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If you have back pain, you are not alone.
About 80% of the population experiences lower back pain at some point in their lives. A significant number of low back injuries are linked to the L4-L5 disc. There are many different pathologies of lower back pain; you can experience pain from dull to sharp.
In this week's blog, Marina Tishaninova takes a look at the most common lumbar spine condition — a herniated disc. We'll explore how to recognize the symptoms of and manage lumbar spine conditions.
What are the most common causes of a herniated disc?
A herniated disc injury can be caused by trauma such as an accident or sudden fall. It can also be caused by regular degeneration of the disc over time. Injuries often occur from strain resulting from repetitive twisting or poor posture while lifting weight (both in and out of the gym.)
If you've been having back pain, ask yourself these questions:
Am I experiencing sharp, radiating, or dull pain?
Am I feeling numbness or tingling?
Am I feeling any loss of sensation or weakness in the surrounding area?
The symptoms of a lumbar disc herniation are unilateral (meaning it affects only one side of the body) and include pain that radiates into the buttocks, leg, and foot.
A disc herniation is typically a cumulative trauma disorder where the annular fibroses in the intervertebral disc tear and eventually the nucleus spills through or “herniates” and compresses the nerve root, resulting in numbness and tingling, radiating pain, loss of sensation, and weakness. The primary component to annular injury involving the disc is the natural aging process or degeneration. Believe it or not, herniation is usually seen in adults 45 years old and younger.
Prolonged sitting results in downward compression forces and, without the proper cushioning normally supplied by the disc, injury to the vital end plate cartilage and other connective tissues in the already problematic area of the spine. This will often eventually result in radiating back pain.
Poor posture - from habit or weak musculature - can compound the problem due to misalignment for extended periods of time.
Which position results in higher disc pressure - sitting or lying supine?
Prolonged sitting will result in higher disc pressure. When you are in the sitting position, your spine is under pressure. This leads to nerve compression and places excessive stress, causing further disc compression. The supine position will feel better because it reduces disc compression.
If you have low back pain, you should avoid excessive uncontrolled trunk flexion with rotation.
- Avoid flexed postures, slight extension preferred
- Avoid prolonged sitting
To treat a herniated disc, one option you can choose is medical management. If you are in pain, it is highly recommended you speak with a physician about ways to it.
There are some other ways to get back to pain-free life. In addition to medical management, you can heal from disc herniation using exercise.
Our Medical Exercise Specialists work with doctors and physical therapists to create unique programming for our clients to help them lead a life free from pain.
Exercise Management for Lower Back Pain:
Since we spend most of our time sitting at a desk with bad posture, gentle stretching may be beneficial. Start with gentle stretches for the back, thighs, and hip flexors.
Managing disc herniation should include cardiovascular, lower extremity, and spinal stabilization training.
- Develop a cardio training program with stationary biking. Ex: 20 min at 60% intensity, adjusting the seat low to eliminate full knee extension.
- Incorporate daily spinal stretching to maintain range of motion.
Gluteal strengthening is also vitally important.
The Glute bridge is effective in strengthening the hips as well as the back of the thigh. The exercise helps to increase core stability, which is vital in lower back management.
- Start by squeezing your glutes and abdominals.
- Raise your hips until your knees, hips, and shoulders are in line.
- Hold two seconds, then return to the starting position.
- Do this for 12 reps.
McKinzie exercises can also be used to centralize back pain.
McKenzie Back Extension:
- Start in the prone position.
- Prop up your elbows for 30 seconds.
- Move into a prone push up with your pelvis remaining in the floor.
- Hold for 30 seconds.
- This helps push up the disk herniation anteriorly.
- Start lying face down with chest off the ground and arms off the ground in a "W" shape.
- Hold for 15 seconds and release completely to the floor with head in comfortable position.
- Performed in slow and controlled motion, this helps to strengthen the lower back.
To manage lower back pain, it's important to increase trunk strength. This challenges your core without compressing the spine.
Finding balance between stability and flexibility is crucial for back stabilization.
Spinal stabilization comes first. There are three levels of spinal stabilization.
The first level is performed when the spine is fully supported. A great example of this is the heel tap. Heel taps build abdominal straight to reduce back pain.
It is important to understand what the neutral spine is. People with disc herniation must to find their neutral spine where it is the most comfortable. Ensure you are in a happy, pain free range of motion. You may feel better in slightly arched positions when lying down.
For example: lying down with knees up, drop a knee to the side, not letting your hips roll over. Make sure your hips stay level.
In addition to the heel tap, another great exercise to begin with is the heel slide.
- Lie down with your legs stretched out in front of you.
- Wear a sock to help you slide.
- With control, slide the heel toward your buttocks along the floor.
- Repeat 12-15 times each side.
When performing the heel slide, refrain from overarching or flattening your back excessively. Keep the hips stable and do not twist or arch the back.
The second level of spine stabilization is performed when the spine is partially supported. To take your heel taps to the next level and add the challenge of balance, add a foam roller.
Heel Taps with Foam Roller:
- Lie face up with the foam roller vertically under your spine
- Place your fingertips on the floor as you lift your legs into tabletop position.
- Maintaining a 90-degree angle, tap your heels to the floor one at a time
Level three lumbar stabilization activities are performed with the spine completely unsupported.
Two great level three exercises are mini squats and stationary lunges. Be sure to maintain neutral spine while performing these exercises.
Although it can feel daunting to start the journey to heal a herniated disc (or any lower back pain,) there are effective and safe exercise movements that help to manage and maintain a pain-free lifestyle.
It is important to remember that if radiating pain, numbness, or tingling develop, you must discontinue exercise, avoid uncontrolled trunk rotation and flexion, and immediately call your doctor or physical therapist.
If you are interested in learning more about our Medical Exercise program, or our corrective exercise methodology, email us at firstname.lastname@example.org or set up your free appointment for a fitness assessment!
Meet the Author
Medical Exercise Specialist
NASM Certified Personal Trainer
Corrective Exercise Specialist
StrongFirst Kettlebell Specialist
Yoga Certified Instructor
Born and raised in Russia, Marina received her bachelor’s degree in International Relations. She moved to the United States in 2011 and started her second bachelor’s degree in Corporate Business. After graduation, she realized that she wanted to become a fitness professional because she has always been active, with a focus in gymnastics and dancing.
Marina is an avid learner and is certified in many training styles including kettlebells, yoga, and corrective exercise. Her fitness interests include dancing, boxing, yoga, and kettlebell flow training. Because of Marina’s wealth of knowledge and interests, a personal training session with her will be sure to keep the client excited while working toward their fitness goals.
“I get excited at the prospect of helping my clients stay motivated to achieve both their long-term and short-term fitness goals. It is a rewarding feeling to help people and I love inspiring them to make positive changes in their lives.”
Marina considers herself a compassionate coach, so her clients feel comfortable opening up. “I am dedicated to my clients’ needs, encouraging, and adaptive.”