Exercises for Lower Back Injuries
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Lower back injuries can occur in almost any sport, but are especially prevalent in sports that require frequent bending, twisting or lifting. For example, athletes in basketball, football, tennis or weightlifting often struggle with lower back problems.
The lower back is the most difficult area of the body to diagnose. This area is composed of large muscles, small muscles, ligaments, joints, discs, and vital organs - all possible causes of lower back pain.
SACROILIAC JOINT (SI JOINT) PAIN
The ‘sacrum’ refers to the triangle shaped bone that is below the lumbar spine, while the ‘ilia’ are the large hip bones. Together they create two sacroiliac joints; one of the left and one on the right. The main function of the SI joint is to carry the weight of the upper body when you are standing or walking in order to allow each leg to move forwards and backwards.
Sacroiliac joint pain is typically slightly below the lower back and sometimes extends down into the hip and buttocks area. Pain in this joint is often described as ‘sharp’, ‘dull’ or ‘achy’. SI joint pain is usually unilateral - meaning it occurs on either the right or left side. Moving from a sitting position to a standing position may also reproduce symptoms in the area.
Sacroiliac joint pain occurs when there is inflammation in the joint. Common causes for SI joint pain include:
damage to the ligaments that surround the joint
one leg being longer or shorter than the other
looser ligaments in the body during pregnancy.
LUMBAR FACET JOINT SYNDROME
Lumbar facets are the joints in the lower back that allow for spinal movements such as rotation, bending forwards and backwards or from side to side. These lower back joints bear the most weight in the body and are therefore most susceptible to injury compared with those of the neck and upper back.
As people get older, it’s common for this area to degenerate, while facet joints themselves typically become stiff - which can lead to pain. The syndrome can also be caused through trauma to the lower back - sustained after injuries from falls, improper lifting or car accidents, amongst others.
Symptoms of lumbar facet syndrome may vary in terms of intensity and characteristics. Pain can be described as anywhere from mild discomfort to severe, acute pain and disability. Unlike some other forms of lower back pain, pain may also go down towards the buttocks but will never extend below the knee.
People with lumbar facet syndrome will almost always experience pain when producing the coupled movement of extension (backward bending) and sideways rotation towards the area of pain.
LUMBAR DISC HERNIATION / DISCOGENIC LOWER BACK PAIN
Natural movement involves compression and contraction of the spinal vertebrae. Between each lumbar vertebra, you’ll find a disc made of gel-like substance. These discs provide a buffer to the vertabrae as they are compressed, helping to reduce bone-on-bone rubbing.
When the body is placed in certain awkward positions, the gel-like disc can bulge or spill out from between the neighbouring vertabrae and cause a chemical irritation to the spinal nerves exiting the spinal canal. A tear through the disc can cause significant inflammation around the area, which causes severe pain and may cause numbness and tingling if the bulge or the swelling puts pressure on the nerves.
Typically people with a herniated (or bulging) lumbar disc experience most pain when bending forwards. Actions such as coughing, sneezing and bearing down (abdominal straining) increase pressure in the abdomen and are likely to increase the intensity of pain. Pain may be accompanied by symptoms such as numbness and tingling which may extend down to the toes. In severe cases, a disc bulge may lead to decreased strength.
QUICKFIND
Cable Chop - Dead Bug - McKenzie Extensions - Quadratus Lumborum Stretch
For this exercise, you’ll need a cable.
Exercise instructions:
Stand at arms-length to the side of the rack with legs shoulder-width apart.
Holding the cable with one hand on each end, pull the cable straight across your body.
Press the arm nearest the rack fully out.
Reverse the steps and repeat.
Tips on technique:
Keep your core engaged and chest out throughout.
Suggested workout:
3 sets of 6 repetitions on each side.
The dead bug is a core stability exercise that focuses on keeping the lower back in a neutral position by moving opposite arms and legs in a criss-cross pattern.
Exercise instructions:
Lie face up on the floor, raise your arms towards the ceiling and bring up your knees to a 90 degree angle.
Straighten out one leg towards the ground, while simultaneously straightening out the opposite arm into a horizontal position over your head.
Return to the starting position and repeat with the opposite leg and arm.
Tips on technique:
Push the lower back arch slightly into the ground to maintain a stable lumbar spine
Put a rolled up towel under the arch to give you tactile feedback for help in maintaining the downward pressure.
Suggested workout:
3 sets of 6 repetitions (where a repetition includes the action repeated on both sides).
This exercise is specifically for lumbar disc injuries where extension of the lumbar helps to relieve the pain. The McKenzie extension uses gravity to reduce the amount of fluid protruding with the bulge, thereby decreasing pressure around the spinal nerves.
Exercise instructions:
Lay face down with your arms tucked in beside you.
Push down onto your forearms, causing your back to arch while keeping your lower back and abdominal muscles relaxed.
Hold for 5-10 seconds and slowly lower back to the starting position.
Tips on technique:
Try to control your breathing during this exercise.
With each repetition, extend further backwards. You can push up onto your hands in order to gain maximum extension.
Suggested workout:
2 sets of 5-10 repetitions
For acute lower back pain, repeat throughout the day as required.
The quadratus lumborum is a large muscle that stretches from the bottom of the rib cage to the top of your pelvis. The muscle helps to stabilize the lower back and move it from side to side. It gets especially tight during long periods of poor posture.
Exercise instructions:
(To stretch your right side) Stand with legs crossed about half an arms-length outside an open door, with your left side beside one of the vertical door frames and facing 90 degrees from the plane of the door.
While keeping your feet planted, grab the door frame with two horizontal arms by pushing your hips away from the door - creating a ‘C’-shape with your body.
Repeat with the opposite side to stretch the left side quadratus lumborum.
Tips on technique:
Take a deep breath in before pushing out to the side
Slowly breathe out as you lean away from the door frame.
Suggested workout:
Hold the stretch from 10-20 seconds
Do 5 repetitions throughout the day if you are feeling tight.
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