Filed Under (Low Back Pain) by Rick Kaselj on 27-11-2011
I always get great feedback on back pain articles and today I have one on herniated discs.
It is a guest blog post from Sarah E. Rippel, BS, CPT. Enjoy and make sure to Facebook like this and leave us a comment or question. In the article she shares with you her back pain story. Even as fitness professionals, we get injured. We all have an injury recovery story and this is Sarah’s and the exercises she did to over come it.
A herniated disc, also referred to as a bulging or slipped disc, is an injury that can set back even the most highly trained individual. It can result from the effects of aging (as in degenerative disc disease), cumulative and repetitive disc trauma over time, or a specific, traumatic event.
The information presented in this article will focus on the lumbar region. If a herniated disc presses on a nerve, it can cause back pain or sciatica. If you are experiencing low back pain and/or pain down one or both legs, it is advised that you seek the help of a licensed health-care provider.
The goal of herniated disc treatment is to decrease stress on the spine. This is typically done utilizing exercises that improve core stability and posture, as well as those which correct muscle imbalances. Manual therapy and other modalities are often used in combination with an exercise plan.
Corrective Exercises for Disc Herniations
#1 – Hip Flexor Stretch
Kneel on a soft surface and bring one leg in front, placing the foot flat on the ground so the knee, positioned over the ankle, is bent at about a 90-degree angle. The back knee should remain on the cushioned surface and should be bent at a 90-degree angle as well. Slide the front foot forward a few inches. Brace the abs and squeeze the glute of the side that is being stretched. Shift the hips forward. The angle of the back knee should now be slightly greater than 90 degrees. Hold for 10 seconds and perform 5-10 repetitions, then switch sides.
For a version of the stretch that’s easier on the knees, try starting from a standing position. Take a big step backwards with one leg. Bend the front knee until it’s over the front foot while simultaneously shifting the hips forward. Keep the back leg straight throughout. Hold for 10 seconds and perform 5-10 repetitions, then switch sides.
#2 – Ham Stretch
Stand next to a bench or table. Lift your leg up onto the table so it is fully extended and straight. Rest your hands on the top of your upper leg for stability. Slowly lean forward, keeping your leg and back straight until you feel a stretch in your hamstring area. Hold the stretch for 10 seconds, then stand back up and rest. Perform 5-10 repetitions and switch sides.
#3 – Bilateral Knee to Chest
Lie on the floor, arms out to the side and knees bent. Slowly bring one knee toward the chest, then the other, aided by placing both hands on the back of thighs. Hold for 10 seconds and perform 5-10 repetitions.
#4 – Single Knee to Chest
From the initial position for the Bilateral Knee to Chest, slowly bring one knee close to the chest, aided by pulling with both hands. Hold for 10 seconds and perform 5-10 repetitions. Switch sides.
#5 – Pelvic Tilts
Lay on your back with your arms by your sides, your knees bent and feet flat. There should be a space between the floor and your low back. Inhale first, and then initiate the pelvic tilt movement as you exhale. When you let your breath out, your belly button should come toward your spine as you tilt the bottom of your pelvis up. This will result in your low back gently stretching and reaching in the direction of the floor. Inhale to come back to starting position. Perform 10 repetitions.
#6 – Bridges
Lay on your back with your arms by your sides, your knees bent and feet flat. Make sure your feet are hip-width apart. Push through your heels to raise your hips up, creating a straight line from your knees to shoulders. Squeeze your glutes and brace your core. If your hips sag or drop, lower yourself back on the floor. The goal is to maintain a straight line from your shoulders to your knees and hold for 20-30 seconds. You may need to begin by holding the bridge position for five-second repetitions as you build your strength.
(Above is a more advanced bridging version with the foam roller)
#7 – Iso Hip Flexion
Start in the same position as the Knee to Chest stretch. Draw both knees toward your chest until your thighs and torso form a 90-degree angle. Place your hands on your knees and try to move them closer to your chest, but resist with your hands so no actual movement occurs. Hold for 10 seconds and then relax, and perform 10 repetitions.
#8 – Safe Crunch
Lie on your back with your left leg extended. Your right knee should be bent and your right foot flat. Place your hands palms down on the floor underneath the natural arch in your lower back. Slowly raise your head and shoulders off the floor without bending your lower back or spine, and hold this position for 5 seconds as you exhale. Perform 5-10 repetitions and then switch legs.
#9 – Bilateral Knee Raise
Sit on the edge of a chair or bench with your knees and feet together. Lean slightly backward, keeping shoulders pulled back and chest up. Bring your knees towards your chest then extend them back out towards the ground. Perform 10 repetitions.
(If you want to know what exercises that I start my clients with that have a disc herniation, check out Core Stability of the Back.)
#10 – Air Bike (more advanced progression)
Sit on the edge of a chair or bench with your knees and feet together. Lean slightly backward, keeping shoulders pulled back and chest up. Bring your knees towards your chest then perform a pedaling motion. Make sure that you aren’t simply pushing the feet in and out, but forming a circular motion with them. Perform 10 repetitions pedaling away from you, and 10 repetitions pedaling toward you.
#11 – Accordions (most advanced progression)
Sit on the ground with your knees bent and feet flat. Your hands should be extended out to the sides and parallel to the ground. Raise your feet off the ground and bring your knees toward your chest. At the same time, bring your hands toward one another and exhale, pretending you are squeezing an accordion. Then extend legs out straight and parallel to the ground and extend arms out to the sides.
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Sarah Rippel has been helping people of all ages and abilities better their lives through improved health and fitness since 1995. She is a former fitness competitor and currently stays on track with her goals as a competitive triathlete. She is the owner and head trainer of Rippel Effect Fitness, which provides outdoor boot camps, small group/one-on-one training, and program design for beginning runners and triathletes. Her website is http://www.fitprosarah.com
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Big thanks to Sarah.
Great article with some great exercises.
Rick Kaselj, MS
Here are some other exercises that may be of benefit to you:
If you are looking for more on what to do with a client with lower back pain, I did a course that takes you through it all, call Core Stability for the Rehab Client :
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Structural Assessment and Corrective Exercise Program Design with Justin Price
