Exercise is one of the most significant ways we can increase our longevity, improve our health, and decrease our pain and suffering. Proper exercise can improve flexibility, increase strength, and even reduce back pain. Knowing the best exercises to improve your health or decrease your pain is essential to a workout plan or a pain management program.
The Back Muscles and Abs: Roles and Responsibilities
The bones of the spine provide the supporting frame for the back. Connected to this frame is an intricate system of muscles and ligaments that increase the strength and stability of the spine, arms and legs.
The abdominal muscles and back muscles are key components of this muscular network, and provide the strength to keep the body upright and for movement. When these core muscles are in poor condition, additional stress is applied to the spine as it supports the body, and back injury or back pain is more likely.
Goals of Back and Abdominal Exercise
Different abdominal and back exercises focus on the muscles that support the spine, which are grouped in three categories:
- Extensors (back and gluteal muscles). These muscles are used to straighten the back (stand), lift and extend, and abduct the hip (move the thigh away from the body).
- Flexors (abdominal and iliopsoas muscles). These muscles are used to bend and support the spine from the front. The flexors also control the arch of the lumbar (lower) spine, and flex and adduct the hip (move the thigh in toward the body).
- Obliques or Rotators (paraspinal (side) muscles). These muscles are used to stabilize the spine when upright. The obliques also rotate the spine and help maintain proper posture and spinal curvature.
Physical Therapy Programs
Two of the most commonly used back strengthening programs are the McKenzie Method and dynamic stabilization, both of which are typically learned by working with a physical therapist. The kind of program prescribed typically depends on the patient’s condition and needs, as well as the doctor’s preference and familiarity with an exercise program.
When appropriate, exercises from both the McKenzie Method and dynamic stabilization may be combined.
Strengthening through the McKenzie Method
McKenzie Method exercises are designed to alleviate back pain caused by conditions affecting a spinal disc, such as degenerative disc disease or a herniated disc. These exercises are usually less effective for pain caused by osteoarthritis in the facet joints and/or spinal stenosis.
One of the primary goals of the McKenzie Method is “centralizing” pain, through:
- Strengthening muscles around the spine, so pressure is removed from the facet joints and spinal discs
- Removing pressure on a nerve root, which reduces radicular pain (sciatica)
Dynamic Stabilization Exercises
The goal of dynamic stabilization exercises is to find and maintain the neutral spine—a natural posture that accommodates the spine’s curvature and minimizes stress. Maintaining the neutral spine in a healthy posture is achieved through muscle conditioning and a learned awareness of joint positions (called proprioception).
Dynamic stabilization includes a range of exercises that can accommodate nearly anyone. For more severe pain, it is usually recommended to start with an exercise such as leg raises that gently and gradually strengthen the low back and core muscles. More rigorous exercises may include pelvic tilts or exercises using an exercise ball.