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Exercise principles to reduce chronic pain

Exercise can be an effective way to reduce pain and improve mobility over time, but sometimes it can aggravate chronic low back pain. While there are many treatments available to manage or reduce low back pain, in order to heal from chronic low back pain and have lasting relief, you must retrain the nervous system along with the musculoskeletal system. 

It’s important to understand the principles behind proper exercise in order to calm the nervous system and properly target low back issues without causing further injury. This article will discuss five key principles you must follow for exercises to reduce low back pain effectively and safely.

There are mountains of research that identify movement as the number one best thing to relieve pain in muscles and joints. Movement pumps fresh, oxygen-rich blood to the joints and muscles, which rejuvenates them and flushes out all the nasty stuff that causes inflammation and pain. It also causes the release of natural pain relievers called endorphins and stimulates the production of special fluids that keep your joints moving smoothly as a well-oiled machine.

You might be wondering, “Where do I start, and how do I get all of these benefits without making my pain worse?”

Well, you are in luck!

Here are 5 key principles of exercise to reduce low back pain that can be easily grasped and applied to your routine. 

Key Principle #1: Learn to Push TO the pain, Not Through the Pain

Many people make the mistake of pushing through their pain when exercising. They have the mindset of “NO PAIN, NO GAIN.” They push through the pain to get work done, thinking that pain is weakness leaving the body or if it hurts, it’s working.  But this approach makes the pain pathways stronger, resulting in frequent and longer flare-ups and worsening existing conditions(4). 

And when flare-ups are severe, it’s hard to get out of bed or function normally for a few days. So they follow “Rest is the Best” at this time and don’t get an opportunity to train or adapt the nervous system. When you run between these two cycles from No Pain No Gain to Rest is the Best approach, you don’t give the nervous system the opportunity to retrain itself(4).

How to retrain the nervous system

It’s important to know how much to exercise and when to stop while exercising in order for it to be beneficial and not detrimental. The key principle you must follow for exercises to reduce low back pain is learning how to touch the pain, tease the pain, and nudge the pain rather than push through it. This means understanding your body’s limits and pain level and respecting them by adjusting the intensity and duration of the exercises accordingly so as not to increase the sensitivity of the nervous system. With this approach, you will be able to gradually increase intensity over time as your nervous system calms down and adapts; the body becomes stronger and more accustomed to each movement pattern. By following this key principle, you will be able to safely engage in exercises that help reduce low back pain over time without risking further harm or injury!

Key Principle #2: Get the Hypoalgesic effects of cardiovascular exercises to reduce low back pain

Many people believe that you need to exercise the lower back area only in order to relieve the low back pain. But cardiovascular exercises are a safe and effective way to reduce low back pain and reap the hypoalgesic effects(1). Here are four reminders for cardio and low back issues:

1. Focus on Slow, steady Cardio, NOT High-Intensity Interval Training: 

When it comes to aerobic exercises for reducing low back pain, slow, steady cardio (SSC) is essential versus high-intensity interval training (HIIT). This is due to the fact that HIIT can stimulate the release of cortisol in the body, which can cause further inflammation and ultimately lead to more discomfort.

2. Target HR is essential: 

Exercise at your target heart rate is critical in order to prompt the body’s hypoalgesic response, which is the reduction of pain and discomfort felt in the lower back. When engaging in aerobic exercise, it is important to maintain an optimal heart rate that falls between 60-80% of your maximum heart rate.

3. Consistency is the Key:

Consistency is key when it comes to exercising to reduce low back pain. Developing a regular exercise routine and sticking with it over time is essential for reducing the intensity of pain in the lower back region. Even on the days when you feel like you can’t do anything, it is important to do even a few minutes. Begin slowly and gradually increase the duration and or intensity as your body becomes more accustomed to these movements.

4. Cardio Stimulates the Natural Pain Chemicals(3): 

Not only does aerobic exercise promote increased blood flow, which can reduce inflammation and pain in the lower back region, but it also stimulates endorphin, morphine, and serotonin release in the brain(3). These are powerful and natural pain relievers. 

Examples of best cardiovascular exercise to reduce low back pain

Key Principle #3: Exercise to improve the mobility over the entire body, not just the painful body parts 

The majority of medical professionals emphasize treating only painful body parts or movements. It temporarily relieves the pain for a few days, but ultimately pain returns.

