8/14/2019 Back Exercise Report
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MEEHAN CHIROPRACTIC AND SPORTS REHAB
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www.DrMehan.com
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8/14/2019 Back Exercise Report
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MEEHAN CHIROPRACTIC AND SPORTS REHAB
2007
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WARNING DISCLAIMER
This report is for information purposes only.
This report is not intended to diagnose the cause of back pain and you should consult
with your doctor when you are suffering from any painful condition.
If you are currently experiencing back pain, especially if the pain extends into your leg or
buttock or if the pain is increasing, immediately see a Chiropractor or your Primary CarePhysician.
You should always be examined by a doctor to determine what is causing your pain.
Before beginning any exercise program you should be examined by a doctor to ensure
that it is safe for you to participate in an exercise program.
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Those who have not the time for bodily exercise will sooner orlater have to find the time for illness.-Edward Stanley
Congratulations on taking the first step to beating back pain reading this report. The next stepis the hardest for most people: following thru with the exercise recommendations, but I am
confident that you can do it.
Allow me to ask you a few questions:
Do you suffer with back pain that goes away only to come back in a month or so?
Have you had you back pain treated only to have it come back again?
Are you tired of painkillers and muscle relaxants that make you feel like you are
walking through a fog all day?
Are you sick and tired of being sick and tired?
Do you want to come home from work and enjoy your time at home without pain?
Have you seen numerous doctors for your back pain with no lasting relief?
If you answered YES to any of these questions then this report is for you.
Back pain is the leading cause of missed work and disability in the U.S. Current estimates are
that 4 out of 5 people will suffer from back pain during their lifetime and if youre reading this
then youre probably either one of those four or else youre trying to avoid being one of them.
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Now to what you all are reading this
report to find out:
The Top 10 Exercises for Beating Back Pain
1. Hamstrings Stretching
2. Psoas Stretching
3. Posterior Pelvic Tilt
4. Leg Raises
5. Bird Dog
6. Bridges7. Back extensions
8. Squats
9. Gym Ball Marching
10. Single leg balance
Now that you know what the exercises are Ill help you find out
which ones you need and then how to do them.
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A little background on the exercises and
how they are organized.
This is by no means an exhaustive list of exercises for beating back pain. These exercises andstretches address the most common problem areas that I see in my office.
If you would like to pinpoint what is causing your back pain and target those causes please
contact me.
Research on back pain and exercise therapy continues to find newer and better approaches to
treating back pain just 20 years ago bed rest was the most frequent recommendation and now
we know that staying in bed for to long with a bad back only makes you feel worse and prolongs
your recovery.
The exercises in this report are broken down into 3 main areas:
1) Stretching-Flexibility, especially muscles of the low back and hip areas (exercises #1 & 2)
Inflexible or tight muscles will limit your movement and other areas will have tomake up for it putting that area under higher stress.
Tight muscles will inhibit other muscles, when your hip flexors are overly tight then
they can inhibit your hamstrings putting greater demand on your lower back muscles.
2) Strength and muscular endurance-Core muscle strength and endurance (exercises #3-8)
For your low back to be stable your core (low back, abdominal and hip) muscles must
be strong and conditioned.
3) Balance-Balance (exercises #9 &10)
Balance is a key factor in preventing back pain as well as recovering from a bout ofback pain. If you have poor balance then you are much more likely to injure your
back in the future.
Balance also represents the coordination necessary to use your core muscles tostabilize your back (yes you can have great abs and low back muscles and still have
poor stability if cant coordinate these muscles).
Most of the exercises begin with a test so you can determine if you need to do it, these tests also
allow you to re-test yourself after you have been performing the exercises so you can see your
progress.
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Visual Guide to Muscles
This is a general diagram to give you an idea of where the muscles that I refer to in this report
are located.
Of special note the Psoas muscle attaches to the inside of the thigh and runs deep in the
abdomen (the reason I outlined it with a dotted line) to attach along the spine.
Now on to the good stuff, the exercises.
TransverseAbdominus
Hamstrings
Glutes
Low backS inal Erectors
Psoas
Lower Abs
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Flexibility/Stretching Exercises (#1 & 2)
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1. Stretching hamstringsa. Test Lie on your back with your legs out straight in front of you. Raise your
right leg up keeping the knee straight, as high as you can (if you want you can
have a partner help you). You should be able to get to where your leg forms a 90angle to your body, if you cant reach that point then you have some work to do.
b. Why - Hamstring tightness is a common problem due to the prolonged sitting
many of us must do at work every day. When the hamstrings are tight they canpull your pelvis (your hips) out of alignment and place greater stress on the
muscles and joints of your low back.c. How its done -
Hamstring StretchStarting position:
Lie on your back with both legs stretched out in front of you.Execution:
Bend one knee up to your chest and wrap a towel over the bottom of your foot.
