How to exercise for herniated lumbar spine? 6 exercises

Egor Khodyrev

fitness trainer

“The human spine consists of 32-33 vertebrae, separated from each other by cartilage layers – intervertebral discs. Thanks to them the back is mobile, which allows us to rotate, bend and straighten. They also absorb shocks and stresses that occur during walking, running, jumping and any other movement. Intervertebral discs can become damaged in any of the five spinal regions. This can especially occur with age, as the disc loses fluid and dries out over the years.”

The spine is divided into five divisions:

  1. The cervical division consists of seven vertebrae located in the neck.
  2. The thoracic section consists of 12 vertebrae located in the rib cage.
  3. The lumbar region consists of five vertebrae located in the lower back.
  4. The sacral region consists of five fused vertebrae located below the waist.
  5. The coccygeal region consists of 3-4 fused vertebrae at the bottom of the spine.

What we’ll tell you about

Intervertebral disc injuries

The intervertebral disc is made up of a soft inner part and a hard outer ring. Injury or damage that accumulates over time can cause the inner part of the disc to press on or protrude beyond the protective wall of the outer ring.

This can cause herniated discs, protrusions or other problems accompanied by back and limb pain, stiffness of movement, numbness, weakness in the arms and other unpleasant symptoms.

Cause of herniated discs in the lower back

The lumbar spine consists of massive vertebrae, they bear the heaviest loads. That is why herniation in this place is a very common phenomenon. According to the WHO, in 2020, lower back pain affected 619 million people worldwide.

The causes can be excessive physical exertion, spinal diseases, metabolic disorders, congenital features. Especially at risk are people who are overweight, weak muscles and sedentary lifestyle.

Most often hernias are found in the lower lumbar spine, especially between the fourth and fifth vertebrae, as well as between the fifth lumbar vertebra and the first sacral vertebra.

In most cases, this is due to aging and wear and tear on the disc. Sometimes herniated discs also appear in healthy people as a result of a blow, fall or any other serious injury. This can lead to a worsening of an existing herniated disc that has not manifested itself before.

Symptoms of a herniated disc in the lumbar spine

Your condition will depend on where the herniated disc is located and what nerve root it is pressing on. Here are some of the most common body signals.

  1. Back pain. Constant or periodic. The condition can worsen at night, with certain movements, coughing, sneezing, as well as with prolonged standing and sitting.
  2. Pain, numbness, burning, or tingling. May occur on one side of the body.
  3. Muscle weakness and impaired reflexes in the knee or ankle.
  4. Deterioration of bladder or bowel function.
  5. Sciatica. This is pain that starts in the back or buttock area and travels down the leg to the calf muscle or foot.

Important! Symptoms of lumbar disc disease can be similar to other problems, so always see your doctor for a correct diagnosis and appropriate treatments.

How to diagnose a herniated disc?

The doctor will conduct an examination, clarify the symptoms, find out when you first felt unpleasant sensations and what movements increase the pain. Next, the specialist will test muscle strength, nerve function, sensitivity and reflexes.

MRI is the gold standard for diagnosis, but it does not offer a 100% guarantee. Pain may not be related to the hernia, the presence of a hernia is not always accompanied by pain, so additional methods are used to find out the cause of pain and possible consequences.

  1. X-ray;
  2. myelogram;
  3. computerized tomography;
  4. electromyography;
  5. discography.

How to treat a lumbar intervertebral hernia?

Intervertebral hernias of the lumbar spine are treated by a neurologist and other specialists using different methods, depending on the severity and level of pain. The main goal is to remove the factors that caused the hernia, if any, as well as to eliminate pain, discomfort and other symptoms. The treatment plan is individualized.

Sometimes conservative treatment is enough, including massage, physiotherapy, wearing a corset, the use of anti-inflammatory drugs, painkillers, lifestyle changes. In more serious cases, surgical intervention may be required.

  1. Bed rest. Usually it is used in the most acute period.
  2. Weight control. Reducing excess weight helps to reduce the load on the spine.
  3. Mastering the proper mechanics of body movements. This reduces the likelihood of increased pain or disc damage.
  4. Therapeutic exercise to strengthen muscles.
  5. Physical therapy. It may include ultrasound, massage, shockwave therapy and other methods.
    Use of a back brace.
  6. Medications to control pain and relax the muscles.

Complex of exercises for herniated lumbar spine

The complex we propose is aimed at eliminating symptoms and alleviating the condition of herniated lumbar spine. These exercises can also be used as a preventive measure.

With a hernia, it is necessary to approach the training carefully, so as not to aggravate the condition. Do the movements smoothly and under control for 10-15 repetitions. Avoid sharp movements. If there are painful sensations when performing exercises, immediately stop the exercise.

Gluteal bridge

This exercise trains the muscles of the back of the thigh and buttocks.

