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Real Life Nutrition Questions Answered

Real Life Fitness Questions Answered

Emma Brown
Nutritionist

Janet Aylott
Nutritionist

Kelly Marshall
Fitness Consultant

Q.

What exercises can I do with a back problem?

Hi, I posted a question on the forum and have received replies that suggest I ask you the same question. I am struggling to lose/maintain weight mainly because I am unable to walk for longer then 30-45 minutes at a time. This is caused by protrusions at the base of my spine and the suggestion is that these swell and then press on the nerves resulting in my losing sensation in my lower legs and feet. I am doing Pilates and have a Swiss Ball in order to strengthen my core muscles and lumbar region muscles, which is working, but I am unable to do the amount of exercise that I was doing previously. This included aerobics, step and boxercise, so I was quite fit and active and had been so for the last 15 years or so. I am looking for an exercise that will help me to lose/maintain weight (hopefully build up some sort of sweat!) but with low impact on my spine. The forum has suggested swimming, back stroke possibly. Do you have any other suggestions?

A.

Our expert says...

Hi,

 

It sounds like you have taken a very educated approach to training with your back issue! Pilates is a good option because it focuses on the principles of core stability, (the strength of the deep abdominal muscles), which improves our control around the lower back and hip area and helps maintain stable / aligned sacroiliac joints and minimise compression on vertebral discs.

A stronger 'core' allows the muscles that attach into the pelvis and lower back area to work better and helps to prevent muscle imbalances and pain due to tension in a muscle. Core training is the key focus when dealing with spinal issues to do with disc compression, as the balance and strength of the surrounding soft tissue directly affects the level of stress and potential vulnerability with the discs. This is why using a swiss ball is also an excellent decision!

Swimming may also be beneficial for increasing the strength and mobility around the pelvis area though this will depend on your particular swimming technique (quality of), so you will need to try it to see how it affects you. If you can swim with no pain then do a small amount, have 2 days rest and then do the same again. Repeat this for 2-4 weeks and if you do not experience aggravation then carry on! This trial and error method is going to be the best approach for widening the range of activities you can safely use to exercise without aggravation.

Try non-impact cardio machines (i.e. X-trainer, bike) to see if they are comfortable as an option but I would recommend you do some core training at the start of your session before trying the aforementioned machines to ensure your core muscles are switched on and provide optimum support to your spine as you then cardio train.

 

Over time, as your core gets stronger and stronger the range of activities (or the length/intensity you can do on them) may well increase so be prepared to reconsider options that at the moment may not feel comfortable.  With reference to the core/abdominal training you do, just consider the following teaching points to ensure the best adaptations to your efforts (this information is taken from a post I have previously answered for a person with a similar lower back issue):

 

“The best way to activate and improve your core muscles without aggravating your lower back  is by statically training the abdominals as the key function of the core muscles is to support and protect the spine in a balanced position all day every day, regardless of what we are doing. Try the following:

1) On a DAILY basis you need to be training your deepest abdominal muscles (transverse abdominals and pelvic floor) so practice the 'drawing-in manoeuvre' as often as you remember. You can do this anywhere (nobody will know!) and it is great to do when you're in a car or at a desk (i.e. any sedentary position), simply start by taking a breath in and as you do, draw your belly button in towards spine. You should feel a tension develop in your midrift (like you have put a belt on!), then as you breath out, keep your belly button drawn towards your spine and breath normally. Hold the tension for as long as you remember, although it wont be long to start with. The more you practice this manoeuvre the more automatic it will become. By strengthening your TVA and retraining it to automatically activate and stay where it should, you can visibly reduce the size of your waist as well as protect your lumbar spine in the long-term.

2) Practice an exercise called the plank which involves firstly lying in a prone position with your elbows underneath your shoulders. Ensure you activate your core using the drawing-in manoeuvre, (as described above) then lift your bum up off the floor till it sits at the same height as your shoulders. You should resemble a plank-type position with a straight back with your elbows, forearms and knees in contact with the floor. If you have your bellybutton pulled in towards your spine and have lifted your bum high enough off the floor you should feel a tension and demand placed on the abdominals but not the lower back . When you have this position then simply try to hold it for as long as you can. This exercise trains your core muscles to stabilize your spine and strengthen to protect against the overuse of the lower back  muscles.

NOTE: if you have a very weak core - which is very likely with chronic lower back pain  - then you may well feel your lower back  muscles help to hold your body in the plank position to start with. Do not work through it and focus on the abdominals and lifting the bum up towards the ceiling. This is NOT an exercise for your back  it is an exercise for your core muscles! When you reach a point during the exercise where you can feel the lower back  helping and can’t get the abdominal muscles to work any harder then that is the time to stop and rest! The plank can be performed on a daily basis with two sets of up to a 1 minute hold (work up to it!) being performed with 30seconds rest in between sets. You will notice a significant difference in the size of your waist as well as your chronic lower back pain  through this exercise. It is phenomenal!

With any exercise you do for your abdominals in the future, bear the following points in mind:

- do the drawing-in manoeuvre before starting the sitting-up part of the movement and aim to keep this activated throughout the exercise.

- As you curl up, try to pull your chest down into your stomach to encourage maximum contraction of your abdominals as opposed to the hip flexors.

- If doing a crunch/sit-up type movement - ensure it takes you 2 seconds to sit up fully and at LEAST 2 seconds to return to the floor. The faster you go with this technique the more likely you will use and strain your back.

  - Keep consciously trying to squeeze your stomach muscles on the way DOWN! If they relax on the way down your back will have to get involved! Try not to let your stomach muscles relax for the WHOLE set!”

Hope this helps

Kelly

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