Straighten your leg until you feel a stretch in the back of your leg. Hold for 10
secs. Repeat 3 times each side performing an extra set on the side that shows thegreatest hamstring tightness.
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2. Stretching psoasa. Test lie on your back with your legs stretched out in front of you. Pull your left
knee up to your chest and while holding it there press the back of your right knee
down to the floor. If your right psoas is very tight you will not be able to bringyour right leg to the floor. If your right psoas is moderately tight you will feel a
stretch in the front of your right thigh or groin area.
b. Why - When the psoas muscle is short and tight it pulls the low back forward
c. How its done -
Psoas StretchStarting position:
Lunge position stride one leg out and bring the knee of your rear leg down tothe ground.
Execution:
Maintain a tall position, dont lean your upper body forward and keep your hips
tucked in. Rock your hips forward until you feel a stretch in the front of your rearleg (the area in the oval in picture below). Hold for 10 secs. Repeat 3 times each
side performing an extra set on the side that shows the greatest hamstring
tightness.
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Strength Exercises (#3, 4, 5, 6, 7 & 8)
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3. Posterior Pelvic Tilt with Abdominal Hollowinga. Test N/A proper performance of this exercise is essential for the performance
of most of the remainder of the exercises in this report.
b. Why - The Posterior Pelvic Tilt is an essential movement for stabilizing your lowback and many exercises for your low back require that you can hold a Posterior
Pelvic Tilt to perform them. Abdominal hollowing, or pulling your gut inactivates a very important muscle for stabilizing your back the Transverse
Abdominus. The Transverse Abdominus muscle acts like a girdle around yourmidsection sort of like your own built support belt.
c. How its done.
PPT exerciseStarting position:
Lying on your back with your hips and knees bent about 45, with your knees andfeet about shoulder width apart.
Execution:
Rock your hips back while pulling in your abdomen, your low back should press
against the floor hold for a second then roll your hips forward lifting your backoff the floor. This may sound easier than it is when you first try it. To help you
learn this exercise I suggest placing your hand under your lower back so that youare able to feel your back press into the floor.
To assist in learning to pull in your belly I use a weighted ball placed on the belly
button to provide feedback as well as act a reminder (if you start to push out the
ball can roll off).
The goal of this exercise is to help you be more aware of the position of your low
back and to find a neutral position for your spine. As you move your hips
forward and back notice how far back your hips go as well as how far forward
the spot between these two is your neutral position which is also the mostcomfortable.
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4. Leg raises (lower abdominal strength)a. Test - Testing for strength of this muscle involves lying on your back with your
legs extended above you as in the picture below. It is very important that you
lower back is kept flat against the floor during this test you can monitor yourlower back by placing one or both of your hands in the small of your back.
Slowly lower your legs to the ground keeping your knees straight note how lowyou can go before your back starts to arch off the floor. Men with good lower
abdominal control can lower their legs all the way to the ground, women to about6 above the ground. If you are unable to do this then you need more work onyour lower abdominal muscles.
b. Why Frequently people with low back pain have either weak lower abdominalsor poor coordination of the abdominals with the surrounding muscles both of
which lead to poor stability in the low back.
c. How its done -
Leg RaisesStarting position:
Begin by lying on your back in the same position as the Pelvic Tilt exercise
above. Adjust your hips so that you are in your neutral position (I told you
youd need the Pelvic Tilt exercise for other exercises), and pull your belly in (usea ball, like in the Pelvic Tilt exercise, if you want).Execution:
Keeping the back in neutral and your belly pulled in bring your knees up to just
past your hips and then lower your feet back to the ground. The straighter yourknee the more difficult this exercise.
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5. Bird Doga. Test none needed, this is an exercise that should be done by everyone, at least as
part of a warm-up.
b. Why - This exercise focuses on working some of the smaller stabilizer muscles inyour low back. Many studies have found weakness of these muscles in people
suffering from chronic or recurring low back pain.c. How its done.
Bird DogStarting position: Begin on your hands and knees with your belly pulled in towardyour spine.
Execution: Raise your left arm and right leg off the floor (your arm should end up
alongside your ear). Repeat with your other arm and leg this is one repetition.
