Important Rehabilitation Exercises after Lower Back Pain
Rehabilitation from lower back pain should focus on re-training the Transverse Abdominis muscle of the core or abdominal region to work correctly during movement. The Transverse Abdominis plays a crucial role in spinal stability as it tenses in order to stabilize the spine as a person begins to lift their leg or arm during walking movements. However in Patients with Lower Back Pain, lower back stiffness or a history of Lower back ache, there is very often a delay in the activation of the Tranverse abdominis during movement. This delay in activating an important spinal stabilizer can lead to further lower back weakness and excessive vertebral mobility in the lower spine.
On-time activation of the transverse abdominis muscle reinforces the stability of the spine and indeed creates a corset-like stability in the lower back. Indeed if one pictures the muscles of the lower back and glutes (buttock region) and the backward pull that these muscles when bending backwards then they can understand the need for an opposite stabiliser on the front of the body namely the abdominal muscles of Transverse Abdominis, Rectus Abdominis and the Hip Flexors.
Strengthening of Spinal stabilizer
Under the guidance of your Physical therapist, the Transverse abdominis can be strengthened using an exercise breathing technique called the ‘Drawing-in Maneuver’ this involves drawing the naval or bellying button partially inwards towards the spine while continually to breath as normal. A visual analogy that a patient should use is to imagine that you are attempting to close the zip on the waist line of very tight fitting trousers, you will hold your belly button inwards in order to successfully achieve the task of closing the zip. Now in terms of an exercise, imagine that you have to draw or suck in your belly button inwards towards your spine with only a 30% effort (hence a mild drawing inwards of the stomach) and at the same time you are breathing normally.
This is something that you can practice by breathing slowly. A further addition to this technique is when you initiate a movement of the arm or leg, the patient should slowly exhale and draw the belly button inwards to the spine when commencing kicking a football and when swinging a golf club. This breathing technique to activate this important spinal muscle and with professional guidance can be performed in all lower back exercises prescribed by your Practitioner.
Tomás Ryan is a Registered Physical Therapist (MIAPT) with The Irish Association of Physical Therapy and is based in Clonmel & Thurles.
Contact Number: 0504 26672
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