Do you know why? Your body moves as one entire system to perform a particular task. For example, suppose you reach for an object overhead slightly higher than your reach, as shown in the picture.

In that case, you not only have to raise your arms to go for the object, but you also have to look up, so you move your head up, extend your upper back, tighten the core, extend the hips and knees, and even get on your tiptoes if you are a short person like me. Your whole body is involved! So if you have tight shoulders and hips, it can strain the other parts of the body. Every time you reach up, it can keep damaging the lower back because it compensates for different body parts that are stiff, and pain will return. Leave the painful area alone and emphasize opening the other areas of the body which are tight. The majority of the time, the pain goes away without even addressing the painful body part.

It really helps if you can learn to move better overall before you move more. If you’d like to assess your self-mobility and create your own unique flow, join the 7-DAY MOBILITY FLOW CHALLENGE

Focus treating the whole body, not just painful body part.

Key Principle #4: Build a Strong Mind-body connection

In our rehab practice, where I do my day job, we have learned that training motor patterns mean teaching and reinforcing the connection between the muscles and brain, giving long-lasting strength improvement compared to training the muscles exclusively.

Here is an example of motor control training. When you learn to ride a bike, you have to learn it once, right? Once you know how to balance the bike, even if you don’t ride the bike for several years, when you hop on that bike, your body knows exactly how to ride the bike. The same applies to swimming. You don’t have to relearn the motor pattern and connections once they are established unless you have a stroke or brain injury.

The brain can “reorganize” its connections with proper training. It’s called neuroplasticity, and any brain can learn it at any age with correct stimulus, practice, and proper feedback.

Establishing motor patterns is different from muscle hypertrophy (bulking up). Muscle hypertrophy is developed by doing several repetitions and sets to build the muscles versus motor training which needs only a few but highly engaged repetitions that connect with your brain. So stay mindful and feel every movement when you do your exercises. Muscle-focused strength training is needed when muscles are weak or atrophied due to lack of use from an injury or pain.

Work on mind muscle connection to reduce low back pain

Key Principle #5: Build the strength of deeper core muscles exercises to reduce low back pain

We have multiple layers of abdominal/core muscles. The outer layer works on moving your body parts; for example, your rectus abdominis – known as six-packs – and external and internal obliques help you to get out of bed, bend over, twist, and turn. The transverse abdominis, which are the deeper muscles of the abdomen that wrap around the inner core, provide the corset and stability your spine needs. Multifidus are also deeper muscles that are closer to the facet joints of the spine, providing additional stability to the spinal column.  

When you are dealing with chronic pain, your outer layer of the muscles is more active than the deeper muscles due to flight and fight mode—causing the lack of stability. It is crucial to emphasize on deeper muscles of the spine. The number one best exercise is to work on planks in all different ways, like forearm planks, side planks, hand planks, and supine planks. Not only scientifically but in my own experience and my practice, Planks has been the best exercise to reduce low back pain.

Best core stabilization exercises to reduce low back pain

Okay, if you’ve gotten this far you have already started your journey toward overcoming chronic pain. The fact that you have found and read this article is proof. Pat yourself on the back! Well done! Now for Step 2.

After a detailed evaluation and trial and error, I handpick the safest, gentlest movements for your unique condition. As your accountability partner, I will help you stay on track and help you unlock the healing power of movement and exercise without causing nasty flare-ups. With continual communication between visits, I’m available to reinforce your achievements and provide modifications to any difficult movements that cause pain or discomfort.

Ready to take control of your pain and start feeling strong, confident, and renewed? Let’s do this!  Schedule the FREE CONSULTATION CALL

 References: 

  1. Nijs, Jo et al. “Dysfunctional endogenous analgesia during exercise in patients with chronic pain: to exercise or not to exercise?.” Pain Physician vol. 15,3 Suppl (2012): ES205-13.
  2. Puentedura EJ, Louw A. A neuroscience approach to managing athletes with low back pain. Phys Ther Sport. 2012 Aug;13(3):123-33. doi: 10.1016/j.ptsp.2011.12.001. Epub 2011 Dec 27. PMID: 22814445.
  3. Young, Simon N. “How to increase serotonin in the human brain without drugs.” Journal of psychiatry & neuroscience : JPN vol. 32,6 (2007): 394-9.
  4. Louw A. Why You Hurt Therapeutic Neuroscience Education System. Minneapolis, MN: OPTP; 2014.

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