Back pain is the most common thing we see here at Dynamic Osteopaths, and we understand that back injuries can happen for many different reasons. Some of these reasons include poor lifting technique or as a result of an traumatic accident.
Back pain and back injuries have varying degrees of severity, fortunately with the majority getting better and recovering with specific treatment and rehabilitation, without the need for invasive surgery. It goes without saying that corrective treatment and rehabilitation is a crucial aspect of spinal health to ensure correct posture, spinal stability, movement and control awareness and dynamic muscular strength controlling and protecting the spinal structures.
We have all heard the term ‘core strength‘. The core is comprised a group superficial and deep muscles that surrounds the spine to support and stabilise. These muscles transfer and receive forces between the upper and lower limbs. This is why yes of course it is important that core strength is there for support and dynamic control.
When rehabilitating the spine, there are principles that are important and needed to ensure full recovery.
When the acute pain has subsided and you are cleared for back rehab exercises, increasing core strength and dynamic functional stability is vital to the management of back pain and back injury prevention. This will incorporate re-education of movement patterns with better spinal awareness and stability.
Now let's go over the following phases of rehabilitation progression following back injury.
Phase 1 – Spinal Stability and Mobility
Phase one integrates basic exercises to bring gentle stimulation, awareness, strength and stabilisation. It is essential that these exercises, which build the foundations for the core muscles, are completed during the sub-acute phases before progressing.
Pelvic Tilts
Purpose: to learn anterior and posterior tilting of the pelvis and spine. This basic move develops stimulation of basic posture muscles of the pelvis and low back.
Perform: lie on the ground with feet flat to the floor. Place fingers on the hip bones and then learn how to tilt the pelvis toward the ribs, flattening the lower back into the ground. Hold for 2 seconds and then tilt the pelvis away from the rib cage, feeling the lower back lift off the ground. Hold and continue this motion. Practice for 60 seconds.
Leg Slides
Purpose: this exercise increases core stability while extending a leg. It also helps to maintain a neutral spine while providing a functional movement.
Perform: lying on upper back, place hands on the hip bones and engage a neutral spine. Then keep feet on the ground with knees bent at 90 degrees. Engage the abdominals, then extend your right leg and slide the heel along the ground. Return to the starting position and, while maintaining engagement, slide the left heel along the ground. Continue this motion for 6 reps on each leg.
Hip Bridges
Purpose: to engage and strengthen the posterior (rear) muscles of the back, hips and legs.
Perform: lie on the ground with hands next to your sides. Then heels on the ground, knees bent at 90 degree. Push your hips into the air while keeping the feet and the shoulder blades lengthened into the ground. Hold and brace for 2 seconds.
Supermans
Purpose: this exercise provides stability while engaging and strengthening core and hip muscles.
Perform: stand on all-fours position, with the hands under the shoulders. Extend the left leg behind and extend the right (opposite) arm in front (making salute). Keep the abdominals engaged and stabilise the left shoulder. Hold for 10 to 20 seconds and repeat on the opposite side.
Modified Side Plank
Purpose: This move strengthens the obliques and increases shoulder-blade stability and strength.
Perform: come onto the side of the body. Bend the bottom knee and arm 90 degrees. Lift the hips off the ground and keep the right shoulder stabile. Lift the left arm overhead. Hold for 10 seconds and repeat on the opposite side. Progress to legs straight.
Phase 2 – Movement
Phase 2 integrates more dynamic movement and includes progression of stability once phase 1 has been mastered.
Stability leg raises
Perform: Sit on top of a stability ball. Place your hands on the hips and raise one leg. Hold this pose for 15 seconds and then swop legs.
SIngle leg drops
Perform: Lie on the floor with a neutral pelvis. Engage the core and lift both feet, the knees kept at 90 degrees. Then drop one leg to the heel touches the floor, and alternate each leg. Core engaged throughout
Single leg bridges
Perform: Lie on the ground and lift the hips into a static bridge pose. Stabilise the core and glutes as you lift the right knee toward 90 degrees, to a point where the shin is parallel to the ceiling. Release the foot and lift the leg. It is essential to maintain a neutral pelvis without allowing the hip to drop. Continue this motion for 10 reps.
Dynamic superman
Perform: Assume an all-four position, with hands under the shoulders and knees hip-distance apart. Extend the left leg behind and flex the foot. Make a salute with the opposite arm. Keep the abdominals engaged and stabilise the left shoulder so the shoulder blade. Maintain core stability and draw the elbow and knee toward each other and then extend the limbs. Complete10 reps and then switch sides.
Dynamic superman with Thoracic Rotation
Perform: Adopt the position from above and the rotation elbow in towards opposite wrist. Perform this movement for 10 and then swop sides.
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