the nerve fibers in order to block pain signals to the brain thus alleviating the pain.

5. Ultrasound is a non-invasive method that works by warming the internal tissues of the body that results in the relaxation of muscles at the back.

6. Surgical therapy is one of the many methods on how to relieve lower back pain but it is the least thing to do when the patient does not respond to therapies. It is depending on the doctor's advice if surgery is really needed and consent from the patient must also be considered.

Exercises For Lower Back Pain - Reduce Back Pains

How to Exercise Back Pain Relief Using an Exercise Ball

The exercise ball isn't just for yoga! If you want more back support or have an interest in back stretching, then simple exercises for lower back pain such as the exercise ball can be an alternative to back therapy. In reality, when mixed with back treatment, back stretching on an exercise ball can be effective exercises for lower back pain for reducing pain and even speeding recovery from back surgery. You must use this form of exercises for lower back pain constantly, as it'll help in helping you recover much faster and will strengthen your back in the process.

Consider the following Exercises using only your body weight and a ball.

Sitting Exercise Ball Stretches

One of the exercises for lower back pain you can stretch and bolster your back just by sitting on an exercise ball with your feet flat on the floor. Start by lifting just your heels from the floor, one at a time. Then raise each foot, then each leg up higher and higher. Do not go up high enough to cause more pain, as the goal is back stretching not making the difficulty worse.

On days when you have more major agony, you may want to do some exercises for lower back pain like : just sit on the ball and balance your body for short periods of time. Just the act of balancing can be of benefit, since the balancing act comes from your core muscles. This implies there are truly no excuses for not using the ball even on days where you are experiencing slight pain.

Lying Exercise Ball Stretches

Start by lying over the ball on your stomach with your hands and feet on the floor. Carefully lift one arm and the opposite leg up in the air, then lower and switch to the opposite side.

It isn't hard coming up with exercises for lower back pain, particularly if you get a ball and just spend a while checking out different positions. You might also want to try a session of back therapy to get an idea of further moves. There are also workout videos that are available in particular for showing you the way on exercises for lower back pain to effectively use the ball for strengthening your back.

Chiropractic and 3 Easy Exercises: The Answer to Your Low Back Pain!

Back pain is the single biggest reason people go to the doctor. It has been reported that 80% of the population will make a visit to see some type of healthcare specialist because of their back pain. I can tell you, as a chiropractor, that the vast majority of the people that I see in my office for back pain:

A. Have had similar episodes of this back pain in the past
B. Can't link their pain to a mechanism of injury (this is just a fancy way of saying that there is no good reason for their back to hurt).
C. Will have more episodes of back pain in the future, which will get
worse and more frequent, unless they do something about it.

The healthcare industry does not have any great answers to treat chronic back pain. This is why there are so many different types of practitioners who treat it. Chiropractors, Physical Therapists, Family Medicine Doctors, Orthopedic Surgeons, Neurosurgeons, Physiatrists, and the list goes on.

I have found over the years that the best way to treat Chronic Low Back Pain is to not get it. The best way to do that is to maintain low back and hip mobility, alignment and strength. In my office, I utilize various manual therapies such as spinal manipulation (Chiropractic Adjustments), Soft Tissue Techniques (think highly specialized massage therapy), and various types of stretches in order to increase mobility and spinal alignment, to great effect. The true secret, however, to maintaining the mobility and alignment that is achieved in the office, is specific exercises performed by you at home on a habitual basis. The following three exercises are my favorites for keeping the low back/ hip complex strong.

1. Squats - Begin with your feet about shoulder width apart and your toes slightly pointed out. Begin the movement by moving your butt back and down, while hinging forward at the waist (do not round your back). I like to move my hands up to parallel with the floor as I go down. Squat down as deeply as you can. You have a good idea that you are doing this exercise correctly if you look down, while at the bottom of the squat and your knees are in line or slightly behind your toes. Return to standing. Repeat 20 or 30 times.

2. Lunges- Begin this movement standing with your feet about 6-8 inches apart. Step forward with your right foot (take a big step), and lower yourself so that your left knee is almost touching the floor. Make sure that your back is straight and that you are not bent forward at the waist. Also, make sure that your knee is in-line with or slightly behind the end of your toes. Next, stand up and then bring your right foot back to where you started. Repeat the exercise with the opposite leg. Do 10-15 on each leg.

3. 1-leg Romanian Dead Lift- Place a dumbbell or Kettlebell that weighs 10-20 pounds on the floor and stand with it right in front of you. Stand on one foot. Bend down (at the waist with a flat back and abs held tight) to pick up the weight with your opposite hand. Stand up with the weight. Bend down to return the weight (from the waist with a flat back and abs held tight). If this is too difficult for you, skip the weight and just try to touch your toe or your knee. Just make sure that your lower back remains flat and that you keep your abdominals tight. Repeat 10-15 times. Do the other leg 10-15 reps.

That's it. If you can do these exercises correctly and you do them on a regular basis (3-5 days per week), chronic low back pain will have a hard time finding your address. I have found that by combining these exercises with regular but infrequent chiropractic treatment, my patients generally manage to stay pretty pain-free. Of course, the more regular you are about doing the exercises, the more "infrequent" your chiropractic treatment will be.

How to Treat a Pinched Nerve in Your Lower Back

If you are suffering from pain caused by a pinched nerve in in your lower back you are not alone. Millions of people are suffering just like you. Not only in the United States but throughout the whole world.

Luckily, there are a multitude of treatments that can effectively get rid of your pain.

Always make sure that you practice proper body posture and mechanics throughout the day. Simple things like bending your knees when you are picking something up from the ground and even sitting and standing upright instead of slouching can often times provide dramatic relief.

Simple stretching exercises also work wonders to alleviate symptoms.

Strengthening exercises of the abdominal and lumbar spine muscles should also be incorporated into your routine. These muscles support and protect your spine and spinal discs. In a way they are the armor of your body.

Stay active. Many people mistakenly believe that bed rest is the best treatment for back pain. This is a huge misconception. Clinical studies have proven that staying active is one of the best ways to get rid of your symptoms. Bike riding is one of the best exercises for staying active and not putting a great deal of stress on your body.

If these suggestions do not do the trick, then you definitely want to see your Family Chiropractor and Medical Doctor. Sometimes, your symptoms can be caused by a disc herniation and your Doctor will have to order the appropriate diagnostic studies like an MRI to properly diagnose your condition.

The Key To Lower Back Pain Relief

The quickest and easiest way to get lower back pain relief is to take a packet of Nurofen, or if the pain is breath-takingly excruciating, a packet of Oxycontin. This is the medical industry gold standard treatment for lower back pain.

Whilst a lot of doctors encourage people to take the drug route, and to be sure, if the pain is bad enough, it might be the only thing that brings sufficient relief to start getting on with life, it will be a tortuous route if it's the only one you take.

On the one hand lower back pain is not caused by a lack of Nurofen or Oxycontin. On the other hand taking a drug to mask the pain diverts people's attention away from doing what they really need to do to permanently relieve their pain.

The medical industry logic goes like this; 'Take the tablet, pain goes away, problem fixed! Next!'

Well, it doesn't work that way. A problem masked is not a problem fixed. It's the great medical industry legerdemain. The pain in the foreground may have gone, but the problem that caused it is still lurking in the back ground, ready to flare up again at the slightest provocation.

Then there's the big worry. Not only does taking Oxycontin not treat the underlying cause of the pain, you could compound your back problem with an opiate addiction problem.

But, turning attention away from the quick fix, the key to lower back pain relief comes in two parts.

First find out what's causing the pain.

No motor mechanic would stay in business for long if they didn't know the cause of a particular problem. In fact motor mechanics are much better at diagnosing the causes of misalignment in various moving parts of motor cars than doctors, radiologists and surgeons are at diagnosing the causes of misalignment in the moving parts of human bodies.

In the sit down society the cause of the problem is rarely at the site where it's painful. So rubbing, crunching, heating and vibrating the bones in your lower back will not do much to fix the underlying cause of the pain.

It's highly likely that the cause of your lower back pain comes from a pelvis that's been drawn out of alignment. Once the pelvis moves out of alignment the bones above it are drawn out of alignment as well, stretching ligaments, tendons and muscles beyond their pain threshold and causing discs to herniate.

You think there's something wrong with your lower back, which there undoubtedly is, but the cause usually lies in weak and tight muscles attached to your pelvis - front, back and sides.

Tight muscles have taken the pelvis out of alignment. Weak muscles have fallen down on the critical job of giving support to its structural alignment.

Which brings us to the second key to lower back pain relief, which is, to start doing the strength and flexibility exercises designed to support the bones throughout your body, and particularly your pelvis, in better alignment.

Loosening tight muscles can be done with a range of exercises, some of which, like 'static back' and the 'supine groin stretch', require absolutely no effort at all. All you have to do is lie on the floor for an hour each night while you watch TV and let gravity do the work for you.

