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Eighty percent of Americans have some
form of a back problem -- leading to $24 billion spent in
medical costs each year directly related to low-back pain.
Many Daily Health News readers have asked about
exercising with back pain and if I know which exercises are
gentle on the back. For options, I spoke with Karl Knopf, PhD,
a leading authority on exercise for baby boomers and author of
Weights for 50 Plus: Building Strength, Staying Healthy and
Enjoying an Active Lifestyle (Ulysses).
POSTURE FIRST
Poor posture is a major contributor to
back pain. Dr. Knopf believes that the first order of business
for strengthening and rehabilitating the back are posture
exercises, which can be practiced absolutely anywhere.
"Stand upright with your weight evenly distributed over
the balls of your feet and heels, with legs slightly bent.
Then tilt your pelvis slightly forward so your tailbone is
slightly tucked under your hips. Make the distance from your
belly button to your sternum as far as possible by letting the
chest rise and open, countering the "hunched over"
effect. Your chin, sternum and belly button should be lined up
from the front. From the side it should look like your
earlobes are over your shoulders, which are over your
hips." Practice that alignment whenever you are standing.
When you sit, the alignment should be the same. Make sure you
sit on the "sit bones" of the buttocks, not on the
tailbone.
GUIDEWIRES FOR YOUR
BACK
The back alone can't hold your body
upright. "Think of standing a pencil upright on your desk
balanced on the eraser," Dr. Knopf told me. "You
could make it stand -- but it would take a lot of work and
balance. How much more efficient to have guide wires? Well,
the guide wires are the muscles that help keep the back
aligned. These need strengthening to build a strong support
system for the back.
The three basic "guide wire"
muscle groups for the back are the abdominals, the gluteals
(buttocks) and the perispinals (the muscles that run up and
down the spine). "While many baby boomers are aware of
the importance of training their abs, they often neglect the
buttocks muscles, which are the other side of the guide wires.
To strengthen the abs, back and glutes, Dr. Knopf recommends
the following exercises...
1. Buttocks strengthener:
Lie on your back with knees bent and feet flat on the floor.
Tighten butt muscles and lift the butt off the floor slowly.
Hold for a few seconds, return. Do 10 repetitions.
2. Hamstring stretch:
Lie on your back, feet straight out. Pull your right knee
into the chest and hold it there for a few seconds. Then
gently extend the leg toward the ceiling until you feel a
stretch in the hamstrings. Hold, return to start and repeat
with the other leg. This stretches the hamstrings.
3. Mad cat: Get on your
hands and knees. Arch your back like a cat. Keep your neck
in a relaxed neutral position. Hold for 10 seconds, then
release. (Note: Don't do this if you have a
ruptured disc.)
OTHER EXERCISES THAT
ARE GENTLE ON THE BACK
When choosing other exercises that are
gentle on the back, Dr. Knopf recommends exercises that are
done with the back supported and no "load" (or
weight) on the spine.
Dr. Knopf has high praise for two
specific forms of exercise. "The recumbent bike is my
all-time favorite," he told me. The recumbent bike, found
in almost all gyms, is a bicycle (in either stationary or
outdoor road versions) that allows you to sit on the bicycle
as you would in a chair with your back supported, instead of
upright or hunched over the way traditional bicycles do. Dr.
Knopf also loves water exercise. "Vertical water exercise
allows you to work all muscle groups without putting any
stress or strain on the back whatsoever," he told me.
As for strength-training exercises,
again, Dr. Knopf recommends those in which the back is
supported and that avoid putting any "load" on it. His
favorites...
2. Lat pulldowns to the
front
3. Sit-to-stands (see
below).
Avoid:
Military or shoulder press... squats.
"You have to be careful with leg
exercises," Dr. Knopf told me. "If there's injury or
pain, I'd prefer you do sit-to-stands. In this
exercise, you sit on the edge of a chair, then stand up and
sit down again. It's a "no load" version of the
squat that works the front of the legs without putting any
strain on the spine. You could work up to holding dumbbells in
your hands to increase the resistance and build more strength.
For anyone with chronic back pain who
wants to exercise and eliminate pain, Dr. Knopf strongly
suggested finding a physiatrist. "They are the most
underused medical specialty I know of," he told me. A
physiatrist is a medical doctor who treats chronic pain and
chronic conditions using a nonsurgical approach that often
includes exercise. "They have no vested interest in doing
surgery, and are usually very open minded to medical
interventions such as chiropractic and acupuncture," said
Dr. Knopf. "I've had back-pain for years, and I always
make the physiatrist the captain of my ship when it comes to
back-pain treatment."
Be well,
Carole Jackson
Bottom Line's Daily Health News
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