What is the best exercise for me? The answer is…it depends! An exercise program for someone recovering from a back injury looks a whole lot different from someone training for a triathlon.
In either case there are some basics that get overlooked:
Although we all have some degree of asymmetry (one hand bigger than the other, etc.) it is important to correct any big alignment issues before you increase your work out. For example, if the arch in your foot has dropped, your hip on that side will drop too. That leads to variety of changes in the surrounding tissues and joints. And if you repeatedly exercise an area that is out of balance, it will eventually wear and start to hurt.
Your joints need to move correctly. If they don’t you will start to get pain at some point in your training program. I see a lot of people with low back pain that is a result of compensation to a stiff and inflexible hip joint.
Muscles also need attention, although most of the time muscles get tight in order to support a problem area. For instance, you can stretch a tight hamstring over and over, but if it is tight in order to protect and support your low back, it will never get “loose”. If you have a specific issue, using a foam roller before and after a work-out can be helpful. Interestingly enough, foam rollers don’t stretch the soft tissue like we thought; it works by firing nerves and receptors in the tissue that ultimately effect how your nervous system fires.
Getting these issues handled will help you to move better and keep you from wearing out as the intensity of your work outs increase.
Exercises to avoid:
Your low back does not like to repeatedly bend and twist, especially if their is a load on it. Exercises like the Superman, Russian Twist, Roman chair, and sit-ups where you touch your elbows to your knees are especially bad. These are popular at boot camps, maybe it’s because they look cool. At the gym, any of the machines that you strap yourself in and either rotate, extend, or bend forward against a weight are also hard on your back.It will probably be another 15 years before health clubs get smart and take these to the dump.
Back muscles are all about endurance, their job is to keep you sitting and standing during the day. You can’t train them like you would train the big muscles in your body (like your biceps, quads, etc). Good starter exercises for the low back are planks, bird-dogs, cat stretches and crunches done correctly. These are called “McGills Exercises”, named after the professor who studied how different exercises load the lumbar discs.
The website I use to send video emails to patients is myrehabexercise.com. This website has really good and clear instructions on how to properly perform a specific exercise. Hats off to Dr. Philip Snell of Portland who developed the site.