Most of the other exercises you need to do don't take much effort either, exercises like the 'hip crossover', the 'wall sit', the 'sit up straight' buttock stretch and the 'prone frog'.

So how long each day do you need to spend waiting for pain relief to kick in?

I'd say that if you spent a couple of hours a night on the stretching program and if you went to the gym three times a week to do a good set of strength exercises, in a couple of months you should be feeling a whole lot better.

Most people say they don't have two hours a day to spend on an exercise program, yet the average American spends well over three hours a day watching TV. You can do your exercises while watching your favourite programs. It's called multi-tasking and it's not all that difficult.

Large number of people have been conned into believing they can't fix themselves, so they put themselves in the hands of the rubbing and crunching industries. It doesn't work that way either. Sooner or later you have to do something to yourself.

So, if you knuckle down, buckle up and spend a couple of hours each day, on the floor while you're watching TV or reading a book, letting gravity and your own muscles do the work, then in 10 years time you'll be able to look back and say you've been pain free for the last 9 years and 10 months.

In the meantime stay tuned, highly tuned and remember, I can give you the exercises but I can't do them for you.

John Miller

Chronic Low Back Pain Relief - What Kind of Mattress is Best?

In a recent nationwide survey on back pain, most survey participants reported using a firm mattress with a 2 cm plywood bed board between it and the box spring. But many of those who expressed the most enthusiasm about their sleeping arrangements suggest omitting the box spring and putting an extra-firm mattress on a platform bed.

If you have the option, don't use a brand-name mattress. Instead, have a foam-rubber company make you a, 15 cm (6 inch) thick, extra-firm mattress. It's less expensive than purportedly corrective mattresses and at least as firm and comfortable.

Futon mattresses on platforms are the next choice of US survey participants. But if your hips, buttocks or thighs are painful, you will probably find the futon too thin and hard, and the cause of unwelcome pressure.

If your bed is too hard (as may be the case with some 'orthopedic beds'), try placing a duvet between the under-sheet and the mattress. This gives a softer surface, especially for a more petite sleeper. Remember that what feels firm to someone of 50 kg (8 stone) is very different to what feels firm to someone of 115 kg (18 stone).

Of the 15 US survey participants who turned hopefully to water beds, 8 switched back to firm mattresses and bed boards, complaining that the bed couldn't be made hard enough to suit them. They also said that the water produced a 'rolling action' that made it difficult for them to control their movements and positions. (However, this has become less of a problem with more recent advances in water-bed technology.)

The other 7 were happy with their water beds so long as the mattresses were kept 'filled to the top' and 'firm'. They said the water enabled the spine to align more comfortably, and that the floating sensation eased the pressure on the spine and muscles. You can also regulate the temperature of water beds, which can be an advantage for treating chronic low back pain.

Some back sufferers give up mattresses altogether and take to the floor when their back pain flares up. But lying on the floor is not recommended for incapacitating pain and muscle spasm, primarily because getting up from and down to the floor may add to your pain. Also, if your low back pain is accompanied by pain and spasming in the hips arid upper legs, even a carpeted floor can put too much pressure on inflamed and sensitive areas, causing more pain and spasm.

If, however, you find yourself stuck between a hard floor and a sagging mattress, take the floor until you can make other arrangements.

Motor Control Exercise For Persistent Low Back Pain

The term "non-specific" low back pain (NS-LBP) arose from the realization that the exact source of pain can often not be identified. Many etiologies for NS-LBP have been proposed, and one theory, the focus of this review, is that NS-LBP can result secondary to malfunction of the muscular stabilizing system of the spine. Specifically, impairments in the function of deep stabilizing muscles such as transversus abdominus (TrA), multifidus, lumbar erectors and abdominal wall (comprised of internal/external obliques, rectus abdominus, quadratus lumborum) have been identified in previous research. The exact relation between muscle dysfunction and NS-LBP is still being elucidated however, as well as the best way to approach the clinical management of this problem.

Motor control exercise was developed based on the principle that many LBP patients have diminished control over their spinal stabilizing musculature. Normally, specific exercises are employed utilizing a motor-learning approach to retrain function, timing, and coordination of trunk and spinal stabilizing muscles (readers are likely familiar with these exercises, developed mainly by the Queensland physiotherapy group and McGill's spinal biomechanics lab at the University of Waterloo).

The purpose of this review was to evaluate the clinical effectiveness of motor control exercise in persistent NS-LBP by conducting a literature review. Three systematic reviews have been published on this topic (1,2,3), but newer trials have been published that were included in this review. Pertinent Results: Studies included in the review were grouped into four categories for analysis, each addressed separately below. 14 studies overall were deemed eligible for inclusion. A number of trials included in previous reviews (referenced below) were not included - these studies were excluded because they were performed on acute patients, included those with neck pain and headache only, or did not use a motor control intervention according to the review definition. No placebo-controlled studies were identified. Four new studies were included in this review - representing data on a total of 560 patients.

Motor Control Exercise vs. Minimal Intervention or as a Supplement (7 studies):

4 studies compared MCE to minimal intervention, while 3 used MCE as a supplement to another intervention
PEDro scores ranged from 4-8
pooled results favor MCE for pain, disability at each follow-up
these studies did not provide any evidence that MCE was effective for improving quality of life

Motor Control Exercise vs. Manual Therapy (4 studies):

PEDro scores ranges from 4-8
pooled results for pain and disability favored MCE - but the effects were small and only statistically significant in 2 of 6 estimates
pooled treatment effects on quality of life slightly favored MCE at short-term follow-up, but favored manual therapy at long-term follow-up

Motor Control Exercise vs. Other Forms of Exercise (5 studies):

PEDro scores ranged from 2-8 (the study with a score of 2 was assessed from a conference proceeding)
using a random effects model, the results indicate that MCE was better than other forms of exercise only for reducing disability in the short-term - these point estimates were small (5.1 out of 100) and suggest that MCE may be just as effective as general exercise, which would include less complex forms of exercise

Motor Control Exercise vs. Surgery (Lumbar Fusion)

the one study in this category has a PEDro score of 8
long-term follow-up on 61 patients revealed no significant difference in pain, disability, or quality of life between MCE or surgery

Clinical Application & Conclusions:

This review provides evidence that motor control exercise (MCE) can reduce pain and disability, forming an effective part of the clinical management of persistent non-specific LBP. It is more effective than minimal intervention and beneficial when added to other interventions. This review did not demonstrate that MCE is superior to other approaches such as manual therapy, other exercise interventions, or surgery.

Manual therapists should be aware of the evidence on this topic, as "core stability" exercises are commonly discussed in the popular media. The correct application of these exercises is paramount, and beyond the scope of this paper and Research Review. Contemporary clinicians should also maintain awareness that this review solidifies the recommendation that general exercise can be an appropriate treatment for chronic LBP as well, in addition to MCE, or in isolation - GET YOUR PATIENTS MOVING!.

This review does not cloud the picture for the management of back pain, but emphasizes the likelihood that there isn't one all encompassing answer for the management of chronic LBP. Interventions such as MCE are hard to study consistently among study groups, and factors such as patient group differences, intervention details and application, and so on, can influence individual trials. Unfortunately, the literature to date is too limited to tease out the effects of these factors.

Study Methods:

Trials included in this review had to involve patients with LBP that persisted beyond the acute phase - hence "persistent low back pain". This includes those with subacute, chronic, and recurrent LBP with or without leg pain lasting longer than 6 weeks. Studies had to be randomized or quasi-randomized trials comparing motor control exercise to placebo treatment, no treatment, another active treatment, or as an addition to another treatment (when included as an addition, motor control exercise had to comprise 40% of the treatment). Motor control exercise was defined as specific spinal stabilizing or core exercises targeting spinal musculature to improve coordination or the spine and pelvis (both Queensland and McGill approaches would apply here). Finally, one of the following outcomes had to be reported in each trial: pain, disability, quality of life, recurrence, or return to work.

Study quality was assessed using the PEDro scale (included studies received a mean score of 6 - range 2-8). Outcomes were extracted for short-term (less than 3 months), intermediate (3-12 months) and long-term (less than 12 month) follow-up. Scores for pain and disability were converted to a 0-100 scale.

Benefits of Doing Back Exercises for Lower Back Pain

Low back pain issue is a common saga a result of the poor way of life many people are following in today's times. The reality is, it is one of the most popular lower back conditions causing missed work. Americans devote approximately $50 billion every year on back pain relief treatment program. In spite of everything, many people endure the pain, and wrongly reckon that have grown to be strong enough for much more vigorous training, ending up to a lot more prolonged pain.

Oftentimes, muscles on the lower back are placed in threat of stress when you do just about any combination of flexion, side to side flexion, and turning after which stretches and moves the spinal column back into its neutral location. Back muscles perform a huge role in your everyday life. Any one thinking about embarking on an exercise routine should include back exercises into their exercise program in order to reinforce the lower back.

