BACK TO FITNESS
by Dr. Brian S. Seaman, DC, FCCSS(C), FICC
As another year goes by, there is the inevitable increased
focus on fitness as our thoughts turn to "getting
back into shape"!
There are many components to any fitness program
strength, flexibility and cardiovascular ("cardio").
The benefits of fitness and being "in shape"
are well known and also include an increased level of
energy and stress reduction.
One area which is often overlooked is fitness of your
back. We dont see our backs yet it is well known
that 80% of us will suffer a significant episode of
lower back pain at some time during our lives. Patients
usually only ask their health care professionals about
their backs, after they have had an episode of back
pain. It is quite simple really being that we
dont see it (our backs) we often forget
about it until it causes pain!
Caring for your back, is somewhat like caring for your
teeth. In between your dental check-ups, you brush,
floss and rinse, to decrease the possibility of cavities
and gum disease. The same analogy can apply to your
back. Exercising your back using a variety of stretching
and strengthening exercises, as well as ensuring that
a proper balance of the muscles is maintained, reduces
the possibility of back pain.
Unfortunately, most peoples interest in their
back exercise program is directly proportional to the
amount of pain which you are experiencing. Research
has shown that only 20% of patients continue with their
exercise program after six months.
However, it is important that you give this careful
consideration and I can assure you that the effort that
you put into developing and maintaining a good back
exercise program, will pay you benefits. It is important
to ensure that the various components of your exercise
program are in place. As I mentioned earlier, this would
include stretching, strengthening movements, and ensuring
there is a proper balance between the various muscle
Stretching exercises enhance the flexibility of our
muscle groups. By doing so, it improves your range of
movement, and can reduce the possibility of having muscle
"strains". As an aside, this differs from
a "sprain" which is a stretching type injury
to a ligament or joint capsule. Currently there is debate
within the health field, as to the benefit of stretching.
However, from a personal perspective, the benefits of
ensuring that there is a stretching component to your
back exercise program, is very important. There can
also be some very practical considerations to this as
we do tend to lose a certain degree of flexibility as
we get older.
Strengthening is also very important for the health
of our backs. There are a number of ways of doing this
including basic floor exercises which can be done at
home, incorporation of stability ball exercises to increase
core muscle strength, and a variety of resistance training
which can include hand weights, tubing, or specific
An important component of back fitness, is the concept
of balance. Most people think of balance as our coordination,
or ability to maintain our balance such as when standing
on one foot. However, ensuring that there is a proper
balance of strength, and flexibility, between various
muscle groups is important. For instance, back problems
can also develop as a result of a combination of weak
abdominal muscles (your stomach), tight back muscles
(the paraspinals or large muscles which run down either
side of the spine) and dominant hip flexors (for instance
your psoas which brings your knee up to your chest).
This combination causes the lower back to adopt a more
lordotic posture. A hyperlordosis or "sway back"
can increase the strain and compression on the posterior
joints or facets, of the spine. These small joints can
become restricted or hypomobile as a result of this.
This in turn can lead to what is referred to as mechanical
type back pain. Mechanical type back pain accounts for
upwards of 90% or more of back pain cases. Most people
think of "slipped discs" (they dont
actually slip) and "pinched nerves" as the
primary causes of lower back pain. Actually this is
not the case. Mechanical type back pain is often very
successfully treated with a variety of conservative
approaches (such as manipulation and exercise) which
you should discuss with your health care professional.
Exercises can also obviously benefit your cardiovascular
health by strengthening your heart and improving your
As we get older, exercise becomes very important for
the health of our "back bones", specifically
the bone density of our vertebrae.
It is well known that weight bearing exercises such
as walking, running and resistance training, enhances
the density of our bones. In other words it helps to
battle what is often referred to by patients these days
Years ago, "osteo" was only used by individuals
referring to "osteoarthritis". However osteoporosis
has become much more well known, and is a very important
factor with our health, especially with women, as you
grow older. Osteoporosis can create a lot of problems
in menopausal women. Be sure to talk about your health
care professional about this. A bone density study may
be indicated to establish your level of bone density,
and determine if additional approaches are needed such
as:Increased focus or modification of your exercise
program or activities.Pharmacotherapy or medication
prescribed by your family physician (ie. Fosamax, Didrical,
Actonel).Calcium supplementation with Vitamin D.
Exercise can be a valuable means of preventing, treating
and managing back pain. Dont ignore because you
cant see it
(the back that is)! Conservative treatment is often
the best approach to back pain surgery is seldom
needed. If you experience back pain, stop the activity,
ice the injured area and consult with your health care
FIRST AID FOR BACK PAIN
Ice is often the best choice it helps to reduce
the irritation and inflammation of the tissues (muscles,
ligaments and joint
capsules) as well as the small spinal joints (facets).
Think of a back injury like an ankle sprain would
you put a heating pad on an ankle sprain? Obviously
not! As a general rule, icing 3-4x/daily, for 15-20
minutes is beneficial. Be sure not to leave the ice
on too long as the body will shunt blood back to the
injured area if it is left on for too long. However
if your back pain is not responding, or getting worse,
be sure to consult with your back care professional.
If you develop leg pain, tingling or numbness, this
could indicate a disc injury.
Be aware of how activity affects your back.
Remember to exercise the muscles that support your back.
Stretch, strengthen and balance your back muscles.
Use ice not heat.
Dont ignore back pain.
Your back is very important to your health. Dont
ignore it if it sends you a message pay attention
and look after it!
Remember a healthy back is part of your overall
health and well being. Take care of it!
Active Woman Canada, January 2003
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