Last month, we reviewed studies that compared chronic low back pain (cLBP) exercisers to non-exercise control groups and examined how those in the exercise groups experienced significant improvements in pain and disability/function compared with those who remained inactive, regardless of the type of exercise. We also reviewed a few popular Swiss or gym ball exercises. This month, we will introduce some core stabilizing exercises that can be done on the floor.
There are benefits to Swiss ball exercises like balance or proprioception stimulation. In fact, five minutes of ball exercises equal 35 minutes of floor exercising when focusing on balance or proprioception. It is a well-known fact that as we age, we lose our “kinesthetic sense”, or balance skills, so incorporating balance into any exercise program is a good idea!
However, the “con” of Swiss ball exercises is convenience, as such a piece of equipment is less portable. We cannot easily travel with a gym ball, but we all have access to the floor regardless of our location. Also, with exercises performed on the floor, you can achieve stronger muscle contractions due to greater stability. Ideally, MIX the two together! Also, include a 20-30 minute brisk walk for aerobic benefits! Here are some great floor core stabilization exercises (try holding for 5-10 seconds, repeat 5-10 times, whatever is tolerated):
1) Pelvic tilts – First, with the knees bent about 90° with your feet on the floor, flatten your low back against the floor by rocking your pelvis back.
2) Dead Bug – On your back with hips and knees both bent 90° (like sitting in a chair on your back), straighten out the right arm and left leg simultaneously and alternate sides SLOWLY.
3) Superman – Lay on your stomach with your arm and legs stretched our (like “Superman” flying). Raise one arm and the opposite leg (i.e. right arm/ left leg) and slowly alternate between the other opposing pair. Make it harder by raising BOTH arms and legs at the same time! NOTE: A pillow under the waist helps.
4) Bridge – Lay on your back with your knees bent. Lift the buttocks off the ground and push your heels into the floor. Do one leg at a time to make it more challenging.
5) Sit-ups – There are three leg positions to make it progressively harder (knees bent/feet flat on floor, knees & hips both bent 90°, etc.). Lift your breast bone towards the ceiling and alternate between coming straight up and left and right trunk twists.
6) Side Bridge (Plank) - If no shoulder problems exist, lay sideways propped up on an elbow and lift the hips off the floor to a straight body position.
7) Standing squats – Try a quarter, half, or full squat (knee pain dependant) with or without hand weights and with or without a ball squeezed between the knees. Lunges can be substituted or added if desired.
8) 4-point Quadruped – Kneeling on all fours, straighten out the right arm / left leg, and alternate. At the same time, suck in your belly (“abdominal hollowing”) to facilitate the deep transverse abdominis and multifidus muscles. Add a dynamic component by rotating the trunk and approximating your hand to the floor / opposite leg up in the air keeping the body in a straight line.
You may wonder, “Do I need an MRI scan of my back.”
Also, if you feel leg pain it may indicate things are getting worse and may indicate a bulge on the disc or worse yet a herniated disc in your back. Some people will try stretching the lower back first to see if they get relief. Pain very low in the lower back may be originating from the coccyx or tailbone. A pulled muscle in the back generally will get better with rest. Persistent or worsening pain intensity and/or frequency necessitates a visit to see a professional.
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