Q: “One of my New Year’s Resolutions is to get back to the gym on a regular basis, but I have chronic back pain. What exercises are safe for me to do?”
A: One of the most common misconceptions physical therapists come across is that those individuals suffering from chronic back pain believe exercise will worsen their pain and symptoms. In reality, however, exercise is a large percentage of what these individuals need most.
Our bodies are extremely intelligent. When we experience pain, in this case in our low back, our first tendency is to avoid movements that aggravate the symptoms as a protective mechanism. Although this may be beneficial initially, the decrease in movement results in the muscles shutting down in a sense, and not performing in the manner we need them to. This further leads into what we call instability of the spine, which causes even more pain in the future. If our muscles around the spine are weak, we are unable to sit, stand, or walk for the periods we need to or lift the amount we need to daily. Exercising and stabilizing the low back, lower extremity, and core musculature is crucial to break this vicious pain cycle.
It is difficult to say which exercises are safe to perform without a formal evaluation conducted by a physical therapist, as all people are unique and require different exercise types and workloads. Physical therapists can identify one’s specific weaknesses, provide the most appropriate exercises for that individual, and ensure the exercises are performed safely. People with chronic low back pain need to perform exercises that increase the strength, firing, and endurance of the lumbopelvic stabilizers and hip and lower extremity musculature so the body can withstand the strenuous forces that are placed on the spine each day. A few examples of exercise you can do on gym equipment include the leg press, hip abduction/adduction, hamstring curls, and the row machine.
Aside from muscular strength, we all must also have a strong and healthy cardiovascular system to perform our daily activities. Aerobic activities such as biking, walking, and swimming are beneficial to everyone. Not maintaining a healthy weight will also further increase low back pain. A key point to remember is that a combination of strengthening exercises, aerobic activities, and a healthy diet are key to eliminating a person’s chronic low back pain and optimizing his/her quality of life.
Ask a PT is a monthly blog feature where physical therapists at PT Solutions Physical Therapy give their professional input on a popular patient question. Do you have a question that you’d like answered? Leave us a comment below!
About the PT
Jordan Brewer, PT, DPT is originally from Alexander City, Alabama and currently resides in Destin, Florida. From an early age Dr. Brewer was eager to work in the medical field and help others. After being a physical therapy patient himself during his teenage years following an orthopedic surgery, he knew he wanted to pursue physical therapy as a profession. Initially graduating from the University of Alabama with a Bachelor’s in Health Sciences, he obtained his Doctorate of Physical Therapy from the University of South Alabama. Joining PT Solutions in 2012, Dr. Brewer is currently a clinic director in Panama City Beach. He places a high focus on utilizing a combination of manual therapy techniques and therapeutic exercise to help patients with a variety of diagnoses including sports injuries and musculoskeletal, neurological, and vestibular disorders. Outside of work, he plays softball year-round and enjoys going to the beach, boating, biking, and paddle boarding.