Stabilizing the Lumbar Spine During Common Low Back Exercises

Stabilizing the Lumbar Spine During Common Low Back Exercises

 

During a recent treatment of a patient recovering from lower back strain, she began the Straight Leg Raise exercise for hip strength and spinal stability.  The patient had been previously educated on core recruitment during activities.  However, during the Straight Leg Raise, she complained of difficulty controlling her lower back from moving.  She stated "It feels like my lower back is moving and unstable."  Even after providing manual cues to engage the core, she still had difficulty maintaining spinal stability.  That's when we incorporated shoulder isometrics during the Straight Leg Raise.  Here's what I had her do:

Initial performance without shoulder isometric

Straight Leg Raise with shoulder isometric

 

Having one knee flexed while raising the other leg helps to prevent flattening the lower back into the floor - This maintains more of a neutral spine position.  Prior to lifting the leg, press your hands into the medicine balls.  You will feel your trunk muscles 'engage.'  Follow this with the Straight Leg Raise.  This will help maintain spinal stability, and many times decreases lower back pain.  For a full rehab protocol on lower back pain, check out www.lowbackpainvideos.com 



Spine CPM Unit

Spinal CPM

 

Following a Total Knee Replacement, many surgeons will immediately place their patient's leg into a CPM or Continuous Passive Motion Unit in order to 'get the knee moving' so that functional range of motion may be reached as soon as possible.  Some surgeons are advocates of the CPM, while others avoid it.  As it is very common to see a knee or even a shoulder CPM unit, for me years ago it was not so common to see a Spine CPM unit.  However, the clinic I had worked for purchased one for more than $50,000 and used it for many of the patients suffering from lower back pain.  I initially used it but did not notice much of an improvement in my patients' progress.  Many of them actually felt worse.  As I studied more about treating lower back pain, I learned that although many of these patients have limited trunk range of motion, my goal should be to stabilize and strengthen their spine in the neutral position, while maximizing hip and knee mobility, rather than attempting to maximize their spinal flexibility.  Once the patient has progressed through stabilization and into endurance and strength training, then trunk flexibility may be focused on.  However, this is not the main focus and many studies even show that increasing spinal flexibility does not predict whether a patient will or will not have recurring back trouble.  My take home message is that for clients suffering from lower back pain, I must first work on trunk stabilization in the neutral position, and not be so concerned about their spinal flexibility. 

 

Check out this video on the Spine Six Biomotion Unit and let me know if you have had successful or unsuccessful experiences with it: Spine Six Biomotion.  You may also recognize the picture below, which is similar in concept, but was being sold to households.