Whilst the short answer is - loosen off tight hamstring, buttock and hip flexor muscles and embark on a serious all round body strengthening program - the longer answer may provide you with a better understanding of why you need to do these exercises to relieve back pain.
A few weeks ago I unsubscribed from a medically-oriented back pain forum because I thought that most of the information supplied by regular writers was unhelpful.
In answer to the question, 'What's the cause of back pain?' most of the correspondents made statements like this one:
'... there is a central disc protrusion with a focul annular tear... facet joint arthropathy and ligamentum flavum hypertrophy... there is a disc bulge which is paracentral to the left side and extended in to the foramen and far laterally... there is mild crowding of the cauda equine... .
Whilst it's all well and good to know what's going on in your back, we need to go back a stage and find out what has caused the 'central disc protrusion with a focul annular tear... facet joint arthropathy, ligamentum flavum hypertrophy... and disc bulge.'
Few people in the medical industry know where to look.
An X-ray is useless. It just tells you what's happened. It doesn't tell you why it's happened.
Neither will the radiologist nor the doctor tell you that you've generated the problem yourself. The incident that brought the problem to a head - lifting a bag of groceries into your car, digging in the garden, sneezing... will get the blame, but we all know that normal healthy human beings are designed to put groceries into cars, dig the garden and sneeze without collapsing in a screaming heap.
It's highly likely that what's happened over the weeks, months, years and decades, as muscles have gradually tightened and become weaker, bones have moved out of alignment. That's why it's a personally generated dysfunction. It's why rubbing, crunching, heating and vibrating the spot where it hurts isn't going to lead to the permanent restoration of poor function to good. These activities are not related to what really needs to be done.
And when bones are out of alignment it only takes an incident of minor proportion to tip you over the edge into 'central disc protrusion with a focul annular tear... facet joint arthropathy, ligamentum flavum hypertrophy... and disc bulge' territory.
Q. So what is the underlying cause of a high proportion of back pain?
A. Vertebrae that are out of alignment.
Q. Why are vertebrae out of alignment?
A. Usually because the pelvis is out of alignment.
Q. Why is the pelvis out of alignment?
A. Because tight muscles - usually hamstring, buttock and hip flexor have pulled it out of alignment.
Q. Why are these muscles tight?
A. Tight muscles come with decades of sitting down for long periods of time, often with a poor posture - and without a flexibility training program. Just doing a few yoga exercises every couple of days would be enough to stop it from happening.
Unfortunately, most therapists will get straight to work rubbing, crunching, heating and vibrating at the spot where it's painful and forget to give you a good flexibility training program for the muscles further down the body that are causing the problem.
Plus people get a warm feeling in their singlet when they've been rubbed, crunched, heated and vibrated. It feels like it must be doing them good. They love someone to do something to them, even if they're better off doing something to themselves.
A physio might get you to do the cobra yoga pose (masquerading as the McKenzie exercise). The doctor might tell you to lie on your bed and bring your knees up to your chest. Both exercises are useful but miss the point, which is focusing on loosening of hamstring, buttock and hip flexor muscles.
So when it comes to lower back exercises always keep in mind that the underlying cause of the pain it rarely located at the site of the pain. You need to loosen off hamstring, buttock and hip flexor muscles.
You also need a good, all round body strengthening program - situps, pressups, squats and the Superman back arch. You can do that at home.
If you go to a gym three times a week and spend 40 minutes pushing and pulling weights, so much the better.
In the meantime stay tuned, highly tuned and remember that when it comes to lower back exercises, the key ones are those that loosen off tight hamstring, buttock and hip flexor muscles.
John Miller
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