Movement RX for Acute Lower Back Pain

Dear Movers,

Have you ever experienced lower back pain (LBP) that makes you miss work or play? If the answer is yes, you are not alone. Lower back pain is one of the most common health issues that we face today. If you have experienced or are experiencing LBP, you may be interested in the new guideline for non-invasive treatment of acute (short term) LBP published in February 2017 by the American College of Physicians.

The ACP tells acute LBP sufferers to “Stay active and wait it out.”  It recommends that doctors avoid prescribing painkillers, muscle relaxants, anti-inflammatories, and steroid injections, and have their acute LPB patients try alternative therapies like exercise, acupuncture, massage, or yoga.

Note that the ACP guidelines apply to persons with acute (not chronic) LBP. Acute LBP is the most common type of LBP and involves pain that is present for 4 weeks or less and does not radiate down the leg. Acute, short term LBP is a biomechanical disturbance of the way that the spine, muscle, intervertebral discs, and nerves fit together. It may arise suddenly because of an accident or lifting something heavy. Or it may occur gradually because of age-related changes to the spine or sedentary lifestyles.

The ACP guidelines do not apply to LBP that is subacute (lasting 4-12 weeks) or chronic (lasting 12 weeks or longer). Long term LBP may require other kinds of treatment, including surgery.

With that in mind, I would like to describe several of my favorite intelligent moves that may help with you with short term LPB. Be mindful and easy as you practice these moves. Listen to your body. Listen to your inner athlete (everybody has one!). If any move creates any pain or tension, make it smaller or stop altogether. If the move involves moving your legs, make sure that you are using your legs and not your lower back.

Try the moves that appeal to you and your inner athlete. Then choose three or four and make them part of your daily movement practice. Do the ACP guidelines work for you? Let me know your results.

Note: These suggestions are intended to assist you in improving your health and overall well-being and are not a substitute for the professional judgment of a medical professional.

Personally, I know that a practice of aware, intelligent movement can change the trajectory of a fragile lower back. I had a laminectomy at Ll5-S1 in 1979, spent over a decade following the surgery experiencing periodic relapses into pain that sent me to bed for weeks. Finally, I discovered through trial and error and my ongoing interest is moving better, that moving less was not helpful. Over the years, I have collected moves that I practice regularly to maintain a stable lower back. Relapses are few and far between. The last one was over five years ago. And even then, I was able to recover quickly by moving often but keeping my lumbar quiet and stable as I moved. Now, I listen to my body, when my lower back feels unstable, I direct the focus of my movement practice on the moves that I have shared with. It works every time! I am very happy to be able to share these tips and tricks with you. Have fun!

