Exercise For Healing

Exercises for a Stronger Back

Tuesday, August 26, 2008 - 5:10pm

By Michele Silence, MA

Back problems plaque eight out of ten people during the course of a lifetime. Some 80 billion dollars are spent on back pain each year which usually takes hold of 30-year-olds to 50-year-olds, right in the middle of typically busy, active lives.

It is estimated that the majority of back problems can be prevented and alleviated by keeping the musculoskeletal system strong and limber.  Specific exercises and stretches that can help you develop a stronger and more resilient back follow. Do them regularly, several times a week for a strong, limber back. If you feel pain with any of them, discontinue the exercise and ask your physician for variations appropriate for you.


1. Back Extensions
Lie over an exercise ball face down. With hands behind your head, lift your upper body until your spine forms a straight line. 
Safety Note: Do not swing or arch the back excessively.

Back Extension Stretches (click image to enlarge)
Back Extension Exercises (click to enlarge)
2. Pelvic Tilts
Lie on the floor with knees bent. Lift pelvis off the ground and then back down.
Safety Note: Keep back on the ground and only tilt the pelvis upward.

Pelvic Tilt (click to enlarge)
Pelvic Tilt (click to enlarge)
3. Wall Roll Downs
Place ball on a wall and lean against it. Roll down and up.
Safety Note: Make sure the feet are far enough out in front that the knees stay at a right angle at the bottom of the movement.


Wall Roll Down Stretch (click to enlarge)

Wall Roll Down Stretch (click image to enlarge)

4. Abdominal Crunches
Sit on an exercise ball and walk your feet out in front of you until the middle of your back is pressing against the ball. Place hands behind head and lift shoulders off the ball while pressing back into the ball. Return to starting position and repeat.
Safety Note: Do not arch back on the return phase.

Abdominal Crunch Exercises (click to enlarge)

Abdominal Crunch Exercises (click to enlarge)


1. Back Stretch
Lie on your back on the floor. Make your body into a round ball and hold.

Back Stretch (click image to enlarge)

2. Abductor/Gluteal Stretch
Lie on your back with knees bent. Place one foot on the other knee. Lift both knees to the chest. Repeat on other side.

Abductor Stretch (click to enlarge)

3. Lower Back Stretch
Pull one leg into the chest, the other leg bent with foot on the floor. Let top knee drop to the opposite side of the body and hold. Repeat on other leg.
Lower Back Stretch (click image to enlarge)
4. Quad stretch
Lie on floor with knees bent. Widen legs and tilt both knees to the side while trying to get the knees to the floor. Repeat other side.

Quad Stretch (click to enlarge)

5. Abdominal Stretch
Lie flat on the floor and lengthen arms overhead and legs downward.
Ab Stretch (click to enlarge)
Benefits of Back Exercises

By taking care of your back you will not only ward off back pain but improve your posture as well. You will stand taller, look younger, and be strong enough to protect yourself from being injured by day-to-day activities.

*This article is intended for general information purposes only, is not individual-specific, nor is it intended to replace the advice of your healthcare team.

Expert Q&A

Bone density: Can it be improved?

What can I do to improve my bone density?

First, it is helpful to remember that bones aren’t just dead structures that hold the body up. They are living tissues that actively respond to the demands placed on them. They are constantly being broken down and rebuilt. As we get older, this breaking-down process can outpace the building-up process. We need to tell the body “Hey, I’m still using this stuff, so don’t get rid of it!” We do this in a few ways: through our diet, our hormones, and our activity.

A healthy diet helps improve bone density

Eating well should be a lifelong project. This means taking in enough calories to support activity (but not so many that excessive body fat is deposited), along with important nutrients such as calcium, magnesium and vitamin D. Ideally, good nutrition should come from your food, not supplements. However, as women age, they might consider a combination supplement of calcium, magnesium and vitamin D to augment a healthy diet. Moderate consumption of soy products may also be beneficial, (although some evidence suggests that women with thyroid conditions should avoid soy). Under-nourishment and a lower-than-healthy bodyweight may be detrimental over the long term. For maintaining bone density, it’s better to be a little bit (but not a lot) heavier than too light.

