Simple stretches unlock freedom from back pain for the desk-bound
Sunday, Mar. 23
By Chris Marino
Low back pain is the third most common reason Americans visits their doctor behind skin disorders and joint pain. Twenty-four percent of the population complains of some sort of ache. What many people don’t take into account is their daily routine being the main culprit in causing and exacerbating their symptoms.
Many of our region's workers spend a significant portion of their day commuting to Northern Virginia. In the case of office workers, a major portion of time is spent sitting at a desk. While this is not the only reason for back pain, it is likely contributor.
People often hear that better posture would help with their spine pain, but how many actually understand the science behind this suggestion?
The idea of setting oneself in good posture is to align the vertebral column to place weight through the spine and surrounding structures correctly. A good analogy would be if the tires on your car are misaligned, you begin to wear down one side quicker than the other. The same can be said of the spine. If you do not sit and/or stand in proper alignment, increased pressure can occur where it should not, causing inflammation, irritation, and deterioration.
Placing oneself in a sedentary position for an extended period of time, like a car or in an office chair, causes the core musculature to turn off. Core musculature refers specifically to the abdominal and lower back muscles. With the majority of these commuters spending anywhere between nine and 12 hours a day in the seated position, the force of their weight has to be put somewhere.
The two most common reasons for poor posturing are decreased strength in core musculature and tension in the hip musculature. If the core muscles are not activated, then the weight of the body is placed through the spine, causing us to slump in unnatural planes, just like misaligning car tires.
If there is extra tension, specifically in the hip flexors, the muscles that raise your leg towards your body, and the hamstrings, the muscles that bend your knee, the pelvis may be pulled into the wrong position. This will then cause your spine to improperly align, adding to the stress in your back.
If you have pain while sitting, your hamstrings may be a contributing factor. When sitting, one should be able to maintain a curve in their low back in the direction away from the back of the chair. This is called “lumbar lordosis.”
To set yourself up for this position, both thighs should be flat on the chair you are sitting in with your backside touching the back of the chair. If you have difficulty setting yourself in this position, your hamstrings may be too tight to allow your pelvis to sit this way, and you should perform hamstring stretches daily until possible.
If you have more pain in your low back when lying flat or standing, your hip flexors may be the culprit. Due to the location of attachment, your hip flexors can cause an increased lordosis in your low back, putting excessive stretch through your low back. Keeping your hip flexors flexible and strong abdominal musculature can help keep your low back in good alignment and put the stress through the core where it belongs.
All stretches should be held for between 15-30 seconds. The reason behind this is when a muscle feels a pull, your body will naturally begin to contract the muscle as a safeguard to stop the muscle from tearing. The “hold” of a stretch is meant to allow the body to realize the muscle will not tear and it begins to relax. The relaxing phase is when the muscle begins to lengthen. This stretch must be held until the muscle begins to relax and lengthen.
When it comes to core strengthening, nothing beats the old fashioned sit-up. But a common mistake to performing them is the individual does not need to raise themselves up to their knees. When performing a crunch, the person should be lying flat on their back with their knees bent, feet flat on the floor.
Pick a spot about 6 inches above the knees and point both hands with arms straight at this point. Then lift the head, shoulders and upper back off the ground. There does not need to be a hold at the top, but all points do have to rise off the ground. Occasionally people will feel fatigue in the front of their necks when performing crunches. This is normal. Like the abdominals, the neck muscles will adapt and eventually not be bothersome with the exercise performance.
On the opposite side of the body from the abdominals are the low back extensors and gluteal musculature. They are meant to help stabilize the spine when flexing forward and returning to an erect posture. To exercise these muscles, a “bridge” works best for starters. Lie in the same fashion as a crunch, contract the gluteal musculature and raise the hips straight up. Try not to push through the feet, you will know you are if you feel the front of the thighs squeezing. The only muscles that you should feel tighten are the low back, gluteal region and hamstrings.
The number of crunches and bridges will vary depending on the individual. Remember the muscles have no idea what number they are on, just whether they can perform a repetition or not. Try to do as many as possible without sacrificing form. Once you find yourself adjusting to perform more, you are done with the exercise.
Try to bring each group of muscles to fatigue three times and count the reps. When you perform the exercise again, try to get at least one more total rep than you did previously. For instance, if you performed three sets of 10 reps, try to get at least two sets of 10, and one set of 11. If you can do more, have at it!
Stretches can be performed daily while the crunches and bridges should only be performed three to four times a week. Your body needs time between exercises to allow the muscles to grow and adapt. If you constantly provide a stimulus, they never get to rest and can become inflamed and irritated, known as overtraining. It does take six to eight weeks of consistent stimulus for muscles to change their structures permanently, so stick with it and you will see a difference.
It is normal to be mildly sore about 24 hours after performing the exercises. This soreness will last anywhere from 24 to 48 hours and eventually your body will adapt.
You should begin to notice a difference in your back pain within the first two weeks as your muscles begin to adapt to the new routine. If any of these exercises and stretches begin to increase your pain to uncontrollable levels, consult your physician.
Enjoy, have fun and remember that 15 minutes of exercise for 24 hours of pain relief is a good trade.
Chris Marino is a Physical Therapist with Blue Ridge Orthopaedic & Spine Center.
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