Low back pain is the “Karen” of orthopedic injuries. If you’ve had it before, you’re amongst the other 90% of the population to experience symptoms over the course of life. Pain can be localized to the low back, or radiate into the hips or down the legs. It can cause sensations of numbness or tingling, burning, along with stiffness and muscle spasm. Regardless of how it manifests it’s ugly self, low back pain often prevents people from exercising – whether this is due to pain itself or just fear.
The old-school recommendation of bedrest until pain resolves is just that: outdated. It can actually prolong symptoms and contribute to the chronicity of the injury. Staying as active as possible, while modifying painful movements, actually speeds up the healing process.
A common focus while rehabbing lower back pain is on the overall function of the “core”. Core is in quotations because it isn’t just one area – it is a system that works together to provide support during movement. Just because you have low back pain, doesn’t mean you are weak or your core “doesn’t work”. However, the purpose of this post is to provide a handful of exercises that allow you to continue to strengthen the core without pain stopping you.
These exercises should be pain free. Modify weight, sets, reps, intensity, and duration based on your specific needs.
1. Farmers carry:
This is a great place to start. Hold 2 kettlebells by your side with shoulder blades engaged and ribs stacked over hips. Walk around with a slower, controlled pace making sure to avoid breath-holding and swinging the weights. Appreciate the core kicking in to keep your midsection stacked. This exercise can be done to fatigue to help train endurance of these postural muscles.
2. Palloff Press:
This is a great stabilization exercise that works on anti-rotation. Find neutral spine to start – this should be in a pain free position. Holding a band or cable close to you, inhale to begin, exhale and press the cable straight out. Try to keep your midsection still – avoid rotating into the band. You should feel your abdominals kick in to keep you in “neutral”. Inhale as you return back in.
3. Hip hinge:
This foundational movement pattern is key for so many exercises: Kettlebell swings, deadlifts, power cleans, bent over rows and more. It is important to be able to dissociate the low back from the hips. Using a dowel, line it up along the length of your spine. Hinge your hips back, allowing a slight bend in the knees. Keep your back lined up with the dowel. Use your glutes to come up to stand. Once you master this movement without pain, load it up: take it into a weighted deadlift, bent over row, etc.
4. Kneeling overhead press:
This movement is to help train your core as you move weight overhead – especially if this is a provocative movement for you! As you move resistance band/dumbbells overhead, exhale and feel your abdominal muscles activate. The challenge is to keep your back in the neutral position as you press the weights. Sure – you’ll feel your shoulders working, but it does take some coordination in the midsection as well.
5. Plank variations:
The beauty of the plank is that it can be modified endlessly to fit your ability. If you’re in acute pain, start by shifting your weight forward while on your knees. Once this feels better, progress to a high plank. You can then add in shoulder taps, leg marches, plank pull through with a weight (see…the variety is endless). If a plank is fairly uncomfortable, try starting with a modified side plank.
Like I mentioned, back pain is THE KAREN, and she doesn’t make things easy. It can take several weeks for pain to resolve and can be frustrating. However, this is an area that physical therapists are familiar with! We can cater plans specifically to you and your activity of choice. The goal is to stay moving and try not to stress too much.
If you are having trouble resolving your back pain, reach out to a physical therapist! If you are local to Charlotte, and want to see me in person at GROW PT, connect with me at annie@growptcharlotte.com. I also offer virtual sessions for those out of state.