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Post-Injury Exercise

Is Exercising Safe for Those with Back Pain?

Many people with back pain don't know whether it is safe to do exercises or if exercises will worsen their condition. It all depends on the cause of the back pain.

Exercising after Acute Back Injury

In the case of a sudden back injury, back exercises (except for gentle stretching exercises) are usually best started after the majority of back pain has resolved.

When back pain is caused by a sudden injury, maintaining day-to-day activities is usually recommended. Back pain from a sudden injury such as a fall or lifting something heavy usually involves injury to soft tissues (muscles, ligaments, discs). Be sure to see a physician after a sudden back injury to rule out more serious injuries such a fractured vertebra.

Bed Rest for a Couple of Days Only: Muscles go into spasms at the site of an acute injury (triggered by inflammation). Muscle spasms restrict movement to protect the body from further injury. Muscle spasms may cause intense pain. For the first couple of days after an acute back injury, lying on a firm surface may be helpful in relieving muscle spasms and pain.

After a couple of days, bed rest is counterproductive. It is important to maintain day-to-day activities, as bed rest will not speed up recovery and prolonged bed rest causes wasting of the muscles and bone loss. Weakened muscles make recovery more difficult.

Get up and get moving as soon as possible. Increase activity slowly. Try to get up and walk around the house a little. Do a little more every day. Walking activates the core - the muscles that support the spine are used just keep your back upright.

*If you have back pain you should consult a doctor or physical therapist before starting back exercises.

Start with gentle stretching exercises. Stretching exercises for the back increase circulation to the muscles to speed healing, relieve tight muscles and back pain, and help increase mobility. A warm shower or bath before exercising will loosen up tight muscles and ease pain, making the exercises easier to do.

Moderate, low-impact aerobics such as walking and swimming (swimming is actually no-impact) can usually be started before the back pain has totally resolved. Walking tones and increases the endurance of the core muscles (lower back, abs, hips, and buttocks) and legs. Walking, being a weight-bearing activity (body weight supported by legs), also helps maintain bone density in the lower back, hips, and legs. Aerobic exercise also increases circulation and the amount of oxygen in the blood, which aids in healing. Stay away from high impact activities until you have completely recovered from a back injury and introduce them slowly.

When you have sufficiently recovered from your back injury begin strengthening exercises that target your core muscles (as recommended by your doctor or physical therapist). Stronger back, abdominal, and buttocks muscles (muscles that support the spine) improve posture and increase core stability, which reduces the chance of injury and recurring back pain. Do strengthening exercises regularly to maintain strong muscles. See Back Exercises page.

Until back pain is gone, avoid exercises that put pressure on the lower back, such as leg lifts done in a face down position. If you are unsure as to what exercises are safe, a physical therapist can create a personalized exercise program for you to follow.

Exercising with Chronic Pain

In most cases, back exercises are safe for those with chronic back pain. Exercising is beneficial for various conditions causing back pain, even osteoarthritis of the spine. Always check with a doctor or physical therapist as to which exercises are appropriate for you to do.

Fear of injuring the back or worsening chronic back pain may lead to an avoidance of exercise or physical activity, leading to deconditioning of the core muscles. Weakened core muscles contribute to poor posture and a decrease in core stability and increases the risk of back injury and chronic or recurring back pain. Strengthening the muscles that support the spine, particularly lower back and abs, increase core stability and can prevent back pain from recurring.

Tip: Warm water exercises are particularly beneficial for those with osteoarthritis. Warm water increases circulation, speeds healing, relaxes tense muscles, and eases pain, which makes the exercises easier to perform. Many public pools offer warm-water exercise classes.

If you have back pain you should consult a doctor or physical therapist before starting back exercises.