Natalie Thomas, PT, DPT, is a doctor of physical therapy and managing director of In Motion O.C. in Irvine, California. www.InMotionOC.com
Because we get so many e-mails from readers pleading for fresh information on back pain relief, we contacted postural specialist Natalie Thomas, DPT, of In Motion O.C., a physical therapy and fitness facility in Irvine, California. She told us that sitting for hours each day (as many of us do) can create major postural imbalances that lead to chronic back pain. “Muscles often shorten and atrophy when not used enough. Since muscles push and pull bones, these muscle changes can alter the way you stand and move and negatively affect the efficiency with which your body functions,” she said.
Example: Prolonged sitting shortens the hip flexors, the muscles in the front of the hips. When you stand, these shortened muscles change the position of the pelvis… so the spine, which connects to the pelvis, becomes compromised… the chain of imbalances continues up the spine to the neck… and the head juts forward as the body tries to balance itself. “The body was not meant to be in that position, so back pain is inevitable,” Dr. Thomas said.
If you have back pain: Try the postural exercise routine below. It is generalized to be appropriate for most people, but as with any exercise regimen, get your doctor’s OK before beginning. Each of the following exercises is designed to set up your body for the next one, Dr. Thomas said, so do the moves in the order given. For best results, do the 35-minute routine daily.
1. Static Back is a stationary stretch that causes back muscles to release while allowing the upper back to fall into extension (the opposite of contraction). Lie face-up in front of a sturdy chair, with your legs raised and buttocks close to the chair’s front legs. Bend knees to 90° and place calves on chair seat (feet should not hit back of chair), with legs relaxed and however far apart you find comfortable. Stretch arms straight out from shoulders to rest on floor, palms up. Relax entire body, allowing your lower back to settle into floor (do not force). Hold for five minutes.
2. Pullovers further encourage back muscles to relax into extension. Start: Get into Static Back position (see exercise #1). With knees close together (no more than two inches apart), buckle a belt around lower thighs… then press thighs outward against belt to maintain gentle but constant pressure throughout entire exercise. Move: Interlace fingers, palms together, and stretch arms straight up above chest toward ceiling. Keeping elbows straight, slowly lower arms until hands touch floor behind your head… then raise arms toward ceiling again. Repeat 30 times with a steady, controlled movement. When finished, remove belt.
3. Flexion Crunches strengthen abdominal muscles, taking pressure off your lower back. Start: Lie face-up with buttocks about six inches from a wall and place feet flat against wall, hip-width apart. Allow knees to bend at about a 60° angle so upper thighs are close to chest. Interlace fingers behind head… keep elbows back… gaze at ceiling overhead. Move: Keeping lower back pressed into floor, use abdominal muscles to lift head and upper shoulders straight up (not forward) four to six inches off floor as you exhale… then immediately lower yourself toward floor as you inhale. This move is called a crunch. Repeat 30 times at a moderate pace without resting between crunches… relax briefly… then do 30 more.
4. Kneeling Groin Stretch elongates hip flexors. Kneel on floor with knees several inches apart and upper body erect. Keeping right knee down, lift left knee and place left foot flat on floor about 24 inches in front of you. Place hands on left thigh… let hips sink forward and toward floor, keeping upper body erect (do not lean forward), to feel a stretch in right hip. Hold for one minute… repeat on opposite side.
5. Supine Groin Stretch aligns the hip, knee and ankle connection… elongates hip flexors… and helps release tightness up the spine. Begin in Static Back position (see exercise #1), except place only the left calf on chair… extend right leg and rest it on floor alongside the chair, with outside of right foot resting against a block or box so that foot and right leg do not roll out. Stretch arms along the floor, straight out from shoulders, palms up. Relax entire body and hold for 10 minutes… repeat with opposite leg on the chair.
6. Airbench strengthens the newly elongated hip flexors, fixing the pelvis in its new, healthier position. Stand with your back against a wall. Carefully walk forward as you bend knees and allow back to slide down wall. Continue until knees are bent to 90°. Feet should be hip-width apart and pointed straight ahead… heels directly under or slightly in front of knees… and entire spine and back of head pressed against wall. Hold for 90 seconds.