The balance of "female" hormones affects bone density

Estrogens and progestins, so-called “female” hormones, are a factor in maintaining bone density for both men and women (yes, men have small amounts of “female hormones,” just like women have small amounts of “male” androgens). However, recent results from large-scale studies suggest that hormone replacement therapy (HRT) in menopausal women can increase the risk of health concerns for many people. Thus, HRT is not a one-size-fits all prescription. Researchers are also exploring the possibility of prescribing low doses of androgens to women in later life, as these hormones play an important role.

Exercise can improve your bone density

This brings us to activity. Bones are designed to be loaded by either impact or weight. For example, the femur is designed to absorb and respond to the stresses of moving your pelvis around, to downward loading along its length (for example, when squatting with weight), as well as impact traveling upwards through the leg when you take a step or a jump. This means that staying active, and including impact and weight-bearing movements is critical. Weight training is obviously weight bearing, but also consider activities such as boxing or basketball. In the first case, there is impact loading on the upper body and the lower body when doing the obligatory rope jumping that is part of a boxer’s workout (and recreational boxers need hit only pads and bags, not people). In the second case, there is impact loading from running and jumping. Impact should be moderate, of course – jumping off rooftops will be detrimental to your bone health!

Is is ever too late to improve your bone density?

If bone loss has already begun, your doctor may suggest drugs that help slow the process, but this should occur under the guidance of a medical professional. Drugs alone contribute only a small part – remember that the bones need a reason to stay strong.

It’s never too early to think about bone density. Women build peak bone mass in their late teens and through their twenties. It’s also never too late—even older women who begin a weight training program show improvements in bone density as well as other things like balance and strength, which help prevent the kind of falls that break bones.


Khosla, Sundeep, L. Joseph Melton, III, Elizabeth J. Atkinson and W. M. O’Fallon. “Relationship of Serum Sex Steroid Levels to Longitudinal Changes in Bone Density in Young Versus Elderly Men”. The Journal of Clinical Endocrinology & Metabolism 86 (8): 3555-3561 (2001).

Palomba, Stefano, Francesco Orio, Jr., et al. “Effect of Estrogen Replacement Plus Low-Dose Alendronate Treatment on Bone Density in Surgically Postmenopausal Women with Osteoporosis”. The Journal of Clinical Endocrinology & Metabolism 87 (4): 1502-1508 (2002).

Thomas T, B. Burguera, et al. “Role of serum leptin, insulin, and estrogen levels as potential mediators of the relationship between fat mass and bone mineral density in men versus women”. Bone 29 (2): 114-120 (August 2001).

Krista Scott-Dixon, PhD
Contributing Expert

Have a question for our Experts? Send it in!

Expert Q&A

Spina bifida: Exercise suggestions for weight loss

I have a disability called spina bifida which does not allow me to move as much. I already have an exercise plan where I’m doing 30 minutes of cardio and abdominal exercises. I can't lose weight that easily, so I give up. Can you think of any enjoyable exercise routines that would fit my disability?

-Craig from North Carolina

If you already have an exercise plan, that’s a great start. Bear in mind that the purpose of an exercise plan is more than just losing weight. There are many things that exercise provides that are more important in terms of assuring quality of life, such as cardiovascular health, muscular strength, mobility, balance, kinesthesia (physical awareness), and metabolic benefits (for example, improving insulin sensitivity). This doesn’t mean that you shouldn’t care about maintaining healthy levels of body fat, especially since excess weight can limit mobility and have various negative effects, but it does mean that there are many things to consider when judging whether an exercise plan “works.” The benefits of regular activity may not always be immediately obvious.

What should you look for in your exercise plan?

