Are Back Problems Limiting Your Cardiac Exercise?

Cardiac Fitness Institute - London Health Science Centre - Ontario
2003

Low back pain is one of the most common complaints among adults in North America. It accounts for more lost person-hours than any other type of occupational injury and is the most frequent cause of activity limitation in individuals under age 45. In the U.S., it costs at least $ 16 billion each year and disables 3.4 million individuals. However, with exercise and being physically fit, we can decrease the likelihood of this problem from happening to us. But what if you already have this problem? While diagnosis and treatment of lower back pain are complicated, hopefully this article can help us all to have a " layman's " understanding of what pain to pay attention to, potential causes, treatments and reducing risk of future back problems.

It is important to not only pay attention to pain in the central part of the lower back but also in the buttock/hip area, in the back or outside of the thigh and down into the calf, even including "pins and needles" in the foot [pain that goes down the leg is caused by pressure on the sciatic nerve and is called " sciatica "]. If any of these symptoms persist, your family doctor should be notified for further testing.

Most low back pain is caused by prolonged overstretching of ligaments and other surrounding soft tissue. This pain produced by overstretching arises particularly when we develop poor postural habits. Whenever we remain in a relaxed position, be it standing, sitting or lying, prolonged stretching can easily occur. As well, severe overstretching, to the point of damaging soft tissue, can result from such things as the twisting motion of swinging at a tennis ball, shooting a slapshot in hockey or swinging a golf club. Strains from falls and lifting excessively heavy objects [especially when the legs are not used to do the lifting] can cause severe overstretching.

Treatments for low back pain vary from person to person and depends upon a number of other factors. One treatment could include taking such medications as ASA, Ibuprofin or Robaxicet/Robaxicil to reduce inflammation. Acupuncture, chiropractic treatment, therapeutic massage and physiotherapy are also effective. A relatively new approach is a specific regimen of self-treatment back exercises designed around the severity and location of your back pain [ a book entitled " Treat Your Own Back " by Robin McKenzie - this is an excellent educational tool for anyone suffering from low back pain ].

To minimize the risk of future back problems requires a few things from us:

1. We have to change our posture: sit as little as possible but if you must sit, choose a firm, high chair with a straight back and lumbar roll against your lower back. Avoid sitting on a low soft couch with your legs straight out in front of you. When getting up from a sitting position, move to the front of the seat, stand up by straightening the legs and avoid bending forward at the waist. Drive the car as little as possible; if you must drive, your seat must be far enough back from the steering wheel to allow you to drive with relatively straight arms. This holds your upper body back and prevents you from slouching. A lumbar roll should always be used when driving. If working in the garden, do so from down on all fours. If you have acute back pain, you should not lift at all! If you must lift, avoid awkward or heavy items and always use correct lifting techniques.

2. A firm mattress supported by a firm base such as a 3/4 " thick piece of plywood between the mattress and box spring or placed directly on the floor will help keep your back in neutral position while you sleep. Also, when getting up from bed, turn on one side, draw both knees up, drop your feet over the edge of the bed and push yourself up to a sitting position using your arms.

3. And last but definitely one of the most important is to strengthen the abdominal and lower back muscles specifically and increase overall flexibility [a " Back Exercise " handout is available by asking our staff]. It should be noted that non-weight bearing aerobic exercise on an exercise bicycle [especially a recumbent one, because it would help insure proper posture] or in a swimming pool, should not make an existing back problem worse - but you should seek direction from your family doctor on the matter first.

In conclusion, low back pain can seriously affect your ability to do aerobic exercise for your cardiac fitness. Therefore, it is very important that we pay attention to the early warning signs of the various pain locations that were mentioned above and seek medical advice as soon as possible. Doing this can help minimize the extent of the problem and the rehabilitation of your back problem can start earlier, thereby speeding recovery from your back pain and enabling you to resume cardiac fitness exercising with minimal downtime. Don't let back problems limit your cardiac exercise.

Resource Manual for Guidelines for Exercise Testing and Prescription 2nd edition - American College of Sports Medicine
Treat Your Own Back - Robin McKenzie

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