You can easily find exercises for your low back injury on the internet with a quick Google search. These generic rehab exercises are the same ones you brought home from physical therapy, and even though they are needed to help you gain back strength and mobility, as well as, future injury prevention, they have their limits. For the most part, they’re the same exercises repeated over and over from different sources.
Low Back Injury: Not Every Body Is The Same
A quick side note about physical therapy
Physical therapy helps! As long as you give it a chance to. One too many times I’ve heard people tell me they have stopped physical therapy because they felt it wasn’t working. Some people expect to be 100% healed after a few weeks, some people feel like the exercises they do there, they can do at home, which for the most part never get done. Some people complete physical therapy, but physical activity ends there.
No one wants to be told that they can’t do certain things because of their injury. We want (and need) to get back to life as soon as possible. But it’s true that you’re limited to certain movements. You have to avoid putting too much stress on your spine, avoid bending your spine, twisting your torso, and so on.
Getting back on track
Your frame is different from everyone else. What might help one person may not help you, and I want to get into this a little deeper.
You already know that your core is the protector of your spine. Your core muscles not only need to be strong, but also needs to be flexible. A perfect balance makes perfect spine support.
Muscle synergy is extremely important. It means that your brain controls the balance and coordination of your agonist (main muscle involved in movement) and antagonist (supporting muscle involved in movement. They basically work as a team. Muscle synergy works throughout your entire body, but right now, we’re focusing on your spine.
So, for example, starting with the deep muscles in your upper body, there are two muscles that run along your spine; the multifidus runs along the side of your spine, and the semispinalis runs a long the middle of your spine. These muscles are triggered to activate by your brain to stabilize your low back before limb movements occur. These muscles work together with your pelvic floor and transverse abdominis.
Now, when you lift an object up from the floor you’re using your erector spinae muscle group (longissimus, iliocostalis and spinalis) located intermediate of your spine, your rectus abdominis is used to support those low back muscles. Specifically with the movement of bend and lift, your erector spinae is the agonist and your rectus abdominis is the antagonist. Which would seem like its automatically activating without you trying, but what is really happening is your brain is sending signals to your muscles when you’re performing the movement. When you have a weak core, its not doing its job to support your spine, and leads to injury. Which is why you see a lot of abdominal exercises as primary.
Depending on your lifestyle, your body might need some extra attention in one area rather than what is considered common among the back injury population.
With permission from both people, I want to give you quick examples of two clients I’ve worked with by just giving you the basics of what happened. Lisa (40) and Amanda (26). They have never met, but if they did they would quickly find the one thing they have in common, disc herniation. Both completed physical therapy, but both are still in pain. Common outcome of disc herniation, right? They still need to work, and get on with their life.
This is where they differ…
Lisa has had surgeries done on her back when she was in her 20’s. Not realizing that she had a serious low back problem, the condition was left untreated, and her injuries became a domino effect that lead to two emergency surgeries. Almost losing the ability to ever walk again, she went through the whole ordeal of rehabilitation.
Exercising was never part of her life before she got hurt, so even though her doctors suggested that she start, it wasn’t a priority. She did for awhile, but that ended quick. Lisa likes to push herself to the point where she would aggravate her low back injury, be out of commission for weeks, then once she feels better does it all over again. Which is why she never followed an exercise program.
Then there was muscle compensation. Lisa has trained her muscles to perform tasks they weren’t meant to do (remember muscle synergy). Throughout the years of compensating for her back, she has developed other issues. She had poor posture, and her flexibility was next to none.
Amanda never had surgeries because she took immediate action. She told me the second she felt that something wasn’t right with her back, she went to go see her doctor. She saw a physical therapist. After finishing that, she decided to hire a personal trainer that is knowledgeable about her condition. She didn’t stop, which is the key to recovery.
There were many times she had to cancel sessions because she was in too much pain, which is great that she knows her limit. The second she felt like she can continue with her sessions, she would.
Both women were considered obese on the BMI scale. So, part of rehabilitating their low back injury was weight loss. However, even though they had a similar issue, their bodies called for different remedies. Lisa had to take quite some time. Starting from scratch, her program consisted a mixture of physical therapy for all the new injuries including the hernations, a diet change, and a low intensity cardio routine.
Amanda was already working out here and there. She was able to work on the elliptical for her cardio routine, and low intensity aerobics. Because she recently finished her physical therapy sessions, she was able to move on with progression exercises. Her diet has changed as well.
Every person’s body frame is different. You might need to focus on a different group of muscles than the person who has a similar injury. Your lifestyle plays a huge role. What type of work you do, whether or not you’re active when you get home, you might have a hobby that requires at least some physical activity. What might have worked for one person might not necessarily work for you, and that can easily make a person give up and feel like there is no hope, but I promise you there is a light at the end of the tunnel.