Back pain is a very common, yet tricky condition to recover from. Like many others, you may feel like you’ve tried every exercise, stretch, and medication without the relief you’ve been looking for. There are a million gimmicky things to buy that claim to get rid of your back pain, but unfortunately most of them are totally fraudulent. Thankfully however, through the application of exploratory Physical Therapy, we know what can really eliminate your back pain without unneeded surgery or gimmicks.

At Transform Rehabilitation, we use specific movement techniques, strengthening and stretching exercises to help decrease, and eventually eliminate back pain. Physical Therapy has been shown to be the most effective conservative intervention in treating back pain. The only tricky part with physical therapy is that not every person responds the same way to exercises and interventions, even if it helped somebody else with the same exact complaints. We can’t just give you a specific list of exercises to perform, and voilà, your back pain is cured. Physical therapists need do some testing and experimenting to figure out what works specifically for you.

Directional Preference

One way to determine what exercises are appropriate (specific to you) is based off of how your pain responds to certain repetitive movements. We use a technique called repeated motion testing to determine what movements your back prefers, and what direction we should be encouraging your back to move into. For instance, I’ll often tell my patients with back pain to perform a repeated prone press up just to see how their back pain responds to the movement. Then we look at the following.

Did your pain intensity increase, decrease, or did it remain unchanged? Also, it is important to know if your pain changed in it’s location or overall size. The way you respond to this repeated motion guides us to specific exercises that will help decrease your back pain.

Prone Press Up

How to do the Prone Press Up
•Start out by laying on your stomach (prone position).
•Inhale.
•Press up with your arms while keeping your back relaxed.
•Exhale at the top, allow your hips to sink further down, and hold position for a couple seconds.
•Slowly lower self back to prone position.
•Repeat.

Core Stability

Another important thing we look at is Core Stability. Many are unaware that Back Pain will instinctively:

• • Cause you to rest.
  • Make you avoid activating your core.
  • Be more sedentary to avoid increasing the pain.

Prolonged inactivity will cause your muscles to get smaller and weaker, even after only a few days. Most of the time a person’s back pain will feel better after rest, but their core will become weaker and will be more vulnerable for re-injury. If that person attempts to bend over or lift something heavy, they are at higher risk of injuring their back due to their weakness.

When we train our patients to re-engage the core musculature in order to get strong again, we focus on strengthening the four parts of the core:

• • the abdomen.
  • the lumbar musculature.
  • the diaphragm.
  • and the pelvic floor.

We assess each of these four components of the core to determine what needs the most attention to get stronger. Then we train to activate all four parts of the core equally during functional movements to ensure the risk for re-injury is reduced.  Remember, strengthening is not all about the weight!

So another one of the exercises we use to assess and strengthen your back, specifically the lumbar musculature, is the Lumbar Extension on GHD.

Lumbar Extension on GHD

How to do the Lumbar Extension on GHD
•Adjust the machine so the pad is placed directly under the pelvis/hip area when you’re in the starting position
•Ensure ankles are secure, and feet are in full contact with the plate.
•Start hanging over the pad with your arms crossed in a relaxed position.
•Begin by tightening your glutes and hamstrings and begin extending up with your lower back (lumbar region).
•Segmentally extend further up by using the upper back (thoracic region) until you are parallel with the floor.
•Lower yourself by relaxing your upper back first, followed by the lower back (lumbar) until you end in the starting position.

Spine Mobility

The third important area to assess and strengthen when somebody’s back is painful and weak is Spine Mobility. One of the first things that happens as a response to back pain is the trunk becoming stiff and ridged. This is a protective response to prevent pain and re-injury, but many people will accommodate to a more ridged trunk as their new normal.

One may think that a stiff trunk is a strong trunk, but don’t be fooled. Limitations in range of motion are usually an indicator for weakness and instability. Having full trunk rotation, flexion and extension ranges of motion is important, but even more important is being strong and having full control in all planes of your range of motion. Trunk/spine stretching to obtain all of your available range of motion and performing core stability exercises in every part of your range of motion is crucial to eliminate your back pain and reduce the chances of re-occurrence or incurring a greater injury.

Lunge with Trunk Rotation

How to Perform the Lunge with Trunk Rotation
•Assume a forward lunge position.
•Hold the lunge position and rotate trunk towards the leading foot.
•Slowly return trunk to forward position and step up to repeat on the other side.

The Hope – No Back Pain for You
The tests and exercises from a physical therapist will help assess and eventually eliminate your back pain. Some people can do this on their own, but most will need professional help. If you find yourself in need of some additional help, consult an experienced physical therapy professional in your local area. If that area happens to be the the Lehigh Valley, Transform Rehabilitation would be glad to help you get back to your normal, active life.

Talk to the Physical Therapists at Transform Rehabilitation. They can advise you on the most effective treatment for your back pain. For more details, visit our services page. To make an appointment, click here.