Technique

  • Lie on your back. Bend your legs at the knees and rest your heels firmly on the floor. Place your feet at a distance of 20-25 cm from each other.
  • Pay attention to the position of the foot and knee joint. They stand flat under each other and do not collapse inward or outward.
  • Make a natural flexion in the lower back, and avoid strong flexion.
  • As you exhale, lift your pelvis up to a straight line with your back, holding at the top for one second or more.
  • As you inhale, smoothly and under control lower the pelvis to the lowest point. Keep the muscles of the buttocks and abs in a slight tension.

Quadroplex

The exercise strengthens the spine and cortical muscles.

Technique

  • Stand on all fours and distribute your body weight evenly on your arms and legs.
  • Make a natural bend in the lower back and lower your shoulders down. Also tense your abs.
  • As you exhale, simultaneously raise your right arm up and forward, and take your left leg up and back.
  • Hold this position for one second.
  • Avoid severe overextension in the lower back during the exercise.
  • As you inhale, slowly and controlled return the right arm and left leg to the starting position.

Twists on the abs

This exercise trains the abdominal muscles.

Technique

  • Lie on your back. Bend your legs at the knees. Make a natural bend in the lower back. Try to avoid a strong bend.
  • Place your hands on your chest or grasp your ears with them. This will eliminate unnecessary movements in the neck and take the load off the cervical region.
  • As you exhale, bend your torso, pulling your shoulder blades off the floor. Hold in the upper position for one second.
  • All movements are performed strictly due to the strength of the abdominal muscles. It is important that the lower back does not come off the floor during the exercise.
  • As you inhale, smoothly bend the body to the starting position.

Leg extension lying on your side

This exercise trains the middle gluteal muscles.

Technique

  • Lie on your side with straight legs, point your toes towards yourself. One hand can be placed on the floor, and the other hand can be placed under the head to stabilize the body and take the load off the neck.
  • As you exhale, slowly, without jerking, bring the straight leg up to an angle of 45 degrees or slightly higher, pausing briefly at the top point.
  • As you inhale, smoothly and under control bring the straight leg back to the starting position, pointing the toe toward you.

McGill curls

This exercise trains the abdominal muscles.

Technique

  • Lie on your back. Bend one leg at the knee and place it on the floor, and the other leg stretched forward.
  • Relax your neck. Place your hands on your chest or grasp your ears. This will eliminate unnecessary movements in the neck and relieve it of the load.
  • As you exhale, gently bend the body, pulling the shoulder blades off the floor and bringing the ribs closer to the pelvis. Hold in the upper point for one or two seconds.
  • As you inhale, slowly and under control, bend the body back to the starting position. Next, switch legs.

McGill side plank

This exercise trains the oblique muscles and gluteus medius.

Technique

  • Lie on your side, resting your left foot and left elbow on the floor.
  • Make a natural bend in the lower back and lower your shoulders down. Tense your abs. You can place your right hand on your shoulder.
  • Using your cortex muscles, hold the plank position on your side. Make sure that the body is level, and the pelvis does not fall up or down.
  • Hold this position for 5-15 seconds and repeat the same on the other side.
  • You can also perform a lighter version of the exercise with a knee rest on bent legs.

Recommendations when performing the exercise

Pace of Execution. Do the exercises slowly. Fast and sudden movements take some of the load away from the muscles due to inertia. This reduces the potential for strength and muscle growth. Also, sudden and uncontrolled movements increase the risk of aggravating an intervertebral disc injury.

Movement amplitude. Exercises that are too short in amplitude don’t load the muscles enough, and excessive amplitude can provoke injury, so perform the exercise at a set amplitude.

Load. Give preference to moderate loads and gradually increase the intensity of the workout. If you have previously trained in a strength training format, here is a different training format – more gentle. Avoid twisting or overextending the spine, as well as heavy loads on the lower back.

Stretching. Do stretching exercises for your back muscles, hips, and buttocks. This can reduce tension in the lower back area.

Breathing. When doing exercises, pay attention to proper breathing. Deep breathing will help relax your muscles and improve blood circulation.

Stopping for pain. If there are unpleasant sensations, it is necessary to immediately stop exercising and consult a doctor.

Exercise with a trainer. It is more effective and safer to exercise personally with a trainer or a doctor of LFC to master the correct technique of performance and pick up loads.

Contraindications

Properly selected exercises and adequate load favorably affect the health of the spine, but there are individual contraindications.

It is recommended to consult a specialist before training. Especially in case of cardiovascular disease, spine and joint problems, herniated and protrusion of intervertebral discs, obesity, some neurological diseases and osteochondrosis.

Grigory Dudin

doctor of physical therapy and sports medicine, therapist

“A herniated disc is not always the cause of back pain. A large percentage of pain is related to other problems. When exercising, you should not experience “those familiar” pain sensations during exercise, after exercise and the next day. You may feel mild discomfort up to 3-4 points on subjective sensations from 0 to a possible 10. Where 0 is no pain at all, 5 is a grimace of pain on your face, and 10 is unbearable pain. It shouldn’t be easy at all.”

Limit exercise if you have:

  • acute joint pain;
  • recent surgery or trauma;
  • infections;
  • high body temperature;
  • exacerbation of chronic diseases;
  • exacerbation of spinal conditions.
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