What exercises are the best to create strength and stability in the low back region? There is an on-going and evolving discussion on this matter. The short answer is, “it depends”. There may be some general guidelines that the majority of the population can benefit from but depending on your health history, results of a physical examination, x-ray or other imaging findings – the priority of what you need to do first might be different than someone else.
At the very basic core (no pun intended) of the discussion is the fine line between flexibility and strength. Often, these two features of any mechanical area of the body have an inverse relationship. Flexibility of a region might come at a loss of some stability/strength. It doesn’t always have to – but at extreme ends, this is what we commonly see in practice.
Few questions to ask first are:
1) Are you currently in pain? If yes, what structure(s) or tissues are causing the pain? This helps determine what your initial goal should be: immediately work on loosening a tight area or go straight to stability or strength.
2) Do the results of your physical examination suggest there may be some mechanical compromise that currently is not the source of your pain, but will definitely play a role in how your body will receive load when you exercise? For example, we will commonly find that hips, buttocks and hamstrings are often involved in patients experiencing low back pain. Sometimes, the mid back region can contribute to it. It might seem counter-intuitive, but working on areas away from the site of pain can often be an appropriate strategy.
3) What pace should you do these stretches and exercises and how should you increase progression? Should you lift heavy but not do it as often? Should you keep it light but engage with it everyday?
The vast majority of research currently suggests that prolonged static postures (whether sitting behind a desk or standing for long periods of time) are culprits in leading to fatigue and weakness in the lumbar spine. Generally speaking, compound movements like deadlifts and squats are a good recommendation. However, if you are not conditioned for exercise, it is a great idea to start with what we consider to be body-weight “foundational movements”. Refer to the videos available on our website to get a glimpse of what that may look like. ( www.kanatachiropractor.com/exercise-rehab )
It is also recommended that you engage in mobilization/stretches of the hips, hamstrings and buttocks as an over-all strategy to make your low back more resilient to stress/fatigue.
As always, an appropriate and thorough assessment by a chiropractor is recommended before you engage with any significant exercise program to make sure it is appropriate for you.
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