There are two main things to consider when looking for exercise that you’ll stick with:

  • What your own abilities are (i.e. What movements can you do easily? do with some tolerable discomfort or difficulty? not do at all? What fits best into your lifestyle and schedule?)
  • What kinds of things do you personally enjoy? (e.g. Do you like things that are social? Challenging? Sport-based? Etc.)

Exercise plan considerations for people with spina bifida

People with spina bifida tend to have lower levels of muscle mass compared to the general population, which means they require fewer calories overall. It also means that they are likely to benefit from a well-designed resistance training program.

If you need to be seated for much of the exercise, there are plenty of variations on good basic weight training exercises that you can do with free weights (which can be as light as you need). Check out this bodybuilding website and Exercise Rx—there are plenty of seated versions shown in the exercise directories. In addition, check out The National Center on Physical Activity and Disability’s website. They have plenty of ideas for training with spina bifida and mobility disorders.

Also, be creative! I’ve worked with clients who were in wheelchairs because of mobility disorders, and come up with lots of outside-the-box ideas for fun, interesting workouts. For example, we removed the seat from a regular stationary bicycle, pushed the wheelchair up behind it, and voila! instant cheapo recumbent bike! We did shadow boxing, practicing hitting and kicking targets from seated positions. If clients could stand and walk without too much effort, we’d swing a sledgehammer around, squat by getting in and out of a chair for reps, or have walking races uphill. Sometimes they could do quite a lot as long as they had something to hang on to for balance.

Bottom line: Think of the movements you can do, and then think of ways to make them fun and challenging. And add resistance, if possible.

Just a reminder: A good nutrition program is essential for losing body fat. You may wish to consult with a dietitian who can help you work towards your goals.

Krista Scott-Dixon, PhD
Contributing Expert

Have a question for our Experts? Send it in!

Sciatica Treatment: Exercises That Help Sciatica

Monday, December 18, 2006 - 4:11pm

By Michele Silence, MA

Sciatica pain affects millions of people each year. The term sciatica does not refer to a medical condition. Rather, it is a word that describes symptoms which are the result of an irritated or compressed nerve in the lower spine. In reality, there are a number of conditions that can lead to sciatica pain. Once you know the cause, you can begin a program to alleviate your sciatica pain.

Causes of sciatica

The major causes of sciatica pain are:

1.   Spinal stenosis resulting in sciatica

The passageway holding the nerves to the spine narrows or tightens.

2.   Sciatica as a regult of degenerative disc disease

A degenerative disc impinges on the root of a nerve.

3.   Tight hamstring muscles leading to sciatica

This increases tightness in the lower back, leading to some of the other causes listed here.

4.   Sciatica caused by sacroiliac joint dysfunction

Sacroiliac joint becomes inflamed and rubs against the nerve.

5.   Herniated disc induced sciatica

When a spinal disc protrudes backwards.

6.   Isthmic spondylolisthesis producing sciatica

Need help stretching? Try these tools:

Magic Circle - This is the inflexible person's best friend. This flexible ring helps you reach and maintain positions you never imagined.
Foam Rollers - Your other best friend. These simple devices can help you work out tightness in your legs and back.

One of the lowest discs in the back slips forward.

7.   Sciatica and Piriformis syndrome

The piriformis muscles itself irritates the sciatica nerve and causes pain.

Exercises for sciatica sufferers

In order to successfully alleviate sciatica pain, you must exercise and stretch daily. If you make this routine a part of your daily care, your symptoms will most likely decrease and your pain can be kept to a minimum. If you suffer from sciatica pain, you can help yourself by strengthening and stretching the abdominals and back. Here’s what you need to do:

To Strengthen:

Curl Downs

Curls downs for sciatica treatment.

Curl downs for sciatica treatment.

Abdominal Crunch

Abdominal crunches sciatica exercises.

Abdominal crunches for sciatica treatment.

