Best 4 gentle yet effective core exercises for lower back pain - Be My Healer
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Best 4 gentle yet effective core exercises for lower back pain

4 safe beginner core exercises for lower back pain

This post is for those who have pain in the lower back or pelvis region, or are currently living a sedentary lifestyle. I will show you the most basic exercises for lower back pain to kick-start your journey to recovery.

How to get from “moving my body is painful” to “I just held my body in a perfect plank for 3 whole minutes, I rock!”?

Let’s admit that whichever way you try is going to be a steep climb. However, the important thing is to know how to take the first step. You may not need to be a fitness expert before your back starts to feel better. After all, feeling better matters way more than the ability to pump out any number of  repetition exercises.

Exercise #1: Diaphragmatic Breathing

Target: Diaphragm. The diaphragm is the muscle separating our abdominal content from our chest content. It is also our primary breathing muscle, in theory. Why do I say that? Because patients who suffer from pain, stress, and chronic health issues, tend to “forget” the techniques to breath with their diaphragm. How does that affect the fitness of your body?

1. Our diaphragm muscle forms one of the walls of our abdominal cavity. A weak and flabby diaphragm makes it harder to hold pressure in the abdominal cavity. Remember seeing those air puppets at car dealerships? Those rely on air pressure to stay straight and standing. Pressure in our abdominal cavity helps protect our spine.

2. Breathing with our diaphragm allows our lung to expand fully and potentially absorb more oxygen. This is helpful for preventing lung infections and keeping our muscle and brain more energized.

diaphragmatic breathing
Diaphragmatic Breathing
  • Lying down facing the ceiling with both hands on stomach.
  • Breathe in through your nose while focusing on pushing your hands up with your stomach.
  • Then breathe out through pursed lips slowly while relaxing your stomach down.
  • If you have difficulty bulging your belly out and pushing your hands up, you have mostly likely been breathing with your chest. If that your case, this exercise is excellent for you.

Frequency: Try NOT repeating the breathing more than 10 times each set, to avoid hyperventilation and getting dizzy. I recommend this exercise at 3 sets of 10, three times per day for one to two weeks. The diaphragm is a big muscle and strengthens easily given the proper technique. Once you feel adequate with the exercise, you may stop doing it like an exercise, and start forming breathing habits by breathing deeply through your diaphragm three times to start your each of your tasks.

Exercise #2: Transverse abdominis (TA) muscle activation

Target: Transverse abdominis muscle (duh). The transverse abdominis muscle is one of the three layers of our abdominal muscles, commonly abbreviated as TA. Fiber of the TA muscle runs horizontally, making the TA muscle our built-in corset, bracing pressure directly inward, hence the nickname “corset muscle” as well. Same analogy of the air puppet applies here to increase the innate stability of our trunk and protect our spine.

transverse abdominus activation exercise

Source: hep2go.com

TA Activation
  • Lie down facing the ceiling. 
  • Fold up a face towel and place it underneath your lower back in the curviest spot. Use your fingers to feel for the bony angle of the pelvis, and then move your fingers slightly towards midline so that they are resting on the soft fleshy part of your lower stomach.
  • Bend your knees to relax your back and pelvis.
  • Now, pull your bellybutton in towards the spine, but do not straighten out your spine by pushing on the towel.
  • Hold this contraction for 10 seconds and relax. Repeat 10 times.

Two hints that you are not isolating the TA muscle. One is that you feel your back pressing into the towel underneath. Two is that you feel muscles bulging up into your fingers (these are different muscles).

If this is the first time performing this exercise, chances are that you are NOT isolating the TA muscle perfectly. And you may not get it 100% correct on the first day, or your third. This exercise is very very hard, not because it requires strength, but because it takes practice to achieve the precision.

So what do you do if you are not getting it perfectly? You keep doing it! And each time challenge yourself by perfecting it a little bit more. Meanwhile, keep up with the exercise because you are likely strengthening the TA muscle to some degree regardless.

If you are an overachiever or perfectionist, you have my permission to feel frustrated. But please do not give up.

Frequency: hold contraction for 10 seconds, repeat 10 times.  Exercise 1-2 times per day for one to two weeks to progress to a more advanced exercise.

Exercise #3: Bridging

Target: Glut max and some hamstring. Gluteus complex is an important muscle at stabilizing your pelvis and hip in almost everything we do with our body. When our gluteus complex is weak, large amount of control tasks are done in compensation through our lower back muscles, loading up our spine even more. Strong glut max prevents lower back muscle overuse.

bridging exercise
Bridging
  • Lie down facing the ceiling with your knees bent and feet supported on the surface comfortably.
  • Before you move, pull in your belly botton to activate TA (see above exercise), and squeeze your buttocks together.
  • Then, lift your bottom up towards the ceiling until you trunk and knee is in a straight line.
  • Then slowly lower your bottom down until it is placed back onto the surface. Relax TA and un-squeeze buttocks.
  • Repeat after brief rest as needed.

Frequency: 10 – 30 repetition as tolerated, 1-3 times per day for 3-4 weeks.

Note: If you experience pain during this exercise, especially during the highest point of the hip lift, you may try the following recommendations

1. Fold a pillow in half and place it between your thighs. Squeeze the pillow during the exercise to stabilize your pelvis more.

2. Only lift you hip as high as possible in the PAIN FREE ZONE.

3. If you have so much pain that you cannot lift your hip off the surface at all (given that you have already sought medical attention for this condition and are pretty sure that this is a musculoskeletal pain), simply start by squeezing your buttocks together and hold for 10 seconds, 10 repetitions, 3 – 5 times per day. This will provide some glut strengthening given your current condition.

Exercise #4: Clam Shell

Target: gluteus medius muscle. The gluteus med muscle is a very important lateral stabilizer. We, humans, live in a frontal plant dominated life nowadays. We walk, jog, and run in the front and back plane. However, the key to stabilizing your pelvis to allow better control of our back and pelvis is well-rounded core strength. This exercise is a very good starter exercise to get there.

clamshell exercise
Clamshell Exercise
  • Lay on your side (choose one, you will need to do it on both sides anyway). Ideally, you want to press your back and heel against a wall or furniture to prevent compensation.
  • Bend your knees 90 deg and place your foot so that they form a line with your trunk.
  • Then, without moving your trunk, lift your top knee off the bottom knee, while keeping your feet together.
  • Once you cannot move your knees further, slowly place it back on top of the bottom knee.
  • Repeat this exercise anywhere from 10 to 50 repetitions until you are tired and start feeling the burn in your hip. Switch and do the same on the opposite side.

Frequency: My personal preference is to encourage patients to slowly increase their clam shell exercise repetition over time, until they are able to perform 50 on each side. At that time, they will be able to progress to more advanced exercises in this category. So for starters, do clamshell at 1-2 times per day with repetition at your comfort level.

Note: if you have pain with this exercise, especially when the knee is lifted at its highest, you may try to decrease the magnitude of your movement by keeping your knee lifted (hip rotation) in the PAIN FREE ZONE. You do not need your knee all the way up to get good strengthening results with this exercise.

Recommended reading next: 3 effective hip flexor stretch for fast lower back pain relief

Thank you for reading, and I hope you find this post helpful.

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