  1. Bent Knee Leg Lifts
    1. Lay on the floor with both knees bent and the feet parallel and hip width apart.
    2. Create more stability for your lower back by placing a yoga brick between your feet with the inner edges of your feet against the outer edges of the brick.
    3. Spend a few minutes watching your breath.
    4. Keep the pelvis and spine neutral and your lower back stable on the floor. You may wish to place a small towel roll under you at your waist to stabilize the lumbar. Check with your inner athlete.
    5. Gently lift the pelvic floor as if you were zipping a zipper that starts at the pubis and ends at the naval. Do not use your buttocks and do not flatten your lower back.
    6. Breathe easily. Check in with your inner athlete.
    7. Exhale, slowly bring one bent knee up until the knee hovers over the hip (about 90 degrees). Maintain the 90-degree angle.
    8. Inhale, slowly return that leg to its original position.
    9. Keep the upper body (neck and shoulders) and pelvis quiet (except for the pelvic floor lift which continues throughout).
    10. Pay attention to the breath, the movement, and your sensations throughout.
    11. If you experience any pain, including any pain in the lower back, make the movement smaller, don’t lift the leg as high off the floor, or stop altogether.
    12. Repeat 6 times. Switch to the other side and repeat there.
  2. Knee Drops
    1. Lay on the floor with both knees bent and the feet parallel and hip width apart.
    2. Create more stability for your lower back by placing a yoga brick between your feet with the inner edges of your feet against the outside edge of the brick.
    3. Spend a few minutes watching your breath.
    4. Keep the pelvis and spine neutral and your lower back stable on the floor. You may wish to place a small towel roll under you at your waist to stabilize the lumbar. Check with your inner athlete.
    5. Gently life the pelvic floor as if you were zipping a zipper that starts and the pubis and ends at the naval. Do not use your buttocks and do not flatten your lower back.
    6. Breathe easily.
    7. Exhale, move your right knee out to the ride side. Move only as far as the pelvis remains stable and the left leg does not get involved. This may be a very small movement.
    8. Keep the upper body (neck and shoulders) and pelvis quiet (except for the pelvic floor lift which continues throughout).
    9. Inhale, slowly return that leg to its original position.
    10. Pay attention to the breath, the movement, and your sensations throughout.
    11. Repeat 6 times. Switch to the other side and repeat there.
  3. Figure 4
    1. Lay on the floor with both knees bent and the feet parallel and hip width apart.
    2. Spend a few minutes watching your breath.
    3. Keep the pelvis and spine neutral and your lower back stable on the floor. You may wish to place a small towel roll under you at your waist to stabilize the lumbar. Check with your inner athlete.
    4. Gently lift the pelvic floor as if you were zipping a zipper that starts at the pubis and ends at the naval. Do not use your buttocks and do not flatten your lower back.
    5. Breathe easily.
    6. Exhale, slowly bring the R bent knee up until the knee is as far forward as it can go without moving the hip or pelvis.
    7. Then bring the R ankle across the body to rest in front of the left knee.
    8. Stay here and breath. Check in with your inner athlete.
    9. Place your R hand on the inside of your right knee. Press the hand against the knee and the knee against the hand. Keeping that resistance, let the hand win and then let the knee win. Back and forth. Back and forth. With resistance. 4 times.
    10. Then places both hands on the back of your left thigh. Pull the left thigh toward the face without moving the hip or pelvis. Hold for several minutes.
    11. Pay attention to the breath, the movement, and your sensations throughout.
    12. If you experience any pain, including any pain in the lower back, make the movement smaller, don’t lift the leg as high off the floor, or stop altogether.
    13. Switch sides and repeat the pattern on that side.
  4. Revolved Abdomen with a Brick
    1. Lay on the floor with both knees bent and the feet parallel and hip width apart. Place a yoga brick on narrow setting between your thighs.
    2. Spend a few minutes watching your breath.
    3. Keep the pelvis and spine neutral and your lower back stable on the floor. You may wish to place a small towel roll under you at your waist to stabilize the lumbar. Check with your inner athlete.
    4. Gently life the pelvic floor as if you were zipping a zipper that starts and the pubis and ends at the naval. Do not use your buttocks and do not flatten your lower back.
    5. Bring your knees toward your face but no more than 90 degrees. Keep your pelvis and spine in neutral. Press into the brick between your knees.
    6. Breathe easily.
    7. Inhale to prepare.
    8. Exhale, move your right knee out to the right side. As you revolve squeeze the brick, especially with your top knee.
    9. Move only as far as the pelvis remains stable, the knees stay even and matching, and the arms stay on the floor. You will probably not go all the way the left leg does not get involved.
    10. Keep the upper body (neck and shoulders) and pelvis quiet (except for the pelvic floor lift which continues throughout).
    11. Inhale, slowly return your knees to the original position.
    12. Repeat on the other side.
    13. Pay attention to the breath, the movement, and your sensations throughout.
    14. Repeat the entire pattern 6 times.
  5. Bonus #1: Therapy Balls Glute Release
    1. Lay on the floor with both knees bent and the feet parallel and hip width apart.
    2. Keep the pelvis and spine neutral and your lower back stable on the floor. You may wish to place a small towel roll under you at your waist to stabilize the lumbar. Check with your inner athlete.
    3. Spend a few minutes watching your breath.
    4. Place a Roll ModelÔTherapy Ball under each buttocks. In Puerto Vallarta, you can purchase Roll ModelÔTherapy Balls at Intelligent Movement Forever (send me an email) or Yoga Vallarta. In the US, you can purchase at my website online store, www.intelligentmovementforever.com.
    5. Allow the balls to nuzzle into the deep buttocks muscles. Listen to your inner athlete. Move the balls to a slightly different location, if needed, stop altogether, or coming to standing and lean into the therapy balls at the wall.
    6. This work may be very intense if you have piriformis issues although it may also be very good for the piriformis if you stick with it, go slowly, move at your own speed, and listen to your inner guidance.
    7. Bring the soles of your feet together and allow your knees to open away from each other.
    8. Stay there and watch your breath.
    9. Tighten your buttocks for a few seconds and then release. 5 to 8 times.
    10. Pay attention to the breath, the movement, and your sensations throughout.
    11. Remove the therapy balls and return your buttocks to the floor without the therapy balls.
    12. Observe your sensations.
  6. Bonus #2: Wearable Lumbar Stability Ball
    1. To create lumber stability for your lower back while you are seated, wherever you are seated with a backrest or chair back, consider wearing a Lumbar Stability BallÔ created by Intelligent Movement Forever.
    2. This inflatable, no-latex sponge ball comes in a wearable polyester drawstring backpack allowing you to move from one place to another and always have the lumbar support you need without extra effort.
    3. The placement of the ball can be adjusted by (1) adjusting the drawstring cord, (2) changing the degree of inflation of the ball, or adjusting the placement of the ball lower or higher ono your lower back.
    4. The IMF Lumbar Stability BallÔ supports and stabilizes the lumbar spine to relieve lower back pain and strain. It allows and encourages your chest to open, improves seated good posture, and naturally aligns the spine.
    5. In Puerto Vallarta, you can purchase the IMF Lumbar Stability Ball at Intelligent Movement Forever (send me an email at yogawithvia@gmail.com). In the US, you can purchase it at my website online store, www.intelligentmovementforever.com.

Summary

Fortunately, there are measures you can take to relieve most (short term) back pain episodes. Proper body mechanics and target intelligent moves like the ones we have presented here will help heal your back within a few weeks and keep it functional for the long haul. Medical professionals, including the ACP, are agreeing with this good news.

When you have acute LBP, check with your medical professional, practice moves like these, listen to your inner athlete, and wait. You may be surprised and happy with the outcome.

Please contact me at yogawithvia@gmail.com or 971 708 9261 if you would like to work with my privately or join my 90-day online course, MoveEasy101.