FOUR

WEEKS

TO A

BETTER

BACK

If you have turned the page to this chapter with a feeling of foreboding, a feeling that you know what's coming next, you're right. This chapter is about exercise.

It wasn't all that long ago that doctors believed that the only treatment for back pain was bed rest. What we didn't know then was that we were actually doing our patients a disservice. Many times, we were making their conditions worse. Another thing we didn't know was that most back pain is, as I've said over and over throughout this book, due to natural wear and tear on the body. Like any other part of your body, the back will degenerate faster and more severely from a lack of maintenance. Exercise is one of the keys to the body's natural rejuvenation process.

In the medical profession's defense, until recently, most healthcare professionals thought that back pain was almost always the result of injury or some other calamity. We didn't know that the problem was degenerative and aging. Now we do know, and that is very good news indeed for the back pain sufferer.

Four Weeks to a Better Back

In the next few pages I will outline a series of simple exercises that will start you on your way to achieving a life free of back pain, and all it will require from you is 10-15 minutes a day. And a commitment to take care of your back.

Everything is "99 Percent" Attitude

I told you I'd get back to this.

The success of everything in life, from recreation to achieving a successful career to raising a family, depends on attitude. And so does taking care of your back. Nothing is more essential to taking control of the situation than understanding and accepting your back problem. By knowing what the problem is, what to do and how to cope with an attack of back pain, you should no longer have anything to fear.

We have already seen how poor posture and sagging abdominal muscles can cause back pain. As I said in the last chapter, standing straight and good body mechanics is all part of a good attitude, of having high self-esteem. You deserve to feel good! Another point I've stressed throughout this book is that you do have a choice. Your are not doomed to a life plagued with nagging, sometimes incapacitating back pain. You can take control of the situation and turn it around. It's up to you.

Ancient Orientals exercised. Why shouldn't you?

Four Weeks to a Better Back

I know. You're thinking, "All that stuff about self-esteem and attitude is great, Doctor Chiu, but exercise? Eh. . . . It's so boring!" I can almost hear you groan.

Please remember, not only is everything 99 percent attitude, but for every thing worth having there is a trade off. Isn't a life free of back pain life worth a few minutes a day of exercise?

Please, just try it. If not for yourself and your own well-being, well then, try it for me. If for no other reason, try it because I took the time to write this book to tell you that you don't have to suffer anymore. If you're like most people (and whether you like it or not, you probably are) exercise grows on you. It enhances your self-esteem.

A Word of Encouragement and Caution

Isn't there always, a word of caution, I mean? The exercises I am suggesting here are designed primarily for people with degenerative back pain, such as arthritis, worn facet joints, degenerative discs, and so on. If your pain is caused by a fracture, a pinched nerve or some other kind of nondegenerative condition, not only are these exercises probably not going to help much, but they could make matters worse. However, if your back pain is caused by a condition that requires surgery or some other drastic form of treatment, these exercises will help after the initial problem has been treated.

You're wondering, no doubt, how to determine what kind of problem you have. If you have read this far, you should already have a good idea what kind of back pain you have. A rule of thumb is that if the pain is centralized in, say, just your lower back or neck, you are probably suffering from degenerative back pain. If you have accompanying pain in a hip, arm, leg or shoulder, your problem could be more serious. But that is only a rule of thumb. Just to be sure, I'd suggest that before you get into this or any exercise program for back pain that you have a medical consultation and physical examination by your familiy doctor.

Four Weeks to a Better Back

I will be talking more extensively about diagnosis of back pain in Chapter 9. Also included in that chapter will be some guidelines on whether you should see a doctor. If you have any doubts at all about the source of your back pain, please read Chapter 9.

The word of encouragement is that you should remember that you are concerned here with only treating your back pain. You are not in competition with anybodyincluding yourself. You are not trying to prove anything. You are not trying to get better overnight. Not only do I want you to start out slow, with just a few repetitions of each exercise, but I encourage you to do so.

You've undoubtedly heard the expression "No pain, no gain." Well this is not a situation where that idiom applies. However, you may, depending on just how atrophied your muscles are, experience a little muscle soreness in the beginning. Don't worry, it won't hurt for longa week, two at the mostand you will soon feel better. Just don't try to over do it and you will be fine.

If you are already experiencing some back pain when beginning these exercises, a few of them may seem to aggravate the problem. They may make your back hurt a little more, for a few days. Mild aggravation, providing that your back is not injured, will not damage your back or make it worse. It might even help a little. It's part of the trade off I mentioned earlier.

You should do these exercises twice a day, every day. This means that you will have to set aside a few minutes each day for your back, that you will have to establish somewhat of a routine. There will be days, no doubt, when you will not feel like exercising, and there will be days when you just couldn't find the time. If you miss a day, this does not mean that you are worthless, a failure. Missing a workout does not mean that you don't care about your health, that you have no self-esteem. One day missed does not mean that you are establishing a pattern of irresponsibility. It simply means you've missed a day. You'll do them again the next day. The important thing is that you do

Four Weeks to a Better Back

these exercises regularly. And that you give yourself a break when you fail.

Four Weeks of Simple Exercises
to a Better Back

OK. Here we go! I'm pumped up. Aren't you? Over the next few pages you will find a variety of exercises designed to help revitalize you back and neck. You can, depending on the nature of your back problem, choose to do only the ones designed for the specific level of your back in which the problem lies; in deed it will more than likely help.