Lumbar pain or a worn out back can be a common problem for working individuals. The majority of adults endure lumbar pain at some point however for some, it is much more hurting and debilitating. Chronic pain in higher levels can cause despair, loss of job function, wherewithal to accomplish everyday activities and extremely huge health and social expenses caused by medical care and compensation for loss of earnings. If you have lumbar pain, it is necessary that the cause is clinically determined prior to making an attempt any back exercises for lower back pain.

Back exercises for women are definitely vital to make sure overall back health. Womens' exercises for the back must comprise greater than the over-used cord pull-down, given that the muscles on the back have diverse joints in the body, and the way those muscle fibers are generally structured is for it to get ignited through different motions.

Another one of the best back exercises for women is the bent over row, which enables them to attain a total back exercise with no much strain. Typically, it is one of the easiest exercises to perform, also it can be performed with a free weight barbell.

Back exercises for lower back pain can help give relief and help you to recover to a phase when you execute more strenuous workouts. Such exercises really don't simply involve stretching. For a strong back, you can do back exercises specific for its muscle group three days a week. For a much healthier back, do not forget that the key is actually to do the suitable type of workout.

Best Lower Back Pain Exercises

There are millions of people the world over who suffer with pain in their lower backs and try various treatment remedies. The back pain could occur occasionally or it may be a chronic problem. If this is caused by stress or due to strain then you may find some relief with ample rest. However, if it is a chronic problem then there are other remedies that have been proven to be effective. There are a number of lower back pain exercises that are extremely effective. Sometimes, there are painkillers that are prescribed in severe cases. While these medicines offer temporary relief, this does not offer a permanent solution. In fact, once the effect of the medicine wears off the backache will resume. Hence, it is imperative that you find a permanent solution to fix that bad back.

First up, you must get to the bottom of what is causing the pain. Most often, a lower back pain could be due to excessive weight in the abdominal area. Having a huge beer belly or a huge paunch can lay a lot of stress on the back and thereby cause back aches. Hence, any form of exercise to reduce the paunch must be done under expert guidance otherwise, it will worsen it.

Stretches and yoga are very useful in maintaining a good posture. Bad postures can also be a major cause of back pain. Yoga has been practiced for centuries in most parts of Asia and has gained acceptance worldwide. Yoga is now part of alternative medicine and offers holistic healing as it targets many key areas and bodily functions. It helps improve the quality of life and alleviates the pain symptoms. This is an effective treatment for pain, especially in the lower back. The yoga exercises are generally performed under the expert guidance of a yoga guru or a yoga teacher. Once you are comfortable with the exercises, you can safely practice them at home.

There are back strengthening exercises, which aid in pain relief and relieve painful spasms. Chronic lower back pain can be crippling and it can affect the quality of life. Hence, it is important that the pain is not neglected for a prolonged period of time.

These pain exercises will not only help relieve the pain but regular yoga and back strengthening exercise programs will help in preventing the recurrence of lower back pain.

Recommendations
If you are suffering with lower back pain symptoms, there are a few precautions that you must take. Avoid lifting weights or heavy objects. Never bend down while standing to pick up something or lift something. Instead, bend down on your knees and go to the ground level to pick up things. Maintain a correct posture while standing, sitting, working, reading, etc. Keep the back straight at all times. Apply hot water fomentation to relieve spasms and massage the area with medicated herbal pain relieving balms. Follow these simple tips along with the prescribed lower back pain exercises and get rid of back aches and find a simple yet permanent cure for your back pain.

Chronic Lower Back Pain - How the Alexander Technique Can Help

Chronic lower back pain is certainly frustrating. You are not absolutely certain why you have it or exactly what causes it to be a whole lot worse however it continues coming back.

Your health care provider has sent you for different assessments and scans and there's nothing clearly wrong with your back - nevertheless it is painful!

You've probably tried physiotherapy, however the exercises are painful and challenging to keep up. You feel you can't keep using pain killers. You might try a chiropractor or an osteopath who provides back pain relief although the back pain comes back in time.

How can this be? Could it be that there is something you are doing that is causing the pain?

Think you're spending too long sitting on a computer? It could be that both sitting and standing is uncomfortable and you're feeling like your posture could possibly be improved but you do not know what to do about it?

What's probably happening is you are producing too much effort to complete everyday tasks that is definitely producing muscular tension. It's very common for people to generate an excessive amount of effort to undertake even the simplest of things without even realising it.

Too much muscular effort is unproductive and pulls your whole body out of alignment, takes you off balance and especially tightens your lower back. This is the reason why treatments don't have a sustained outcome, unless you change the way you do everyday activities like sitting, standing and walking.

It is very easy to tighten up but how easy is it stop tightening?

The solution for lots of people has been the Alexander Technique. It is a simple but clever method which you can discover in coaching from a skilled teacher.

Customarily it's been employed for the previous 100 years by actors, musicians and athletes to raise their performance but nowadays lots of people are experiencing the benefits.

It teaches you strategies about how to perform everything with much less effort, more comfort and freedom.

It truly is unique because it recognises your individual habits of muscular tension. An Alexander Technique teacher shows you how to undo these bad habits of tightening and stiffening your own body.

You can learn to move with expansion and release instead of tightening and contraction. Once you have learned the basic principles you've got a skill for all of your life -- an enhanced means of carrying out whatever you choose, using poise together with skill.

Contrary to a number of other back pain solutions the Alexander Technique has been clinically verified. A significant study, financed by the NHS, has been written and published in the British Medical Journal in 2008. It proved the effectiveness of Alexander Technique lessons in relieving chronic lower back pain compared with exercise and massage.

In the UK ensure that your teacher is a member of the Society of Teachers of the Alexander Technique (STAT). They'll have done the necessary 3 year training course.

Abdominal Crunches or Core Crunches: How and When?

A core crunch is not a sit up; it is not an abdominal crunch either. A core crunch is a strong contraction of the deep core muscles in isolation. The deep core muscle is the Transverse Abdominal muscle. This is the key muscle used for core stability and posture control. The benefits are a stable well controlled lower spine and a very strong flat tummy. Weight loss is another benefit because the ability to exercises more efficiently and with better muscle coordination and joint posture control allows a person to exercise stronger, more often and hence burn more calories.

An abdominal crunch is a modified sit up. This uses the long Front Abdominal Muscle. To do this with a stable lower back and maintain a good lower back joint position and person needs have a strong Transverse muscle. So to learn a core crunch first will give a person a much better result with abdominal crunches. To do abdominal crunches with poor deep core stability leaves a person at high risk for lower back pain, disc injury and ongoing back pain. This will then cause the core muscles to decay further, due to the inhibition of this muscle with pain. The Transverse Abdominal muscle is very sensitive to back pain and will switch off when a person is suffering lower back pain. If this pain persists then the muscle actually starts to waste and decay away. The cycle of pain, decay is set up and a person starts to get more pain with exercise instead of less.

The ability to learn and perform core crunches is essential to stop this cycle of wasting and loss of spinal stability. The Transverse Abdominal muscle does not move any body parts therefore a person finds it very hard to learn how to do a core crunch. The long Front Abdominal muscle used to do an abdominal crunch moves the trunk into flexion. This is why a sit up is called abdominal crunch because the trunk is lifted off the floor or bench as the muscle tightens. The deep core muscle only changes the waist line circumference and holds the spine stable. There is no movement with this crunch only a pressure increase. A person must learn how to do this and when.

The Transverse Abdominal Muscle does not move a body part therefore once a person learns this they can literally do hundreds during their daily activities and not interfere with their routine. Once the core crunch is established abdominal crunches will become more effective and build power strength and a flat tummy in no time. This is usually not taught by trainers so many people fail with their abdominal exercises due to the pain that develops.

The do a core crunch simply draw your belly button in as you breathe out. Certainly there is more detail and further instructions to this and if you want to learn more Pure Pilates will teach you.

Core crunches should be a way of life not just an exercise.

Good Exercises For Lower Back Pain

For many people lower back pain can become chronic and is a condition that can have a negative impact the quality of their life.

Fortunately for many people, there are exercises for lower back pain that can help to alleviate most of their discomfort.

It's important to remember that, before you start any training program, you should make sure that you are physically capable of exercising without risking your health - your doctor or health professional can reassure you with regard to this point.

In addition to having a doctor check on the general status of your health, you should also have them check to make sure that the cause of your lower back pain isn't an issue that requires medical intervention.

Once you are certain that you can safely exercise, learning the right exercises for lower back pain can help you to lead a fuller life.

The key to reducing lower back pain is to strengthen your core muscles. This means that you need to train your abdominal muscles as well as your back muscles.

When training your core there are two key things to remember. Firstly, you should train your core at most every other day, and secondly, you should do a wide variety of exercises.

In particular yoga movements such as the plank, chair pose, and downward dog pose place emphasis on your core, forcing the muscles to remain engaged. Not only is yoga a great way to strengthen your core muscles, it also promotes flexibility and balance.

More traditional core strengthening workouts include crunches, leg lifts, and seated knee raises. It's important to remember when performing any of these movements that you need to be aware of what type of pain you are experiencing during the workout.