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6. Bridgesa. Test no home test (I test for activation of this muscle in the office but the
procedure is to involved for this report). Almost everyone can benefit from doing
this exercise especially those who have tight psoas muscles.b. The focus of bridges is to work the gluteal (butt) muscles, these muscles are
frequently weak in people who have tight psoas muscles (see exercise #2).c. How its done
BridgesStarting position:Begin by lying on your back in the same position as the Pelvic Tilt exercise
above. Adjust your hips so that you are in your neutral position (I told you
youd need the Pelvic Tilt exercise for other exercises), and pull your belly in.
Execution: 3Lift your hips off the floor so that your body makes a straight line from your
knees to your shoulders.
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7. Back extensionsa. Test testing for strength and endurance of the back extensors is beyond the
scope of this article and should be supervised by a professional to ensure safety.
b. Why Low back strength and endurance have repeatedly been found in peoplewith low back problems and people with chronic back pain. This exercise
concentrates on the spinal erectors.c. How its done -
Back ExtensionsStarting position:Kneel in front of a Gymball and drape your body over it, your back should be
rounded.
Execution:
Using your low back muscles lift your chest off the ball. Your body should makea straight line from your butt to your shoulders. Hold the top position for a
second or two then lower down and repeat.
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8. Squatsa. Test
Place a piece of tape on the floor one-foot length (your foot) from a wall. Stand
with your feet shoulder width apart with your toes touching the tape and your feetpointing forward. Now squat down as low as you can.
Your head should not touch the wall
Your heels should not rise from the floor
Your feet should remain close to parallel.
Most importantly you should have no pain performing the movement. If
you experience pain with this movement it is wise to be checked byyour doctor.
If you are unable to perform this movement then we have found an area of
weakness that you will need to work on.b. Why Squatting is a movement that we all perform many times each and every
day, whether to sit down, to pick something up off the floor or to go to thebathroom. So if we do it so much why do we need to train it simple most ofus do it wrong. Have you ever seen someone lean forward and then push
themselves up out of a chair, if they need to do that to get out of a chair than they
have some sort of weakness either in low back or legs.
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c. How its done -
SquatsStarting position:
Stand in front of a chair with your feet shoulder width apart. Your hands may beon your waist, your head or you may hold a pole in front of you for balance if you
need it.Execution:Keeping your stomach tight and your belly pulled in, slowly squat down until
your butt touches the chair and then raise your self back to the starting position.
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9. Gym ball marchinga. Test N/A
b. Why This exercise works your balance and coordination in a sitting position, a
position most of us spend way to much time in. To maintain your balance whenyou do this exercise your body is forced to use your hip, low back and abdominal
muscles (your core) in a coordinated fashion
c. How its done -
Gym Ball MarchingStarting position:
Sit on a ball (use a ball that is big enough to sit with your hips and knees at about
90-100 - for most of us that means a 65cm ball). Adjust your hips to find a
neutral position and pull your belly in (another exercise that you needPosterior Pelvic Tilt for).
Execution:
Lift your left foot off the floor, it doesnt have to be high (sounds simple I know
but the first time you try it youll be surprised). Place your left foot back on thefloor and then left your right foot and keep marching. If this is too hard you can
try just lifting your heel off the floor and keeping your toe down
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10. Single leg balancea. Test This test is pretty much self-explanatory, stand on one leg looking straight
ahead and time yourself. Stop timing if you put your other foot down or move
your support leg (no hopping around). You should be able to comfortable standon one leg for at least 30 seconds (ideally longer). For the sake of safety I always
have people do this test near a wall so they can catch themselves if they start tofall.
b. Why Every step we take requires us to balance on one foot (even if its only or
an instant. If we have poor balance any misstep can lead to an injury, sometimesjust a sprained ankle or at the extreme you could even break a bone if you go so
far as to fall.
c. How its done -
Single Leg BalanceStarting position:
Stand facing a wall or chair (so you can steady yourself if you need to). Your
belly should be pulled in and your butt tight while performing the exercise (yesthe Posterior Pelvic Tilt exercise again).
Execution:Lift one foot a few inches from the ground and hold it there while maintainingyour balance.
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Strength and balance exercises should be performed 3 times per week while flexibility exercises
should be performed up to 3 times per day. Your stretching exercises should be performed
before strength and balance exercises since tight muscles can inhibit the weak muscles that youare working on.
Cautions
You should never feel pain while performing any of these exercises if you experience
pain while performing any of these exercises you should see your Chiropractor orPrimary Care Physician.
You should not have more than general muscle soreness the day or two following
exercise if your pain increases the days following exercises you should see your
Chiropractor or Primary Care Physician.
Feel free to contact me if you have any questions regarding the information in this report or if
you would want to have