Lower Back Rehabilitation Article


Lower back rehabilitation when done properly can significantly reduce low back pain by activating muscles of the low back and "core." 80% of people will experience some form of low back pain in their lifetime. Therefore, people should be doing some kind of exercise for the lower back to prevent injuries.

The most common form of lower back pain is "mechanical low back pain," which happens when a patient uses the wrong muscles to load the joints of the lower back. When a patient experiences mechanical low back pain it is very hard to pinpoint a direct cause for the pain. This type of pain usually occurs due to a direct injury to the area, repetitive overuse injury, or posture related injuries.

When the wrong muscle gets loaded by a joint it causes the muscle that was supposed to be loaded to get turned off by the brain. Then the brain really doesn't know that muscle exists for a certain action. For example, people who sit all day long usually have trouble using their gluteus maximus muscle when it comes to hip hinging and other activities that require this muscle to fire.

Therefore; the gluteus maximus muscle will get shut off by the brain and a different muscle will take the blunt of the work. These are usually the muscles of the lower back getting the workload. This can then cause pain.

Proper hip hinge refers to using your hips as hinges to lower your body into a squat position, which is what we all do when we sit down. This action should be dominated by the gluteus maximus muscle and not by the muscles of the lower back.

Lower Back Rehabilitation Exercises:

Cat-Camel Exercise:

The Goal is spinal mobility. Good first exercise in a rehabilitation program. Maintain slow and controlled posture. This exercise has to be pain free. Perform 10-20 reps and 2-3 sets per day.

Abdominal Bracing:

Proper position is on all fours. Bracing the abdominals is exactly what you do when you are going to get punched in the stomach. Place hands around mid-section to check for proper activation. This is very good to train the abdominal muscles in the initial phase of the rehab program. Brace for 3-5 seconds and do 8-10 reps.

Glute Squeezes:

This exercise must be done first to maintain activation of the glutes before progressing to glute bridges. Feel the hamstrings and lower back to make sure the glutes are doing all the work. Simply perform by squeezing the glutes together.

Glute Max Bridges:

Brace the abdominals first. Then squeeze the glutes together and bridge up. This is a very good exercise for gluteus maximus activation and is key in lower back rehabilitation. Feel the hamstrings and lower back to make sure the glutes have the most tone. If the glutes don't have the most tone go back to glute squeezes until this occurs.

Side Bridges:

Start on knees and advance onto feet. Activation of the transverse abdominus (core muscle) contributes to low back stability. Abdominal brace first, then squeeze glutes together to raise up making sure knees, hips, and shoulders are in line. Hold the bridge for 3-5 seconds for beginners and do 10-15 reps. Advanced side bridge can be held for as long as possible for endurance.

Bird Dogs:

It's very important to brace the abdominals first. Stretch opposite arm and leg out and maintain a slow controlled motion to maintain activation of the core and glute muscles.

Body Weight Squats:

This exercise must be done when the patient knows proper hip hinge procedure. Hip hinging is bending at the hips using the glutes to guide the movement. We do not want excessive bending and moving in the lumbar spine.

Tri-Planar Lunges

There are 3 planes of motion sagittal (front to back), frontal ( side to side), and transverse (diagonal movement). Every muscle and joint must be able to move in these planes of motion. So to properly train the glutes movement must occur in 3 planes of motion.

Always consult your physician before starting any exercise or lower back rehabilitation program. These lower back rehabilitation exercises are not suited for everyone. If you feel you should start a rehabilitation program please consult a health care professional.

Written By: Steve Smiley, DC

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