Muscular pain such as cramping or fatigue is a sign that you are pushing your muscles and forcing them to get stronger. Pain in your joints is a sign that you should stop exercising and get the cause for the pain diagnosed.

In addition to core strengthening workouts, a healthy diet and regular aerobic exercise can help you to lose weight, which may also help to reduce pain in the low back area.

Lower back pain can be a problem that causes restrictions on the way you live your life. It can make you uncomfortable when sitting for long periods of time, and make sleeping difficult as well.

Fortunately there are exercises for lower back pain that can help to ease your discomfort and by correctly utilizing them, you can strengthen your core muscles, which should help to reduce the pain.

Remember that your body needs proper nutrition as well as adequate rest in order to perform at an optimum level. As we get older it becomes increasingly important to maintain our physical capabilities by challenging our bodies through exercise.

By eating a healthy diet, exercising regularly, and training your core muscles you can greatly improve the quality of your life by significantly reducing your lower back pain.

Lower Back Pain When Sneezing

If you feel sudden lower back pain when you sneeze, you may find that you have sneezed so hard that you have actually strained or pulled a muscle. Some people go all out when they sneeze, and belt out huge sneezes that seem to rock the whole body. Often this is accompanied by a jolt forward, and something as simple as this can put additional strain on the muscles in the lower back.

If the pain comes on for the first time when you sneeze then the chances are that sneezing has caused the pain directly. However, if you were already experiencing problems in the back region, your sneezing may have simply set off a pre-existing condition or made it worse. The pain that you experience may be very short term or may continue even after several days. If the discomfort continues you may need to visit your doctor to ensure that there is no underlying problem that is causing the pain.

Determining the cause

It can be easy to assume that your back problem has been caused as a result of the sneezing, but there could be another explanation for it. You should ascertain whether there is any other accompanying pain such as leg pain, numbness, or tingling. If the problem continues after a few days you should get it checked out by the doctor, as you may need assistance with the muscle strain. You may even find that something else is causing the pain. Your doctor will be able to run scans and tests to find out the root cause of the pain.

If you have inflammation or you are experiencing constant discomfort your doctor may prescribe painkillers or anti-inflammatory medication. This may be in addition to other treatments such as physical therapy. This type of therapy is considered highly beneficial to those with back issues. It can involve manipulation of the spine and surrounding muscles, massage, and exercise techniques. This combination can help to ease the discomfort as well as improve mobility in the back region.

Alleviate discomfort further with home stretches

Stretching can help with a multitude of back related problems, and you could find that some simple exercises and stretches can benefit you in many ways. Your physical therapist can recommend some excellent stretches. You will be able to relieve tension from the muscles and reduce stiffness. This can help to ease mobility and flexibility so that you can move more easily and painlessly. Just some simple stretches can help to get the blood flowing, stretch the muscles, and strengthen the spine and back. All of this can help to alleviate the symptoms if you have been experiencing lower back pain when sneezing.

Lower Back Pain Exercises That Work

Before we start, we must define lower back pain exercises. Exercise does not just mean stretching or lifting weights, exercises include such things as joint techniques, Acupressure techniques, Trigger Point techniques and neural stimulation. Why?

These are all techniques you can perform yourself at home. Lower back pain exercises are there to reduce or eliminate your pain. If all you do is stretch or exercise the muscles you will only get temporary relief.

Back ache no matter where it is, comes from a combination of both muscle and joint imbalances. Research has shown that all back pain is the result of the accumulation of many micro-injuries over time. The bending, lifting, carrying and poor postures that place tension on your muscles and joints.

Removing pain therefore must target all the areas involved, stretching and exercising will only cover a small portion of this.

So which lower back pain exercises work?

And that is the actual problem and question; most people look for the "one" exercise that will remove all their pain, requiring minimal effort and minimal time to see results.

Now although there are many techniques, such as Trigger Point Release, which can give you almost instant pain relief, to get long lasting relief you must use more than one technique.

For example, the two most important muscles in the lower back are your hip flexors and hamstrings. These help support the pelvis and keep it balanced. If these become tired or tight then the pelvis will become out of balance and back ache is likely.

Once the muscular imbalances have been present, the joint imbalances develop, hence the reason for more than just stretching or exercising muscles. If you get to your back pain quickly a few simple stretches to these muscles can bring significant relief.

However if the muscular tension has been present for a few weeks or longer, you will develop trigger points and joint imbalances. And for most the muscular tension goes unrecognized or forgotten for months rather than weeks. Why?

In those early stages, minor stiffness or tightness is left alone, you believe that it will ease and most times it will. Then there are other times when the stiffness turns to pain, and at this stage you have developed muscle and joint imbalances along with various trigger points in your muscles.

So looking for lower back pain exercises to correct this situation has suddenly become a little more complex. But has it?

Rebalancing muscles is a process of using stretches, neural reflexes (to stimulate their nerve and blood supply) and exercises.

Rebalancing joints is even easier; all you need to do is place the joint (such as your pelvis for lower back pains) in a state of balance and hold it there for a few minutes. The joints will then reset their position easily.

Trigger points are again easily corrected by using digital pressure on them for 20-30 seconds and then stretching the muscle.

Acupressure can tie all these processes together and help improve your body's ability to heal.

Combined these are the most effective lower back pain exercises. Separated and used alone they will only give you temporary relief.

Relieve Back Pain Utilizing an Anti-Burst Core Exercise Ball Or Swiss Ball Chair

I work from home in my home office at my computer. I used to have a sore back at the end of the day even though I would get up periodically to move around and get up and out to run errands. Now, I am more productive during the times I am sitting and working at my computer and have virtually eliminated my back pain! I also find that I am more aware of my posture and no longer slouch over my keyboard.

One of the causes of back pain, according to Dr. Oz, is being sedentary for long periods of time. He said "On average, the body can tolerate being in one position for about 20 minutes before you need to adjust.". This got me thinking about how thankful I was that I no longer use a traditional office chair. I use a big yellow 75cm anti burst core exercise ball. I am 5' 5/12 " tall and feel that this is a good height for me to sit comfortably and work at my computer. I also tried to 65 cm size and found that to be a little too low for me to type comfortably. The stability ball or core exercise ball has a dual purpose. You will improve your posture and stability as well as improve and tone your core, abdominal muscles. There are a multitude of yoga poses and exercises you can also perform on the stability ball. Stability ball exercises include but, are not limited to, the Pelvic Tilt, crunches, push ups, V-ups, Supine Bridge, Russian twist, the Plank, hip extensions and squats. As a more practical alternative, you can also work your core at your computer by using the Health Mark Swiss Ball Chair. Simply rocking side-to-side and rolling the ball in little circles is a perfect solution for exercising at the office on your breaks! Using the ball or the ball chair will not only prevent you from slumping over your desk but will work your core muscles, leg muscles, arm and chest muscles as well.

I also use the wobble disk when I know I am going out will be sitting waiting for longs periods of time for my doctor or office appointments. The Wobble Disk fits neatly on any chair and is easy to pack up and take with me. The nice thing about the wobble disk is that it is not too big or too heavy to take along. I have a variety of purses I use depending on where I am going. Dr. Oz said that "Carrying a handbag that's more than 10 percent of your body weight poses serious health risks for your back..." So I only take what I need depending on where I am going! When used from a sitting position, the Wobble Disk helps activate your back muscles and work your core and may also help prevent yourself from slouching while you sit. I feel good knowing that by sitting on the Wobble Disk may help correct my posture because Dr. Oz said "Slouching Puts 100 Extra Pounds of Stress on the Lower Back". - which may help alleviate prolonged stress on the lower back. The Wobble Disk can be used for a wide range of applications ranging from active sitting, muscle strengthening, joint stabilization, to post natal care. It truly is a 3 in 1 piece of equipment that can benefit anyone from children to the elder generation by combining the advantages of a Gym (Swiss) Ball, Sitting wedge, Wobble Board and Foot Massage. Five minutes on a wobble cushion is approximately equal to a half hour of any other physical activity that involves instability. The recommended usage of the Wobble Disk is to be intermittent; use it for about half an hour at a time, put it aside for a while, and then put it back on the chair. Take it on and off at regular intervals through the day. A variety of positions is the only truly ergonomic occupational posture.

Whether you choose to use the Health Mark Swiss Ball Chair or core exercise ball daily or the Wobble Disk at various times through your day or week the important fact to remember is that either one will help alleviate your lower back pain, strengthen your core muscles and keep you active while you sit. This is also a great idea for a youth or teen bedroom desk area. They may even enjoy sitting down to do their homework! Offering a core ball or swiss ball chair for you child will also help your kids work on rhythm, coordination and balance! Ball therapy is great for any age level and very therapeutic!

Reference: Good Morning America episode on April 12, 2010 where Dr. Oz explained how to avoid back pain from daily activities.

Five Easy Seated Yoga Exercises You Must Do to Release Lower Back Pain at Work

Do you spend the majority of your day sitting down in front of a computer or answering the phone?

