Exercises that stretch and strengthen the muscles of your abdomen and spine can help prevent back problems. Strong back and abdominal muscles help you keep good posture, with your spine in its correct position.

If your muscles are tight, take a warm shower or bath before doing the exercises. Exercise on a rug or mat. Wear loose clothing. Do not wear shoes. Stop doing any exercise that causes pain until you have talked with your healthcare provider.

These exercises are intended only as suggestions. Check with your healthcare provider before starting the exercises. Ask your healthcare provider or physical therapist to help you develop an exercise program. Ask your healthcare provider how many times a week you need to do the exercises.

Caution: If you have a herniated disk or other disk problem, check with your healthcare provider before doing these exercises.

EXERCISES

· Standing hamstring stretch: Put the heel of one leg on a stool about 15 inches high. Keep your leg straight. Lean forward, bending at the hips until you feel a mild stretch in the back of your thigh. Make sure you do not roll your shoulders or bend at the waist when doing this. You want to stretch your leg, not your lower back. Hold the stretch for 15 to 30 seconds. Repeat with each leg 3 times.

· Cat and camel: Get down on your hands and knees. Let your stomach sag, allowing your back to curve downward. Hold this position for 5 seconds. Then arch your back and hold for 5 seconds. Do 3 sets of 10.

· Quadruped arm and leg raise: Get down on your hands and knees. Pull in your belly button and tighten your abdominal muscles to stiffen your spine. While keeping your abdominals tight, raise one arm and the opposite leg away from you. Hold this position for 5 seconds. Lower your arm and leg slowly and change sides. Do this 10 times on each side.

· Pelvic tilt: Lie on your back with your knees bent and your feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. Hold this position for 5 seconds, then relax. Do 3 sets of 10.

· Partial curl: Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles. Tuck your chin to your chest. With your hands stretched out in front of you, curl your upper body forward until your shoulders clear the floor. Hold this position for 3 seconds. Don’t hold your breath. It helps to breathe out as you lift your shoulders up. Relax back to the floor. Repeat 10 times. Build to 3 sets of 10. To challenge yourself, clasp your hands behind your head and keep your elbows out to the side.

· Gluteal stretch: Lie on your back with both knees bent. Rest the ankle of one leg over the knee of your other leg. Grasp the thigh of the bottom leg and pull toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip. Hold the stretch for 15 to 30 seconds. Repeat 3 times with each leg.

· Extension exercise:

· Lie face down on the floor for 5 minutes. If this hurts too much, lie face down with a pillow under your stomach. This should relieve your leg or back pain. When you can lie on your stomach for 5 minutes without a pillow, you can continue with Part B of this exercise.

· After lying on your stomach for 5 minutes, prop yourself up on your elbows for another 5 minutes. If you can do this without having more leg or buttock pain, you can start doing part C of this exercise.

· Lie on your stomach with your hands under your shoulders. Then press down on your hands and extend your elbows while keeping your hips flat on the floor. Hold for 1 second and lower yourself to the floor. Do 3 to 5 sets of 10 repetitions. Rest for 1 minute between sets. You should have no pain in your legs when you do this, but it is normal to feel some pain in your lower back.

Do this exercise several times a day.

· Side plank: Lie on your side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm so your elbow is directly under your shoulder. Lift your hips off the floor and balance on your forearm and the outside of your foot. Try to hold this position for 15 seconds, then slowly lower your hip to the ground. Switch sides and repeat. Work up to holding for 1 minute or longer. This exercise can be made easier by starting with your knees and hips flexed toward your chest.

EXERCISES TO AVOID

It is best to avoid the following exercises because they strain the lower back:

· legs raised straight and together

· full sit-ups or sit-ups with straight legs

· hip twists

SPORTS AND OTHER ACTIVITIES

In addition to strengthening your back muscles, it would be helpful to keep your entire body in shape. Physical activities such as walking or swimming are considered to be back-friendly exercises.

It’s always best to check with your healthcare provider before you start an exercise program. Remember to start slowly.

Good activities for people with back problems include:

· walking

· bicycling

· swimming

· cross-country skiing

Some sports can hurt your back because of rough contact, twisting, sudden impact, or direct stress on your back. Sports that may be dangerous to your back include:

· football

· soccer

· volleyball

· handball

· golf

· weight lifting

· trampoline

· tobogganing

· sledding

· snowmobiling

· snowboarding

· ice hockey