Weight Training: A Benefit Or A Risk For People With Chronic Low Back Pain?
People with chronic back pain live with the uncertainty that they may re-injure their backs at any time and for any reason – big or little. Their fear of back pain caused by new injuries often causes them to limit what they do and how often they do it. Limiting overall activity makes some sense because it limits the chances of hurting your back again. However, limiting your activities can also lead to a poorly conditioned body that lacks muscle tone and strength, which increases the chances for a low back injury. This is the dilemma that many low back pain sufferers experience. The good news is that weight training programs, when done properly, improves overall muscle tone and strength which supports the spine and helps a person with back pain to break this cycle of fear and inactivity.
What are the overall benefits of a weight training program for a person with back pain?
When done properly, weight training can help improve the overall muscle tone and strength of an individual. Increased overall muscle tone and strength improves muscle balance which allows all muscles to “pull their own weight” during a task. This enables a person to participate in work, sports activities and everyday household tasks for longer periods of time with less fatigue, less chance of injury, faster recovery and greater ease. However, because of previous injuries a person with chronic back pain has special needs that must be recognized and addressed by customizing the weight training program.
What components are essential in a weight training program for a person with low back pain?
Any weight training program for a person who has low back pain must be customized to fit the needs and abilities of the individual. An assessment of overall muscle strength and balance is essential. Typically a person with low back pain will have poor overall condition as well as weak “core muscles” which support the low back. A weight-training program must emphasize not only strengthening these core muscles but also achieving a balance between the core muscles on the front and back of the body.
A second and equally important component of a weight program is proprioceptive training of the small muscles, tendons and ligaments adjacent to the spine.
Proprioception or “position sense” helps the brain communicate with the spinal joints which promotes coordination of spinal joint and muscle movement during activities.
Are weight machines, free weights or resistance tubing/rehab ball exercises best for back pain?
An exercise program that includes one, two or all three of these options can be helpful. The key is to understand which system is most helpful during the rehab process. Weight machine provides a specific movement that exercises a specific muscle group. This is important when you are trying to achieve muscle balance between two muscle groups that work in opposition to each other (like the hamstrings and quadriceps). Free weights, those not attached to a machine, like hand weights and barbells help improve overall condition and strength because they recruit several muscle groups simultaneously. Tubing/rehab ball exercises, stimulates proprioception and is easy to use and transport. A weight training program that includes all three may use free weights for overall conditioning, weight machines to target the low back muscles and tubing/rehab ball to improve proprioception. In the absence of availability of one or more of these options an exercise program can be designed to meet the needs of the individual.
Important tips for determining which program and facility is right for you?
Know your diagnosis and potential limitations.
Knowing your diagnosis and potential limitations associated with it is a good starting point. Weight training should be based upon what you can initially do and build from there.
Seek a trainer with specific experience with your condition.
Education, experience, specific training programs and measurable goals are guidelines for choosing a trainer. You should also ask your trainer to consult with your chiropractic physician before beginning.
Tour the facility before you begin.
Tour the facility with your trainer to become familiar with the equipment to be used. Ask how frequently the equipment is maintained, repaired and replaced.
Dr. William Madosky