Perhaps, like me, you are a self-employed entrepreneur and depend on the internet to market your business.

Sitting in the same position for lengthy periods of time, typing and looking at a computer screen, places a lot of strain on your body, particularly your lower back muscles. Weak abdominal muscles, tight hamstrings, being overweight and lack of regular exercise all contribute to lower back pain.

If you sit at your desk and do not stretch your body, when you stand up have you noticed your back muscles are sore, stiff and achy?

Back pain is the third most common reason for consulting a doctor in Britain and is closely related to poor posture, stress and tension.

If you have ever suffered from back pain you will know how painful and deliberating it can be. As a child, I remember my father spending days flat on his back, unable to move or go to work due to lower back pain. Given today's economic climate and rising food and fuel prices you can not afford to be in the same position.

Five Easy Seated Yoga Exercises To Release Lower Back Pain At Work

Yoga is great exercise for bad-back sufferers.

The following five seated exercises can be done at your desk, without any equipment or changing your clothes. They will give your body an overall stretch and help to release stiffness and tension in your lower back.

Aim to do these simple yoga stretches at least three times during your working day. Please consult your GP before you start these exercises and take care to listen and work within the limits of your body.

1. Seated Trunk Twist

Sit comfortably on a chair, feet flat on the floor, raise both elbows up to shoulder height, clasp the hands together.

Inhale and as you exhale slowly twist to one side. Make sure you twist from the base of your spine and keep the back straight throughout the stretch.

Inhale and slowly come back to centre. Repeat in the opposite direction.

Repeat the sequence 3 - 5 times each direction.

2. Seated Cobra

Sit near the edge of your chair. Feet flat on the floor. Hands resting on your lap. Lengthen your spine, slowly arch your back and lilt your head back. Relax and take three deep breathes. Slowly return body back to centre.

3. Seated Cat Stretch

Make sure you have space in front of you. Sitting on chair, bend forward and hold your ankles or shins. Arch your back, relax and repeat 3 - 5 times

4. Upward Arm Stretch

Raise both arms above your head. Place your left hand on your right wrist. Gently stretch to the right. Keep your body strong and straight. Breathe into the stretch. Switch sides and repeat.

5. Seated Spinal Twist

Still sitting, cross your left leg over your right knee. Place your right hand on the crossed knee. Gently turn your body to the left and look behind you. Allow your shoulders to be relaxed as you relax and breathe into the pose. Inhale. Release your arms and legs; return to centre. Exhale. Switch legs and repeat on the opposite side.

Regular practice of these five simple yoga exercises throughout your day. They will help to release tension and soreness in your lower back plus, you will feel more comfortable, fitter and at ease in your body.

Lower Back Pain Exercises and Strengthening Exercises

People who suffer from chronic low back pain secondary to nerve impingement or improper posture would benefit from doing lower back pain exercises. The objectives of these exercises are to promote proper posture, strengthen the trunk muscles which are the abdominals and back muscles and to stretch the tight muscles to facilitate proper movements and posture.

These exercises are usually taught by trained physical therapists during therapy sessions. However, doctors also introduce these to their patients who complain of low back pain to prevent aggravating the condition and initiate trunk muscle strengthening early on.

Lower back pain exercises consist of simple, basic and easy-to-follow exercises which patients can do at home or even at work during their break time. Constant repetition can promote stronger abdominals and back muscles thereby significantly minimizing the pain and promoting proper posture. Here are some of the most basic exercises;

1. Wall slides. You can do this very simple exercise by standing with your back against the wall. Make sure that the back of your head, shoulders and buttocks are against the wall. Put your right or left hand against your lower back (palm facing the wall) as if supporting the natural arc or "lordosis" of your lower back.

The heels of your feet must be approximately 3 inches away from the wall. This posture should be maintained while slowly sliding down against the wall and bending your knees carefully. This is one of the most basic lower back pain exercises that you can do at home or in your office during your break. Do the wall slides for around 10 to 15 repetitions preferably twice daily.

2. Pelvic tilt. Do this exercise lying down on your back. Bend your knees keeping both feet flat on the floor or exercise mat. Place one of your hands on your lower back with the palm against the floor or mat. Hold this position while attempting to press your lower back against your hand which is placed underneath it.

Hold it for 5 counts and relax. Repeat 10 to 15 times. This movement is called the pelvic tilt. You are actually tilting your pelvis backwards by pressing your lower back against the mat. In doing this, you will feel your abdominal muscles tightening as you hold the tilt longer.

3. One of the best lower back pain exercises is the deep lunge. This exercise stretches the muscles in front of your thigh (Quads) and abdomen. You can do this by kneeling on one knee. Put your other foot in front. Slowly lift the knee up and keep looking forward. Hold the position for 5 seconds and repeat 3 times on each side.

4. Knee-to-chest exercise. This exercise stretches your gluteal muscles or butt muscles. Lie on your back and then bring one knee up pulling it gently on your chest. Hold the position for 5 seconds and repeat for 5 times on each side.

These are just some of the most basic and simple lower back pain exercises. There are many other exercises that you can do at home.

Exercises for Herniated Disc Patients

A herniated disc can be a painful and troubling condition. Not only do you experience extreme pain, but your mobility and breadth of activity is minimized. Even once the herniated disc has healed the condition is debilitating, as the fear of a repeat occurrence of the condition settles in.

Exercises for the back muscles and spine can help in all cases and stages of herniated disc disease. As the herniated disc heals, back exercises can be used to help manage pain when combined with other treatments and physical therapy. These exercises are also helpful in regaining mobility and extending your level of activity after a back injury. Finally, back exercises can help you prevent further or additional injury, and avoid recurrences of a herniated disc disease.

There are two exercises that are exceptional for easing back pain while recovering from a herniated disc. The first exercise requires you to lay flat on your back on a bed or the floor. You then raise your knees with your feet on the bed. Wrap your arms or hands around your thighs and lift your knees as close to your chest as possible. It is recommended by most physical therapists that you repeat this exercise for five repetitions several times per day.

Another exercise that you can do to relieve back pain caused by a herniated disc requires you to stand flat footed, away from a wall. You simply place your hands on your lower back, lean back as far as you can, and hold for a few seconds. Physical therapists suggest that you repeat this exorcise as needed when your herniated disc is causing you severe amounts of pain because it takes pressure off of the disc.

There are many great exercises that are great for strengthening your back to prevent further injuries or herniated discs as well. In fact, there are so many that they cannot all be listed here. Most of the exercises that will strengthen your back make use of an exercise ball, available at most department stores or work out supply shops.

One such exorcises requires you to simply lie back on the ball with your feet flat on the floor, and your arms crossed on your chest. Crunch up slowly from your waist and lie back. This exercise will help you to stabilize your spine and take pressure off of any painful areas or the herniated disc. It will also help strengthen the muscles in your back to help prevent any other injury or another case of a herniated disc.

Hip rolls are also great for strengthening the back for the prevention of a herniated disc. Simply lie flat on your back on the floor with your knees bent and your feet flat. You allow your knees to fall toward the floor first right, then left. It is recommended that you turn your head in each direction while doing this, and repeat the exercise about ten times.

The condition of a herniated disc and lower back pain has become very common in recent years, causing doctors and physical therapists to develop many of these types of back exercises. In fact, there are too many exercises to list them all here. If you would like more information about exercises that relieve back pain and strengthen back muscles, you should speak with your physician or therapist.

Ways to Overcome Back Ache and Still Exercise

Inactive muscles lead to obesity, and it makes it more difficult to keep your weight down if you are fighting back pain. Obviously the best way around this problem is to make sure the back area is properly kept in shape, and keeping the back area strong with your physical fitness programs will be great preventive maintenance. In light of that, you will not want to do exercises that over-exert or cause damage or injury to your back.

So what type of exercises can you do if you have back pain, or more specifically lower back pain, which is most typical of athletes and weekend warriors. How significant the injury is will be important, of course, but provided you can stand, walk, or lift light objects, we will assume your back pain is at least manageable. Here are some exercises you may consider:

1. Water aerobics. Most involve activities in waist-deep water while keeping Styrofoam weights lifted overhead. These exercises are low impact and will be easy on the back.

2. Swimming. Sticking to backstroke or breaststroke will cause the least stress on the back, but swimming is great cardio as long as you don't fully extend the body. The water can actually help to relieve back pain.

3. Exercises that use body weight. Squats and knee push ups that don't use additional weight are normally safe, as the amount of weight used will not be excessively taxing. Just be sure to prevent the lower back from bending.

4. Weight machines. Provided you use the right exercises techniques, you can use weight machines without further aggravating a back injury. If you sit up straight and pull in your stomach during the routine, your abdominal muscles will support your lower back. Being pain-free in a seated position, the machine's controlled motion will be less risky than free weights that will require balance.

5. Recumbent bicycle. When riding a bicycle that places you in a laid-back reclining position, your weight will be more comfortably distributed over a larger area. This great aerobic training exercise will alleviate back pain you would probably get if you peddled sitting upright on a conventional bike.

