In rehabilitating the lower back from pain, it is very important to restore full range of motion to an injured or unstable area of the body before starting on a strengthening program. Long term back pain is not only caused by unstable muscles of the core unit, but also due to stiff and inflexible joints and muscles. It makes sense to address this issue with equal importance.
At Hinterland Physio, we have designed a ‘Better Back Program’ – a back rehabilitation program that consists of patients completing 4 stages:
Level 1 – Spinal Mobility and Alignment / Cardiovascular Fitness – increase flexibility, range of motion, and general fitness.
Level 2 – Strengthen Inner Unit / Cardiovascular Fitness – increase smaller core muscle control, and general fitness.
Level 3 – Strengthen Outer Unit / Cardiovascular Fitness – strength of larger muscle groups, and more advanced and specific exercises for fitness.
Level 4 – Maintenance of core stabilization – more advanced exercise program to allow return to work or sporting situations.
Before commencing the program, patients complete a form detailing what activities of daily living are affected due to their pain. This is monitored throughout the program. A number of flexibility and strength tests are also done at the start of the program to monitor the gains made throughout the program.
In all stages of our better back program, an important component for the low back pain patient is to commence and maintain some cardiovascular fitness throughout the program. Reasons for this are: improve oxygen consumption, set up new neural pathways that may override previous pain pathways, increase overall health and wellbeing for the patient. The type of cardiovascular training is decided by the individual patient and therapist, just as long as it is enjoyable for the patient which will increase the likelihood of higher compliance. Cardiovascular training could involve walking, cycling, swimming – as long as there is an elevation on heart rate.
Research on lower back pain has found that exercise and rehabilitation for chronic lower back pain is effective. Great care is taken from our therapists when deciding to progress a patient to the next level of the Better Back Program. Progressing to the next stage too early is one of the most common reasons for program failure.
If you would like to know more about our “Better Back Program”, and increase your core strength and reduce your lower back pain, please speak with one of our physiotherapists at Hinterland Physio, and we will explain in more detail the 4 levels of the “Better Back Program” and how you can start using this program now. If you have tried a similar type of program before, we will also explain why your current core stability program may not have worked and possibly increased your pain.
Your comments on this topic are most welcome.