Low Back Exercises:

We've already seen that lower back pain is often the result of too much stress on the lumbar spine. As I showed you in the chapters on anatomy (Chapter 3) and the causes of back pain (Chapter 4), the low back is supported by several muscle groups, including the back muscles themselves, the abdominals, buttocks and hamstring muscles. The following five exercises are designed to strengthen these muscles, thereby relieving much of the stress on the lower back.

Again, you are not competing with anybody. Do only a few repetitions of each exercise at first, maybe even as few 2 or 3. You can increase by 2-5 repetitions every week or so. Instead of concentrating on how many you can do, concentrate on how you do them. Focus on the muscles you are trying to work. Do each exercise slowly and deliberately. Doing them too fasttrying to rush throughwill not work the muscles as well. The key to strengthening a muscle is allowing the specific muscle you are trying to exercise to do the work.

Ready? OK. The doctor's orders are: 5-10 minutes a session, twice a day. You may begin.

Four Weeks to a Better Back

Pelvic Tilt: Begin this exercise lying flat on your back with your knees crooked. Your arms should be lying on the floor beside you. Tighten your abdominal muscles (but do not hold your breath). Flatten the small of your back to the floor. Using only your abdominal musclesnot your legs and feetraise your buttocks off the floor. Hold this position as long as is comfortable, then lower your buttocks slowly to the floor. Repeat as often as is comfortable.

Four Weeks to a Better Back

Rotator Muscle: Lying on your back with your arms down to your side, bend your knees and bring them to your chest. Now, very slowly and deliberatelyavoid jerkingrotate your lower body from one side to the other, rolling on the floor. You should feel this in your lower back and abdominal muscles. Do it as often as comfortable.

Four Weeks to a Better Back

Hamstring Muscle: Lie flat on your back. With knees bent, lift your legs very slowly until they are perpendicular with your back. Now, remembering to concentrate on your thigh muscles, straighten your legs. Reverse the exercise until your feet are once again on the floor. Repeat as many times as comfortable.

Four Weeks to a Better Back

Thoracic Stretch (Prayer Position): For this exercise you assume a position similar to a Muslim worshiping Allah. Beginning on your knees, stretch your arms out over your head and lie face down, knees still bent, on the floor. Your arms should be supporting you. Now, using your arms and knees for support, stretch your back. Hold the stretching position a few seconds. Relax. Repeat as often as comfortable.

Four Weeks to a Better Back

Abductor (Thigh left and right): For this exercise lie on your left side with your arms down to your side, your legs lying evenly, one on top of the other. Keeping both legs straight, raise your right leg slowly until your feet are two to three feet apart (as you get more limber, you will be more comfortable lifting your leg further). Now, slowly lower your leg. Repeat as many times as comfortable. Turn over and do the same thing from your right side.

Four Weeks to a Better Back

Standing Spinal Extension: Begin standing with your back straight. Place your hands on your lower back for support. Tilt your head back slightly. Using your hands for support, slowly bend backwards. Do not bend to the point of discomfort. Repeat as comfortable.

Four Weeks to a Better Back

Cow and Cat: This exercise gets its name because of the two positions you will move your back into. Begin on your hands and knees, back straight. Now, very slowly, concentrating on your back muscles, arch your back upward, like an angry cat. Now reverse the motion until your back and belly are sloping downward, like a cow. Repeat these steps very slowly, up and down, as many times as comfortable.

Four Weeks to a Better Back

Semi-situp: You are no doubt familiar with the situp. For this exercise you will be doing a half situp. Begin by lying on your back on the floor with your knees bent. You may put your hands across your chest, on your knees or where ever is comfortable. If you choose to put them behind your back, the exercise may be more difficult, and you may find yourself pulling with your arms instead of your stomach muscles. Now, keeping your back straight and concentrating on doing the work with your abdominals, sit up. Raise your upper body about 5 to 6 inches from the floor. Hold the position if you can. Then slowly lower yourself down. Do not sit all the way up or try to touch your elbows to your knees. If your back is already sore, this could cause you problems. Repeat this exercise as often as comfortable.

Four Weeks to a Better Back

Four Neck Exercises

As I have said, the neck is part of the spine. Pain in the neck can often come from the same or similar causes. The following four neck exercises are easy. You can do them almost anywhere. They take very little time and require minimal effort. I call them yes-no-maybe-OK exercises. Here they are.

Yes (nodding): The difference between not only this but all four of these neck exercises is the slowness and deliberateness of the exercise compared to the gesture they are named after. For this exercise you will be nodding just as though you are gesturing yes, but your nod will be exaggerated and slow. Move your head forward as far as you can. Now, slowly bring it back as far as you can. Repeat several times.

Four Weeks to a Better Back

No: Turn your head in a "no" gesture, but do not "shake" your head. Slowly, concentrating on the movement, turn your head from left to right, as many times as comfortable.

Four Weeks to a Better Back

Maybe: Think about the shrug-and-tilt head gesture you use when you're not sure about something. Repeat that gesture slowly, without shrugging, now tilt your head to the other side. Repeat. Isn't this easy?

Four Weeks to a Better Back

OK (head roll): For this exercise, begin with your head in the extreme forward position. Concentrating on keeping your neck extended, roll your head in a circular motion on your neck until it reaches the front again. Repeat a few times. Now rotate your head in the other direction.

Four Weeks to a Better Back