Some exercises that you should avoid at all costs if you have back pain are:

1. Exercises that are painful. As always, listen to what your body tells you. If something is painful, you are aggravating something, which will not promote healing.

2. Bending at the waist. Any exercise that requires repetitive waist-bending, such as dead lifts or crunches, is bad for the lower back.

3. Holding weight away from the body. These exercises have to have the back, and mostly the lower back involved to provide stability and balance. A few of these are overhead presses, side raises and front raises.

Back pain can lead to a lack of physical exercise, and that can lead to overweight and obesity. The combination of back pain and obesity can make it extremely difficult to exercise, but not impossible. If you are properly motivated, there is always a way to overcome a physical handicap to get on a regular exercise routine.

Sharp Middle Back Pain - Tips and Management

Over the course of most people's life we each experience some sort of back trouble at one point or another. It may be tweak from a certain way we turned, lifting something a little heavier then we imagined or just from not being in shape. No matter how it occurs, back injuries are one of the most irritating problems because of how much your body needs it to function throughout the day. Our main objective here is to discuss sharp middle back pain, what happens, and possible avenues to take to help alleviate the pressure.

Common Reasons for Pain in the Middle of Your Back

The biggest reason to get pain over the back is due to muscle strain from the same issues we talked about above. However, there are other times when your back may be hurting from non-strenuous activities like sleeping. Bad posture is also one the main reasons people begin to have issues, which can happen from working at a desk all day or even from being overweight.

Pain over the middle of the back can easily be treated with proper exercise, dieting and other methods, but some forms are not so lucky. For individuals who have acquired arthritis or degenerative disc disease over the years could also make someone complain of daily pain in the same region as well. While certain exercises could help alleviate some of the pain for shorter periods of time, the curing options are a little more discreet and doctor, patient privileged.

So How Can You Get Rid of the Pain

Since we were discussing diseases earlier, its important to consult your physician about any new ways you want to try and use to eliminate your back problem. It could mean a certain diet for those that need to lose weight for the body to work properly, any over-the-counter drugs which have come out exclaiming to fix sharp middle back pain, and anything else you deem necessary. The idea is to try and fix your back issues, not create more problems elsewhere, which is why consulting the family doctor is so important.

Resting is the best way to get rid of regular pains that come from twisting and lifting or bending over which created the discomfort in the first place. You will find that most doctors will tell you to use the cooling and heating methods with ice packs and heating pads. Today however, there are many people who turn to things such as yoga or acupuncture to relieve themselves from this or from it ever occurring again.

The Main Objective

If there is anything to take away from this article, its to not be stubborn with an injury of this nature. If it hurts to walk around, don't. If you can't bend over, don't try. What will happen is a simple sharp middle back pain that could have healed within a few days from rest can become a chronic back pain that winds up lasting for months. In turn, more money will be spent in chiropractors and continuous medicine, which most families don't need the extra financial burden. So relax, the inflammation will go down soon enough and have you right back on your feet.

How Muscle Imbalance in Hockey Players Creates Back Pain

Before I get started on this article I want to ask you where it hurts. During the third period of a game what is aching? My guess is that more than 50% of you have an aching back as the game goes on. Many hockey players come to the gym and ask for some exercises to strengthen their back because it gets fatigued and sore as the game goes on.

Although some players may have weakness in their back extensors, more often this discomfort is related to muscle imbalances. Muscle imbalance in hockey players may also result in sore or tight hips. The most common muscle imbalance in hockey players is tightness in the hip flexors. Hip flexors are the muscles in the front of the hip you can see them in action if you stand tall and lift your foot off the floor bringing your knee up in front of your body. There are a couple of hip flexors that have slightly different actions, but we won't worry about that right now.

Although being a hockey player contributes to this muscle imbalance, it is not the only cause. Think about your daily life. Are you a student? Do you work in an office? If you spend a good portion of your day in a seated position, you are sitting with your hips in a flexed (or bent) position. This places the muscles in a shortened position. Then we leave school or work and hit the ice where we skate from a nice low athletic position with the hips and knees flexed. Since our body only learns by reinforcement, if you put your hip flexors in a shortened position for the majority of the day, then they will take that shortened position to be the normal resting position.

I hope you understand how we get an imbalance of flexibility in the hip flexors. Now let's look at why that is important. One of the hip flexors attaches just below the knee and to the front of the hip bone. Another hip flexor attaches to the thigh and the anterior aspect of the lumbar spine. So if the hip flexors are tight they pull the athlete into a hyper-extended position in the lower back. Next consider the skating stride where you are trying to take your hip into more extension as you stride which will try to pull the hockey player into even more low back hyperextension.

Now to complicate things a little bit think about your back position as you play, your preferred position is likely skating with a flat or slightly rounded lower back. Can you now see how this muscle imbalance can create a tug-of-war between the hips and the lower back? This tug-of-war creates your feelings of discomfort in the most vulnerable link. I want to make sure you understand that this is not just about your back feeling tired or your hips feeling tight. Without doing something to improve muscle imbalances in hockey players, you are just waiting for your next injury to occur.

To improve your hip flexibility there are two very easy stretches to do. Make sure you do both because they target the two different hip flexors in a specific way.

Half Kneeling Hip Flexor

• Kneel on one knee with the other foot flat on the floor in front of your body (the front knee should be bent to 90 degrees, not more).


• Stay tall in your torso; do not lean forward at the hips as this will negate the stretch.


• Maintain your tall torso position and push your hips forward while tucking your butt underneath a little bit. If you have trouble feeling the stretch try flexing the muscles in your butt.


• You should feel this stretch in the front of your hip.


• You may add a sidebend to increase the stretch slightly. If your left knee is on the floor then try side-bending your torso to the right.

Hip Flexor & Quad

• Set up exactly as described above.


• If your left knee is on the floor, you will reach back and grab your left ankle with your left hand and bring your heel up toward your butt (just like you are doing a quadriceps stretch).


• Maintain your tall torso position.


• You will feel this more in the front of your thigh.

Hold each stretch for 30 seconds and complete two repetitions on each side. Make sure you do both variations of this stretch, they target different areas. Incorporate these two flexibility exercises into your daily training and reduce some of your muscle imbalances. This small investment of time will help improve your skating stride and reduce the stress on your hip and lower back.

Pregnancy Back Pain - Appropriate Posture and Exercises Are the Best Remedy

Pregnancy back pain in general and particularly in early pregnancy is a common complaint during pregnancy with more than 50% pregnant women suffering from it. Pregnant women are prone to backaches and back pain due to a number of reasons such as the extra weight of the baby or a change in the center of gravity of their body or due to hormonal changes in the early stages of pregnancy.

With the growth of the uterus, a women's center of gravity shifts forward. This gradually results in a change in the posture and movement style and may often lead to backache. Hormonal changes are a normal part of pregnancy and can cause the ligaments between our pelvic bones to often and our joints to loosen in preparation for the baby's passage through pelvis during birth. In some cases urinary infection can also result in Back pain amongst pregnant women. Severe back pain during pregnancy if accompanied by other symptoms during early period should not be ignored, as it may be a pointer to some major problem.

The most important remedy for curing pregnancy back pain is exercising. Walking, pelvic rock, bridging (on the floor with knees bent and lifting the buttocks into air), mini-crunches with bent knees and lifting the head on exhalation are good exercises for pregnant women and can go a long way in relieving Back Pain.

The right posture and good body mechanics also play an important role in keeping one free of back pain. Good posture is an effective remedy for pregnancy back pain during early days and one should avoid slouching. The use of a lumbar cushion or pillow can help one to avoid slouching and maintaining an appropriate posture. It can also be reduced by appropriate muscular exercises.

A pregnant woman can avoid pregnancy back pain by avoiding standing for longer periods and frequently changing her sitting position. Adequate rest and sleep are also essential for avoiding or eliminating back pain in early pregnancy. A pregnant woman should wear low-heeled shoes with proper arch support to avoid strain on her back. The use of a low stool for resting feet while sitting or standing for long periods can also help in avoiding back pain.

Patients With Back Pain Problems Swear by These Professional Back Pain Exercises For Relief

Speaking with an orthopedic surgeon or even a family practitioner about your chronic pain usually will get you the advice to first try pain exercises before any further treatments are considered. This is great advice, and many times is all that you need to do to relieve your chronic pain.

Upper and lower back pain often have different causes, but beginning a series of pain exercises should be a good treatment for both types. Especially when it comes to lower back pain exercises, stretching aggressively has been shown to be an effective remedy for the pain and stiffness that seems to come naturally as we age. The lower back pain exercises and stretches can counteract some of the aging effects and help you to feel loose and flexible.

DVDs which teach about this type of pain, causes, and treatments are available. Some of the best DVD products also show you how to get nearly immediate relief from upper back pain and lumbar pain, and also how to strengthen your entire back's structure so that you keep the pain at bay.

