Exercise and Low Back Pain
For individuals with low back pain, some exercises help and some hurt your body’s progression toward better function and healing. A common problem is slippage, or spondylolisthesis, of the lumbar vertebra. In the before and after X-rays you can see a patient’s back with forward slippage of the L5 vertebrae. Sit-ups, and any other exercise that pulls on the front of the lumbar spine can have a negative impact on your progress.
The body uses the psoas muscle in order to bring the legs and the hip closer - hip flexion. Most, if not all patients with low back issues, have at least some dysfunction of the psoas. Attempting to use this muscle to do a sit-up can create more slippage and at the very least, aggravate the low back. Also be aware that hip flexion occurs whenever we sit down. The majority of individuals stay locked in hip flexion, where the Anterior Superior Iliac Spine, or ASIS, sits nearly horizontal to the sacrum on a side view X-ray of the low back.
Dr. Jeremy will work to re-engage the psoas by adjusting the misaligned segments of the lumbar spine and working directly with the muscle. He may address the bone that has slid forward by adjusting the vertebrae directly through the abdomen, returning it to a correct position.
Exercises that will stabilize the low back are front squats, box squats, and deadlifts with a weight that is manageable, and easily controlled. Stay away from Russian twists, rowing, and any other exercise that twists the spine with weight or focuses on bring the hip and leg together. The best exercises will focus on strengthening hip extension.