Low back pain (LBP) will most likely strike all of us at some point , at least that’s what the statistics indicate. How we “deal with it” initially can be critical to its progression or cessation. Here are some “highlights” of what to do “WHEN” this happens to you.
STOP: The most important thing you can do is STOP what you are doing—that is, IF you’re “lucky enough” to be pre-warned BEFORE the crisis point of LBP strikes. This step can be critical, as once it hurts “too much,” it may be too late to quickly reverse the process. The “cause” of LBP is often cumulative, meaning it occurs gradually over time, usually from repetitive motion that overloads the region. As stated previously, IF YOU’RE LUCKY, you’ll be warned BEFORE LBP becomes a disabling/preventing activity. Typically, when the tissues in the low back are over-stressed and initially injured, the nerve endings in the injured tissue trigger muscle guarding as a protective mechanism. This reflex “muscle spasm” restricts blood flow resulting in more pain creating a vicious cycle that needs to be STOPPED!
REACT: This is the “hard part” as it requires you to perform something specifically, but once you prove to yourself that this approach really works, you won’t hesitate. You’ll need to determine your “direction preference”, or the position that reduces LBP. Once established, you can perform exercises to help mitigate your back pain. To make this work, you must be able to perform these exercises in public without drawing too much attention so you can feel comfortable doing them at any time at any place.
EXERCISE A: If BENDING FORWARD feels relieving, the exercise of choice is to sit and a) cross one leg over the other, b) pull that knee towards the opposite shoulder, and c) move the knee in various positions so the area of “pull” changes. Work out each tight area by adding an arch to the low back, rotate your trunk towards the side of the flexed knee (sit up tall and twist—if it doesn’t hurt) and alternate between these positions (10-15 seconds at a time) until the stretched area feels “loosened up.” A second exercise is to sit and rotate the trunk until a stretch is felt. Again, alternate between different degrees of low back arching during the twists, feeling for different areas of stretch until it feels looser, usually 5-15 seconds per side. A third exercise is to sit and bend forward, as if to tie a shoe, and hold that position until the tightness “melts away.”
EXERCISE B: If BENDING BACKWARD feels best, exercise options include placing your fists in the small of your back and leaning backward over the fists, or bending backward and holding the position as long as needed to feel relief (usually 5-15 seconds). From a sitting position, try placing a rolled-up towel (make one with a towel rolled tightly like a sleeping bag held with rubber bands) in the small of the back to increase the curve. Lying on your back with the roll and a pillow under the low back can also feel great!
EXERCISE C: THE HAMSTRING & GROIN STRETCH: From standing, 1) place your foot up onto a seat, bench, chair, pipe of a railing, or anything about knee level (it doesn’t have to be very high). If your balance isn’t very good, make sure to hold onto a wall or counter to keep your balance. 2) Keep your knee bent 20-30 degrees and arch your lower back by sticking out the buttocks until you feel the pull or stretch in the hamstrings (back of the leg). 3) Slowly straighten your knee (keep the buttocks poked out and the low back arched) and you will feel the hamstrings gradually get tighter. 4) Change the angle of the knee and/or the amount of l ow back arch/pelvic tilt to modify the pulling intensity in the hamstrings. Continue this stretch for 15-30 seconds or until you feel the muscles loosening up. 5) Stay in that EXACT SAME POSITION and rotate your torso inwards (towards the leg you’re standing on) until you will feel the pull change from the hamstrings to the groin (inside thigh) muscles. You can also go back and forth between the hamstrings and the groin (adductor) muscles and continue the exercise until the back of the leg and groin feel adequately stretched (usually 5 to 15 seconds/leg).
EXERCISE D: THE HIP FLEXOR STRETCH: From standing, 1) step forwards with one leg and stand in a semi-long, stride position (one foot ahead of the other). 2) On the back leg side, rotate the pelvis forwards until the hip lines up with the forward leg hip (or the pelvis is square). 3) Add a posterior pelvic tilt (tuck in your buttock/pelvis or, flatten your low back). 4) Lean backwards (extend the low back) holding the above position. As you extend back, feel for the pull deep inside the upper front part of the thigh/groin area. You can alter between the third and fourth steps to release and re-stretch the hip flexor. Continue the stretch for 5-15 seconds or until you feel it’s stretched out and repeat on the opposite side. This one takes a little work but once you feel it, you will see why it’s so good!
EXERCISE E: THE ADDUCTOR STRETCH: As an alternative to the second part of EXERCISE C (step 5 of the standing hamstring stretch), stand with your legs spread apart fairly wide. Shift your pelvis from side to side (left then right) and feel for the stretch on the inner thigh/groin region. You can increase the stretch by adding a lean to the side you’re shifting the pelvis. Try holding the stretch for 5-15 seconds, alternating between sides 5-10 times.
These exercises are meant to be done in public WHEN you need to stretch. Stop the vicious cycle from getting out of control by STOPPING, STRETCHING, and then resuming your activity if you can!