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Lower back pain often results in inhibition (shutting off) of specific spinal stabilisers which is part of the reason why patients often complain they feel weak or that their back feels vulnerable. Reactivation exercises are important to ‘re-start’ those key stabilisers helping to further reduce pain, improve movement and prevent re-injury.
The side bridge and birddog exercises are excellent first options. They strongly activate many of the key spinal stabilising muscles but with low spine loading making them very effective but also extremely safe meaning that in most cases they can be introduced early into a patient’s recovery program.
NB: Reactivation exercises should be pain free and ‘felt’ in the targeted muscles. If the exercise pains or you are unsure whether you are performing it correctly, stop and check with your chiropractor.
- Start the exercise lying on one side on your knees, feet and forearms, with your hips and knees slightly bent (image 1)
- Your feet, hips and shoulders should all be in one line.
- Lift your lower hip up slightly and pull your lower shoulder down away from your ear so that your spine begins to straighten—this is the ready position (image 2)
- Move into the plank position raising your hips up and forward (image 3).
- Hold the position for 2 breaths before relaxing back into the ready position.
- Try and breathe into your stomach and the sides of your lower ribs rather than into your shoulders.
- You should feel the muscles on the bottom side of the trunk of the trunk working hard.
- Start on your hands and knees with your hands directly under your shoulders and knees directly under your hips. Think about ‘lengthening’ the spine.
- Maintain this trunk position as you reach out one arm in front of you (image 2)
- The goal is to only move from the shoulder, making sure your pelvis doesn’t drop or shift to the side and the lower back doesn’t arch as you reach.
- Hold this position for a few seconds before returning to the start position.
- To progress this exercise you can extend one leg behind you (leg reach – image 3)
- It can be advanced further by extending one arm and opposite leg (arm and leg reach – image 4)
- You should feel your core and hip muscles working, not your lower back.
- Whilst doing these exercises it is important to avoid the following:
- Poking your chin out
- Letting your shoulder blades stick out
- Rounding your mid-back
- Arching your lower back
- Dropping or shifting your pelvis to one side
- Holding your breath
These exercises have been shown to reduce ‘micro’ joint movements that trigger pain for approximately an hour or two after they have been performed. Therefore, in the early stages of recovery, perform them 2-3 times per day to reduce pain and enhance recovery.
Liebenson. C., Journal of Bodywork and Movement Therapies
This post was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey, Channel Islands. For more information about Steffen click here.