Tuesday, April 25, 2017

Back Pain: a Simple Exercise to Help Prevent Back Pain & Strengthen Abdominals

November 8, 2010 by  
Filed under Fitness & Health

This is a simple exercise which can significantly help with low back pain or discomfort: We call it the Modified Squat, also known as Public Toilets.

A Feldenkrais Physical Therapist showed me this simple exercise for a client with severe back pain. It’s a great abdominal strengthener and can help alleviate back pain or discomfort.

The problem: often we get up from a chair without thinking about it and end up hauling ourselves up with our low back arched (in extension).  If we can consciously develop better form when rising, it may keep us from perpetually stressing (or even injuring) a tender back.  Creating muscle memory and achieving better form on rising provides significant benefits:

  • it brings us more “into our body,” which can improve proprioception (where am I in space?) and help to prevent falls
  • we can improve leg strength which can help our knees 🙂
  • we can recruit abdominal and gluteal muscles, which helps with core strength and balance
  • it can improve coordination

The exercise itself is highly functional – it’s basically getting up and down from a chair.   The breathing technique is the key to transferring back strain into abdominal exercise.

Starting position:

  • Stand in front of a sturdy arm chair.
  • Feel the front of the chair on the back of your legs.  This is a good habit to acquire if you have any balance and mobility challenges at all.
  • Feet and legs should be approximately hip width apart
  • Stand tall in neutral spine with relaxed (soft) knees.
  • The Breath: Always start with one full breath!  This sets your stage 🙂
  • Inhale through your nose, exhale through tightly pursed lips.
  • While exhaling, feel that your abdominals contract.
  • Actively pull in your belly button on the exhale, especially on this initial breath.

The movement, standing to sitting:

  • Inhale fully through your nose, feel fully present and erect
  • As you begin to sit and throughout the movement, exhale slowly through pursed lips
  • Hinge forward at your hips, aiming your bottom back as you slowly lower into chair
  • Try not to arch your neck
  • Knees aim in same direction as feet (either straight ahead or slightly out – not in)
  • Use your arms if needed – this works your triceps and can help you perfect your form
  • Try to keep your legs parallel.  If your knees move inward, this might be an indication of impaired leg strength.

The movement, seated to standing:

  • Inhale while seated, sitting up nice and straight, elongating your spine.
  • Throughout the rising movement, exhale strongly through tightly pursed lips.
  • Shift your weight forward, press into your feet,  and rise.
  • As you rise, imagine a little push upwards at the top of your hamstrings.  Push forward with your gluts (gently squeeze your bottom muscles )
  • Try looking where you want to go.  If you look at the floor you might follow your eyes and bow down as you rise.
  • Notice if your thighs stayed parallel.   Wobbly legs is a sign of lack of strength.
  • Inhale to fully standing in neutral spine
  • Pause standing, check your balance

Note:  Exhale with and through the movement, inhale to fully be in either standing or sitting positions.

Progressions:

  • Slower is harder.  Slow down when you want to work harder.
  • Cross arms over chest when you’re ready for more challenge
  • Vary your leg positions (always keeping your knees aiming the same direction as you toes)

Regressions:  Note:  this posting is for generally healthy people.  If you have serious trouble getting up and down from a chair, a visit to your physical therapist can work wonders.

  • If this is difficult, try a taller chair.
  • Scoot to the edge of the chair if you need help.    Especially if you bow down looking at the floor (locking your knees) to get out of a chair.   At this point, you’ll probably want to see your physical therapist for assistance with your form.
  • Speed up the movement slightly, work on fluidity vs. slow and controlled movement.
  • Make sure you use an arm chair initially.  This is much easier.

How many of these should I do?

  • An interesting and important question that you can apply to almost any exercise.
  • We want to do as many as will be beneficial
  • We don’t want to do so many that we risk injury.
  • Since exercise is progressive in nature – meaning that we can IMPROVE – we want to do enough to be challenging and MAINTAIN OPTIMAL FORM.
  • Each one of these chair up and downs is a rep (short for repetition)
  • When your form starts to “fail,” that’s enough for the set. You can rest a few minutes and begin again or do more in the next day or two.
  • NO PAIN!  Stop immediately if any discomfort.

Focus on your body mechanics on this exercise. Work to achieve muscle memory.  Muscle Memory is the ability to do a movement without having to think about it.  It might take you 20 repetitions or it might take you 2000.

Our favorite tip for creating muscle memory: give yourself a pat on the back whenever you do the movement.  When you forget, give yourself a pat on the back for remembering (albeit a little late).   You get do-overs!

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