Many studies have shown that exercise is the key to decreasing back pain.
Performing back exercises in the home can be a little tricky, but can be done well with some creativity! It is so important for back exercises to be performed correctly with good control.
Treating a home care patient with back pain can be perfect example of teamwork. Along with the right back exercises, we can provide education in medication management, activities of daily living with good body mechanics instruction, and even cognitive assist for memory when needed. All these components can play an important role in a patient’s recovery!
These are a few of my favorite exercises.
Family Caregivers and Seniors: This is a general guideline for back pain that you can discuss with your health care team. Especially if you have back surgery, you must follow your physicians guidelines. Always consult a professional before beginning any new exercise program!
Stretching is important to loosen tight structures.
I recommend performing stretches lying down on a firm surface, a supportive mat on the ground is preferable. Check this one out that I recommend. (affiliate link)
Lying down, your spine is unweighted, and you are less likely to cause pain. Stretches should be slow (15-30 seconds) and gentle (no bouncing). Stretching should not cause significantly increased pain or pain radiating down your leg. I recommend 2-3 repetitions of each. Try deep breathing throughout to help relax muscles. If you cannot get up and down off the floor, use a bed with a firm mattress.
Hamstrings/ Calf: Lie supine (on back) bend both knees. Place hands behind one knee and pull knee toward chest (not the whole way). Gently try to straighten leg, while flexing ankle to stretch calf as well. Don’t force the motion! Repeat 2-3 times per leg if able.
Hips/ Glutes: Lie supine and bend both knees. Place right ankle on left knee. If able, grab behind left knee and pull left thigh in toward chest for a right hip stretch Repeat 2-3 times per leg, if able.
Front of hip/ quads: Lying on your side, bend both knees. Reach for foot of top leg and pull foot toward buttock, stretching front of thigh. Avoid twisting back while performing this! Repeat 2-3 times per leg, if able.
Tight muscles may put stress on joints contributing to pain, and stretching programs have been found to relieve pain. However, stretching muscles along with strengthening the muscles in your core, may be even more effective for decreasing stress and pain.
Stabilizing core muscles is important for stability and spinal joint protection.
I also recommend training core muscles for stabilization in a supine position to begin. Perform the exercises slowly, focusing on good alignment and control. I usually begin with 5-10 repetitions and encourage working up to 20 of each, several times per week.
Glute sets: Lie on back (or stand in good posture). Tighten buttocks and hold for 5 seconds. Rest. Repeat.
Lower Trunk Controlled Rotation: Lying on back with knees bent. Keeping abdominals tight, slowly roll knees partway (about 25 percent) to one side, tighten abs again, then slowly return them to center. Repeat rolling 25 percent to the other side and slowly return to center. You must keep abdominals tight, roll slowly and only 25 percent. (This is NOT a stretch where you roll knees to one side and hold!)
Hip Abduction: Lying on back with legs straight. Tighten abdominals, and slowly slide one leg out to side (about 12 inches) and return to center. Keep abdominals tight, and toe pointed toward ceiling (Don’t allow foot to roll out). Perform repetitions on one side, and then switch to the other side.
Strengthening exercises allow you to build control and protection through movement.
Once someone is able to achieve control with supine exercises, you should add standing exercises and progress to using bands or weights. Incorporating good posture and abdominal bracing with exercises is important. Another advancement would be to practise good body mechanics and tight abdominals while performing ADL’s (Activities of daily living). After all, the goal is not to be able to “perform 20 repetitions of an exercise”, but to re-engage in daily activities with less pain!
Cardiovascular Exercise is important for healing and pain reduction.
Cardiovascular exercise improves blood flow to increase healing of tissues. As well, it decreases pain by releasing pain reducing chemicals in your brain when you exercise! It may be more challenging to incorporate this in the home, but you could try walking laps through the house, or up and down the driveway, or using a pedaler, or a recumbent bike (with a supportive seat). Make sure to support the spine- with good footwear, proper assistive device, and good posture / alignment- with all activities.
Don’t be discouraged if you are not able to exercise at intense levels! Even physical activity that is low to moderate intensity, performed around 2-3 times per week, may still improve someone’s chronic pain symptoms (Ambrose, Golightly, 2016).
Back to the old saying, “Just Move”- but move with control, and purpose!
If you use this handout, you can add additional exercises or draw in stick figures if needed.
FOR ACCESS TO THESE AND MANY MORE EDUCATIONAL HANDOUTS PLEASE SEE MY PREMIUM RESOURCES PAGE!
Here is an handy list of Tips for Back Care that you can use for patient education. It is difficult for people to remember everything we teach them!
How do you help patients manage back pain or chronic pain? What would you add to their home program?