Doing the exercises on a regular basis is imperative, so keep the DVD in your player and aim for doing the entire set daily. Even if you miss a day or two, you will have much improved your back's composition, your flexibility, and your posture. These changes will make it easier to go through your daily routines without the back pain that severely limits you now.

Understanding the mechanics of your spine, and how it interconnects with the rest of your body is extremely important to learning the proper form of each of the Back Pain Exercises. DVDs are especially good at teaching form, because you can actually see each exercise performed and how your body and spine should be aligned for safety and effectiveness. Seeing first-hand the information and the back pain exercises in a very clear and interesting manner is important to being able to replicate each one properly.

Another positive aspect of DVDs is that you can immediately put the information to use. Some also explain reasoning behind injuries and pain, and the connection between your body and your mind. In fact, some people with serious injuries have little pain, while some with minor injuries suffer greatly. Once this connection is understood, it is easier to effectively manage your condition with exercises.

Treatments and Exercises for Lower Back Pain

Lumbago, commonly known as lower back pain, is one of the muscle related ailments that is quite common in the workforce. Doctors have noted that this is the number two reason why patients visit a doctor.

The causes of pain in the back may be due to muscle strain or soft tissues sprain at the back. Lower back ache is actually a symptom, which may involve injuries or other diseases. As such, there are three classifications: acute, sub acute and chronic back pain. The acute low back pain's duration is less than 4 weeks. The sub acute pain duration spans from four to twelve weeks. Lastly, chronic pain duration lasts for more than twelve weeks.

There are several ways to treat lumbago. One way is to take pain medications and apply heat compression to the affected area. Massages may also be applied to relieve the pain on the back. There are also exercises that can be used to recondition the lumbar area. However, these exercises for lower back problems may only be applied after the tenderness has subsided. It is important to note that each patient suffering from this ailment should be evaluated by a doctor so that corresponding exercises for lumbago may be tailor fitted to the cause of the malady.

Physical Therapy is also a good option for patients suffering from lumbago, which employs exercises to strengthen the back. There are programs of exercises for lower back pain that would relieve pain especially for chronic pain in the low back area. There are two common exercises for lower back pain programs that are being used by PT professionals. These are Williams' flexion exercises and Mackenzie back exercises, which are specific exercises for the lower region of the back. The first set of exercises is the Williams' flexion exercises which is composed of partial sit-ups, squats, pelvic tilts, hip flexor stretch, single knee to chest, hamstring stretch and double knee to chest exercises. On the other hand, Mackenzie back extension exercises are standing extensions, prone press ups, prone lying and prone lying on elbows and progressive extension with pillows. Exercises for lower back pain are always part of the treatment for chronic lumbago.

There are many ways that one can employ to prevent lumbago. Employees are encouraged to do routine exercises in their workstations to prevent lumbago. Also, one has to do proper stretching and prevention exercises for lower back pain before lifting weights to prevent muscle strains. There are also support devices available in the market that one can use to prevent low back injury. Always remember that prevention is always better and much cheaper than cure.

Exercising After Lumbar Spinal Fusion Surgery

Spinal fusion is a common form of back surgery that entails the fusion of two or more vertebrae to eliminate painful motion caused by degenerated discs or spondylolisthesis. People who are deciding whether to have the procedure or who have had it already often wonder what kind of physical activity they will be capable of after surgery. The following describes both short- and long-term exercise recommendations for people who have had lumbar spinal fusion.

The First Few Months

It can take about half a year for a fusion to set. During this time, it is important to place limitations on physical activity so that the fusion process is not disrupted by jarring motions. You might think bed rest would be the best option to ensure a smooth fusion; however, low-intensity exercise is actually imperative to recovery. It is important to exercise after fusion surgery for a number of reasons:

1. Muscles supporting the spine should be kept strong.
2. The back can become stiff after surgery and stretching exercises will help maintain flexibility.
3. Movement also helps prevent the formation of adhesions or scar tissue that can damage tissues in the back.
4. Maintaining cardiovascular fitness will help deliver fresh blood and oxygen to the healing area, giving it more material to build new bone with.
5. Maintaining a healthy weight will prevent extra stress on the back.

The exact amount of activity you're allowed will depend on what type of fusion you had, the location of fusion, the number of levels fused and your rate of healing. Make sure to discuss post-fusion exercise with your doctor or surgeon. If possible, arrange to see a physical therapist within a few days after surgery to get professional exercise advice. Generally, the following activity plan is followed after a fusion surgery.

The first week of recovery entails walking and gentle stretching of the thighs and back. Light core stabilization exercises that involve moving the arms and legs rather than the trunk may be introduced within the first few weeks. These exercises avoid any stressful movements of the spine such as twisting. As pain decreases, you'll be able to increase the distance of your walks.

After about 6 weeks, you may be able to add more mobile exercises into your routine. After about 9 weeks, if possible, you'll want to increase your aerobic workout to include brisk walking, swimming or another type of low-impact workout. Within the first half year to a year of surgery, you'll need to avoid jarring activities like jogging or contact sports.

For a comprehensive list and description of post-fusion exercises, see http://www.spine-health.com/treatment/spinal-fusion/rehabilitation-following-lumbar-fusion.

Long-Term

Your surgeon may tell you that you can return to any activity once you're healed if the procedure is successful. However, being physically capable of doing an activity and deciding to do it are two different things.

There is a concern with spinal fusion surgery called adjacent segmental degeneration (ASD). ASD entails the degeneration of joints and spinal discs surrounding the site of a fusion, since the disc and joints in that area are no longer absorbing shock and facilitating motion. This means that any high-impact activity you do will cause added stress on the discs and joints surrounding the fusion. The risk of ASD increases with the number of spinal levels fused.

Activities that jar the spine like running and outdoor cycling, or those that combine twisting and force like tennis or golf are, therefore, not ideal activities after having a fusion surgery. They are possible, but you must make a choice about what you're willing to risk. When deciding whether or not to have spinal surgery, those who live athletic lives may wish to look into artificial disc replacement or lumbar dynamic stabilization surgery as an alternative to fusion due to ASD concerns.

If you've had a fusion, one of the best ways to stay active is in the pool. Water takes stress off joints and discs while providing the resistance your body needs to stay fit. Swimming or water aerobics are ideal for people with back problems. Another option is an exercise machine, such as a stationary bike or elliptical, the design of which prevents jarring of the spine.

Exercise after spinal fusion surgery is not only possible but necessary. Keep in mind that you will be able to lead an active life after your recovery, but that your activities may not be the same as they were before surgery.

Exercises Not To Do With Sciatica Or It Will Get Worse

Sciatica could be the largest nerve inside the human body, which runs from your spinal cord for the buttocks and hip and additionally down to the foot. It is the sciatica nerve, which gives the sensation for the thighs, legs and also feet. The intensity regarding sciatica pain may differ from mild aches to sharp soreness. This pain could haunt the reduced back, buttocks, body and legs. Sometimes, a tingling or perhaps pins and needles sensation can be seen in the particular toes. There are some exercises to produce sciatic nerve soreness, but there are usually some exercises which can be better avoided. Several a times, once we are suffering, we always try to find remedies that can help in alleviating the situation. However, we typically neglect, to check exactly what do aggravate the difficulty. Read below for your sciatica exercises in order to avoid to alleviate the situation.

Exercises to Steer clear of for Sciatica

There are a variety of exercises to ease sciatica. Exercises in order to avoid damage however, are a couple of very important notes to keep in mind is that workout routines that cause strain around the lower back needs to be avoided. Let's get acquainted with what are these kinds of exercises for sciatica.

In case you are suffering from sciatica, almost any heavy stretch with the hamstring is usually to be avoided. Hamstring stretch not merely stretches the hamstring, just about all stretches the reason behind the sciatica nerve. Stretching with the root of the particular sciatica nerve could cause severe injury, hence it is advisable avoided.

When working with a sciatica difficulty, abdominal stretches may also be better avoided. Abdominal stretches are proven to exert pressure around the spine and furthermore cause severe nerve irritability. These stretches needs to be done only following your symptoms of sciatica decrease down completely.

Total compression with the spine is also due to heavy deadlifts. This kind of often causes spine soreness and aggravates sciatica difficulty. Many young guys boast about their strength training skills but don't realize the consequences regarding lifting these weighty weights.

Straight legged take a seat ups is one more exercise, which is usually to be avoided by people battling with sciatica. These exercises also put plenty of pressure on the particular spinal discs. To find out more, read more concerning exercises for sciatica leg soreness.

Weight lifting workout routines without proper and also sufficient support for the lower back are often explanation for injury to the particular sciatica nerve. It is advisable to stick to be able to low impact exercises which usually do not put any pressure around the spine. It is very important to strengthen the particular back muscles. In order to try any superior exercises, you should speak to your quality of life care professional regarding it. The advanced exercises needs to be chosen carefully. You will need to take care, the advanced exercises usually do not exert pressure around the back and hamstring muscle groups. You may desire to read more in regards to the exercises for sciatica reduction.

