Simple Back Exercises Performance

Another article has covered the goals and rationale behind setting and observing a lumbar exercise programme and in this article I go over the specifics of lumbar exercises and their performance. Exercise performance varies greatly between patients but the aim is smooth movement with steadily timed motions, moving through the full ranges and holding at the end of the movements for a short time. Pain is to be expected to some extent with exercising but this should not be more than moderate nor should it last for too long afterwards. Successful exercise programmes involve daily repetition over a long period.

Pulling one leg to the chest

Lying down on the bed, get hold of one knee and pull it up towards the chest, holding it at the full bend for a short time. Keep the other leg flat down. This exercise mobilises and stretches the sacroiliac, hip and low back joints, muscles and ligaments.

Both knees to chest exercise

Lying on the back, pull both your knees up to your chest, holding the top position for two seconds. This exercise stretches the hips and sacroiliac joints less than the previous one but increases the flexion stretch on the lumbar spinal structures.

Stretching in the Child Pose

This pose stretches out the whole of the spine by using the bodyweight to stretch the back out over the bent thighs in a kneeling down position, ending up in a curled up position with the face near the ground.

Full Squats

Because the bodyweight is used to stretch out the low back structures in this movement the effect is mechanically more severe and should be done only on advice from a professional therapist or after the easier exercises have already been performed. Advice is typically to perform extension movements after an prolonged time of sitting but end range flexion can also be useful to flex the lowest spinal segments.

Use a block under your heels if you need it to maintain your balance and then deep knee bend until you are in a full squat. The lumbar spine will stretch at the bottom of the movement as you let it go, performing the movement for a half minute at a time.

As this is a relatively severe exercise it would be useful to work at the earlier flexion exercises in lying first before tackling this.

Lying on the front

Sometimes the ability to extend the lumbar spine is restricted and then prone lying, lying on the front, is a useful starting exercise as even this can stress the joints when they are stiff. The back is more extended in this position that it appears on the surface.

Elbow supported prone lying

A progression from lying on the front is to get the patient to support themselves up on their forearms to increase the extension stretch on the lumbar spine. The lumbar spine is placed in greater extension than prone in this position, stressing the tight structures and forcing them to give.

McKenzie Repeated Prone Extensions

McKenzie technique is a form of manipulative treatment at affecting disc dysfunction and derangement. Lying on the front with the hands placed near shoulder level, the patient pushes until their arms are straight whilst leaving the pelvis down on the bed, involving a significant lumbar extension.

This exercise can be aggravating as it is a strong passive extension movement, so physiotherapists test the exercise carefully to make sure there is a positive response before recommending it.

Knee roll exercise for rotation

Lying flat on the back with the knees bent and the feet on the surface, the knees are rolled side to side whilst being kept together. The movement is taken as far as the joints will comfortably go and a little further. The lumbar spine has very limited rotation but other spinal structures may be restricted and respond to movement.

Lumbar Rotations " Manipulation

Stretch Lying on the back, the hip is bent up so the person can hold the knee with the opposite hand. Leaving the shoulders flat on the bed, the knee is pulled across the body by the opposite hand, stretching the low back. The knee can be pulled right over for a large lumbar stretch but preparatory work would be wise for most people.

Autor: Jonathan Blood-Smyth

Jonathan Blood Smyth is a Superintendent of Physiotherapy at an NHS hospital in the South-West of the UK. He specialises in orthopaedic conditions and looking after joint replacements as well as managing chronic pain. Visit the website he edits if you are looking for Physiotherapists in Windsor

Added: February 19, 2009
Source: http://ezinearticles.com/