Exercises for better back care - Mount Sinai Hospital

Relax between each knee-chest exercise for a few seconds. The Basic Cox® Low Back Exercise Program to Accompany Chiropractic Management of Low Back Pain.

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Exercises for better back care

General Instructions
Your best back support is derived from your own back
muscles! Faithful performance of back exercises often
avoids the necessity of an external brace or corset.
Back muscles can give you all the support needed if you
strengthen them by routine performance of prescribed
exercise.

Exercises
Follow the exercise routine prescribed by your doctor.
Gradually increase the frequency of your exercises as
your condition improves, but stop when fatigued. If your
muscles are tight, take a warm shower or tub bath
before performing your back exercises. If the pain
diminishes as you repeat an exercise then the exercise
is the correct one for your condition. On the other hand
if you repeat an exercise and the pain worsens, this
exercise should be discontinued.

Exercise on a rug or mat. Put a small pillow under your
neck. Wear loose clothing. Stop doing any exercise that
causes pain until you have checked with your doctor.


Helpful hints for a healthy back___________________________________________





Standing and walking

Try to point toes straight ahead
when walking; put most of your
weight on your heels; hold your
chest forward and elevate the front
of the pelvis as if walking up an
incline. Stand as if you are trying to
touch the ceiling with the top of your
head, eyes straight ahead. All the
elements of good posture will flow
from these simple maneuvers.

Driving

Use a firm seat with a padded pillow
or special seat support. Sit close to
the wheel with knees bent. On long
trips, stop every one to two hours
and walk to relieve tension and
relax muscles. Often times arching
backwards after prolonged sitting
helps to alleviate low back pain.


Coughing / Sneezing

Stand upright and bend backwards as you
cough or sneeze.

Sitting

Sit in a firm back chair that offers support
to the lumbar area of the spine (low back).
Often times a small roll placed between
the chair and your low back helps to
maintain the hollow (lordosis) of the low
back. Secretaries should adjust posture
and chairs accordingly. Take exercise
breaks from desk work by getting up,
moving around and performing a few back
exercises in the standing position.






Sleeping

Sleep on a firm mattress. With acute
back pain, lie on your back with a
pillow under your knees and head.
often times, rolling a towel lengthwise
and fastening it around your waist can
increase the comfort of your back
while sleeping.

Lifting

Bend your knees; squat and lift with
your thigh muscles, not your back.
Maintain back lordosis (hollow in low
back).
Move slowly and avoid sudden
movements. Try to avoid lifting loads
in front of you above the waist line.
Avoid bending over to lift heavy
objects from car trunks, as this places
a strain on low back muscles.


Working-Standing

Try to avoid fatigue caused by
work requiring long periods of
standing. Flex hips and knees by
placing a foot on a stool or bench.
Avoid standing with excessive
lordosis (too much of a hollow in
the low back). This position strains
the small joints of the back
causing fatigue. Performing the
pelvic tilt while standing also
relieves fatigue.

Working-Stooping

If working in a stooped position
for prolonged periods, then
interrupt posture on regular basis
by standing upright and bend
backwards 6 times. If possible try
to avoid working in a stooped
position for prolonged periods.














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EXERCISES

Flexion

General Comment
Stay as active as possible. Muscles
tighten and stay in spasm if they are
not allowed to stretch.

1. Pelvic Tilt
Lie on your back with knees bent and
feet flat on floor. Press the small of your
back against the floor and tighten your
stomach and buttock muscles. Do not
push with your feet-all the pull should
come from your abdominal muscles.
This should cause the lower end of the
pelvis to rotate forward and f latten your
back against the floor. Hold for six
seconds; relax for six seconds. Repeat
six times. When learning this exercise it
is often helpful to place a hand in
hollow of your back to feel the small of
your back pressing in towards the floor.

2. Cross-Arm Knee
Pushing
Lie on your back with knees bent. Feet
flat on the floor. Adopt the pelvic tilt
(Exercise #1). Bendyour right hip and
knee to form a ninetydegree angle.
(Position A.) Place left hand on right
knee keeping your arm straight. Raise
your head and tuck in your chin. Now
push your leg with your arm to create a
good abdominal contraction. Count to
six and relax. Repeat process six times
with same arm and leg. Now change to
other arm and leg and repeat whole
sequence.
Note: This is an isometric exercise.
There should be no movement.

3. The Curl
Lie on your back with knees bent. Feet
flat on the f loor. Adopt the pelvic tilt
(Exercise #1). Bring your knees to
your chest. Tuck your chin down onto
your chest. Keep your arms straight at
your sides and slightly raised. Curl
yourself up, aiming your forehead for
your knees. Repeat six times.

4. Knee Raising

Lie on your back with knees bent. Feet
flat on the floor. Grasp both knees and
pull them as close to your chest as
possible. Hold for three seconds then
lower them slowly until both feet are
on the floor. Be sure to keep the small
of your back flat against the floor as
your legs return to the starting position
and relax. Repeat six times.

5. Head Raising

Lie on your back, feet flat on floor.
Adopt pelvic tilt (Exercise #1). Hold
your arms straight up in air. Tuck chin
against chest. Now lift head towards
your knees, rolling up as if to sit up.
Keeping feet flat on floor, raise
yourself until shoulder blades clear
thefloor. Hold for six seconds, recline
for six seconds, then repeat six times.

6. Leg Raising

Lie on your back with one hip and
knee bent and one leg straight on
floor. Adopt pelvic tilt (Exercise #1).
Keeping knee of straight leg tight,
raise this leg slowly to level of bent
knee then lower it slowly to the
floor. Repeat exercise six times with
each leg.

7. Extension
General Comment
Recent clinical experience at the
Canadian Back Institute has
demonstrated that the following
extension exercises are often
helpful in alleviating discogenic
pain. Repeat these exercises at two
hour intervals, six to eight times per
day.


a) Lie on your stomach on the floor,
arms at your side and head turned
to one side. Now make a conscious
effort to relax the muscles in your
low back. This position should be
done before you begin each
exercise session. Hold for a few
minutes.


b) Starting position, as for exercise
Va. Put your elbows under youi
shoulders and support your upper
body on your forearms. Should you
notice a reduction in pain, then hold
for 5 minutes. If pain increases then
discontinue. If this exercise has
been successful in decreasing your
pain, then move on to exercise 7c.

c) Starting position. Lie on your
stomach, chin resting on the floor
(1). Then put hands under your
shoulders. Now straighten your
elbows and push up upper part of
body as far as pain permits (2). Keep
the pelvis, hips and legs completely
relaxed. Try to extend your back as
much as possible with your arms as
straight as possible. Hold position for
2 seconds. Return to starting
position. Repeat 10 times.

d) Starting Position. Stand with feet
shoulder width apart. Place hands in
hollow of your back, fingers pointing
backwards (1). Now bend
backwards, at the waist, as far as
you can, keeping knees straight (2).
Hold position for 2 seconds, return to
starting position. Repeat 6 times.

From 3M and CBI information sheet