The most important point out remember in the particular sciatica exercises in order to avoid, is that it's also advisable to focus your consideration on stretching and also strengthening the muscle groups which surround the particular sciatica nerve. The most effective exercise to improve the back could be the pelvic tilt. It is a straightforward exercise which is often made to go for your daily plan easily. Make sure your exercise regime does not worsen the situation instead of remedying it.

The sciatic nerves are those who run down the beds base of the spine, from the back of the particular legs, right till underneath of the toes. When these nervousness get inflamed they cause significant amounts of pain though, and this soreness becomes unbearable after a few years due to the size of the body these kinds of nerves cover. Sciatica pain exercises has to be done with careful attention, as doing these may find yourself aggravating the difficulty further, instead regarding providing relief. It is important that one learns the proper exercises for sciatica soreness, and also performs them inside the right manner. Below are a few stretches for sciatica.

Exercise Can Help Relieve Lower Back Pain

If you are one of the millions of people that suffer from lower back pain, then you need to know that exercise can do wonders for you. When it comes to relieving lower back pain, exercise provides more long term relief than any back pills that your doctor can give you. The fact is, pills only serve to mask the problem by providing temporary relief of the pain, but the problem that is causing much of the pain is still there. Exercise will strengthen the muscles that support your back and improve flexibility thus greatly reducing the chances of future attacks.

You should be doing a three fold program of exercise which includes aerobics, resistance and stretching exercises. Aerobic exercise like walking and bike riding will begin to get your body conditioned properly because it strengthens your heart and lightly works your muscles. Resistance exercise like weight lifting will strengthen the muscles that support your back. Stretching exercises will increase flexibility giving your back a greater range of motion. Your doctor can guide you as to when and how much of each type of exercise you should be getting.

For people with lower back pain, the best aerobic exercises to do are low impact ones like swimming, walking and bike riding. Jogging, dance aerobics and step aerobics all produce repeated impact on your back and on your knee and hip joints as well. In order to get in good condition, start out with 15 minutes of light aerobic work per day, 2-3 times per week, and then gradually build yourself up to 30-40 minutes per day, 4-5 times per week.

You should be working enough to raise your heart rate to be in between 65% to 85% of your maximal heart rate. You determine your maximal heart rate by subtracting your age from 220. Regardless of whether you are walking, bike riding or doing any other aerobic exercise, always maintain good posture. This means sit up strait, stand strait and do not slouch or lean forward. Good posture is essential to any good exercise program.

When it comes to resistance exercising, you always want to concentrate on the abdominal muscles. These muscles play a major part in giving your lower back support and the stronger they are, the more relief for your back. Also important is to do exercises that are designed to specifically strengthen the lower back muscles themselves. You will best benefit from working each muscle group 2-3 times per week. You may want to hire a qualified fitness trainer to help get you on your way by designing a resistance program that is right for you.

Remember that while resistance exercise is great for strengthening the targeted muscles being worked, there should never be any pain involved. Some discomfort should be present in the muscles being worked while performing the exercises for them, but should subside very shortly after completion of the exercise. If there is any pain during the exercises or if discomfort persists for some time after, it is a sign that something is wrong and exercising should be discontinued and your doctor should be consulted immediately.

As far as stretching is concerned, 10-15 minutes of moderate stretching per day is usually enough to get the job done just fine. Here you really want to concentrate on stretching your hamstrings which are the muscles in the back of your upper legs. The looser your hamstring muscles are, the better range of motion your back will have as flexible hamstring muscles do not put the strain on your lower back that tight ones do.

Stretching the lower back muscles is also a must and sitting on the floor with your legs flat on the floor in front of you while you slowly reach for your toes until you can't go any further, hold for 10 seconds, and sit back up is a great exercise to stretch both your hamstrings and your lower back. Repeat this stretch 2-3 times each day.

While there are no miracle cures for lower back pain, you can make living with a lower back condition much easier to deal with by simply incorporating some exercise into your life each day. It is worth the effort in the long run give up 30-40 minutes per day, 4-5 days per week to exercise away your lower back pain.

Can You Handle Your Back Pain After Knee Surgery

The last stage for most of the people is on the operating table for a number of different causes, and because of this there are thousands of people dealing with pain after knee surgery, including back pain. This back pain that's experienced after having surgery can be due to a couple of different things, depending on what the surgery was for in the first place. It doesn't seem reasonable to have back pain after knee surgery since that's was the surgery was supposed to finish, but usually there is a certain healing time to be had before the person having the surgery starts to feel relief.

A lot of strain will be put on your back during your ambulation period either through crutches or through a walker. In place of getting relief from the actual knee problems after having knee joint surgery, patients still report having low back pain after surgery and it seems to hurt them when they need to move themselves. This will further increase your trouble.
Pre surgery requirements include proper conditioning and toning of back and lower limb muscles so that patient do not face must trouble after surgery.

Use A Walking Aid To Avoid Back Pain After Surgery:

Use an aid while walking to avoid pressure on your back as well as knees. Start with two crutches and as the condition improves move on with a single crutch.

One of the treatment to get rid of back pain after knee surgery that you can try at home is to lay on your back with a soft pillow under your knees. Do not put any undue strain on your knees and keep your back straight. This will keep the pressure off from your back and help in relieving the pain. You can also try resting your knees on a pillow that's placed on a chair. Lay on your back and place your knees on the chair. Both of these are great remedies to relieve back pain after knee surgery.

Exercises Are Must To Avoid Back Pain After Knee Surgery:

You should not forget to perform your mild and simple exercises for back pain, and at the same time as doing exercises if you feel pain you must at once stop your exercise and cool down before recommencing once more. Another way of exercising for back pain after knee surgery is to strengthen your critical muscles in the abdomen, lower back, gluteus and quadriceps. And, you can also perform back and leg muscles strengthening by doing isometric exercises which do not involve any movement and strengthen your muscles. This will certainly help you with your back pain after knee surgery.

Abdominal Muscle Recruitment During Exercise

Treatment of low back pain has recently shifted toward restoring proper muscular function of the abdominal wall and low back muscles - the ever popular "core muscles". Despite this common approach to the treatment or prevention of low back pain, little is known about the exact muscle recruitment patterns during commonly used exercises.

This study examined the activation of different regions of the transverse abdominus (TrA), internal and external obliques (IO and EO respectively), and rectus abdominus (RA), as well as lumbar spine and pelvic movement during four commonly used, basic movements:

1. inward movement of the lower abdominal wall
2. abdominal bracing (lateral and anterior flaring of the abdominal wall)
3. posterior pelvic tilting
4. combined inward movement of the upper and lower abdominal wall

All movements were done in prone and supine positions, and were performed with a "mild" muscular effort (2 rating on a Borg exertion scale), mimicking contemporary exercise interventions which focus on low level contractions of the stabilizing muscles. Fine needle EMG electrodes were used to record muscular activity and were inserted using real-time ultrasound imaging to ensure accuracy.

Lumbar spine and pelvic motion were recorded using digital video and LED markers on the spinous process of L3 and the anterior superior iliac spine (ASIS). EMG signals were normalized using maximal contractions (MVC), and each movement was performed three times in random order.

Pertinent results of this study include:

1. TrA activation was best achieved during inward movement of the lower abdominal wall in a supine position - activation was 70%, 100%, and 65% greater that IO, EO, and RA respectively in this position
2. during abdominal bracing, EO activity was greater than that of the upper TrA, IO, and RA
3. lumbar spine and pelvic motion was minimal and did not differ between tasks (except posterior pelvic tilting)
4. there was a significant negative correlation between lumbar spine and pelvic motion and activation of the TrA, while pelvic and lumbar spine motion seemed to increase EO activity

Conclusions & Practical Application:

Although this study did not investigate common exercises per se (such as McGill's "big three") it did investigate some basic movements and instructions that are often given prior to exercise, or very early in low back pain rehabilitation programs. One of the main advantages of this study was that fine needle electrodes were utilized to obtain the EMG recordings.

This technique is commonly thought to provide more accurate readings than surface EMG, particularly in the abdominal wall region. However, due to the invasive nature of this study, only seven subjects were used. Although this is consistent with similar studies in this area, it may limit the statistical power of this study.

From a clinical perspective, this study provides some useful information:

1. if the goal is to preferentially activate the TrA, inward movement of the lower abdominal wall in a supine position seems to work best
2. further, in order to minimize EO activity, lumbar spine and pelvic motion should be minimized to maximally activate the TrA
3. abdominal bracing is not appropriate if the goal of an exercise or movement is to activate the TrA

Preventing and treating low back pain is a complex clinical task. This small study investigated what I consider early phase techniques in a rehabilitation program - that is, establishing proper activation patterns and motor control of the core region. This is usually followed by coordinated incorporation of movements and exercises that functionally train the entire body.

More research is needed to determine the exact movements and instructions we can provide to patients to achieve optimal activation of the abdominal wall muscles to provide stability to the lumbar spine region, and also the best way to progress patients through stability exercises.