Back Extensions

Back extension sciatica exercise.

Back extension sciatica treatment.

To Stretch:


Hamstring stretch for sciatica treatment.


Sciatica abductor stretch.

Back Stretch

Sciatica back stretch treatment.


Sciatica quad stretch treatment.

Remember, chronic or constant pain should be attended to by a physician. If your pain persists or worsens, discontinue stretching and seek the advice of a medical practitioner.

Health and Fitness for Arthritis Sufferers

Wednesday, October 11, 2006 - 12:08pm

By Adam Kessler, CSCS

In 2005, a study found that one-in-three adults in the United States suffers from arthritis, which translates into approximately 66 million people. Of those people, 43 million were diagnosed by a doctor, while 23 million had chronic joint symptoms (but had not been officially diagnosed). Arthritis is second only to heart disease as a cause for work disability. With so many people afflicted and no cure in sight, arthritis sufferers need to understand what they can do to alleviate their symptoms and make this disease easier to tolerate.

Two types of arthritis

There are two common types of arthritis: osteoarthritis and rheumatoid arthritis. Osteoarthritis is more common. In osteoarthritis, the cartilage surrounding the bone breaks down and wears away, which leaves the normal smooth, gliding surfaces of the bone exposed and unprotected. As a result, it is very painful to move, so a person's range of motion becomes limited. In rheumatoid arthritis, tissue inflammation leads to the destruction of the joints. Once a joint becomes affected, the inflammation continues intermittently, leading to swollen and painful joints (and potentially disfigurement of the joints). It is more common among middle-aged women and characterized by periodic flare-ups.

Exercise tips for arthritis sufferers

An exercise program for arthritis sufferers provides several benefits. It increases the range of motion so that joint and muscle elasticity is not compromised when the arthritis flares up. It also helps warm-up and loosen the joints. In my experience, arthritis sufferers can do any exercise, but they must make modifications in their exercise routine to accommodate their daily fluctuations in pain tolerance.

Here are some guidelines to keep in mind when putting together an exercise routine:

  • Warm up extensively. Your warm-up should be longer than usual to get the blood flowing through your joints. This will help improve your range of motion and flexibility for the main workout.
  • Exercise in moderation. You can do a total body workout, as long as you focus on proper form for the exercises chosen. You should perform each repetition at a slow controlled pace. The intensity should be moderate or 40-60% of your maximum weight (the heaviest weight you could possibly do), and you should go for high repetitions, 10-20 repetitions. The exercises should be performed at a full range of motion, to improve joint flexibility and loosening up of the joints.
  • Stretch to improve your flexibility. You should make sure that you stretch to improve your range of motion, which will keep the stress off of the joints.
  • Water workouts are a great option. If you have the ability to do cardiovascular or strength training work in a pool, then take advantage of it. The warm water will help decrease stiffness and relax your muscles, while the buoyancy will take the pressure off of your joints, as you work out in an almost pain free environment.
  • Word of caution. Use the two-hour pain rule as a guide. If you experience excess joint pain or greater-than-normal pain two hours after you have exercised, then you have over-done it and you will want to modify your workout next time. You will do this either by decreasing the exercises done, adjusting the intensity, or choosing different exercises.

Exercise is a smart choice for arthritis suffers

Exercise is not an immediate pain relief formula for arthritis, but it is a proactive solution to fighting off the deterioration of your joints. If you do nothing, you are just going to feel more and more pain with no end in sight. Sure there will be days when you can't exercise, but in the long run, the potential temporary relief you might feel, even if just for 15 minutes at a time, is certainly better than the non-stop pain you will have to live with if you do absolutely nothing.

Exercise Rx: Help For Muscle Trigger Points

Wednesday, September 27, 2006 - 9:23am

By Michele Silence, MA

Just about everyone who exercises regularly suffers occasionally from various body aches and pains. Most ailments come and go. Others seem to pop up way too much. What most people don’t know is that many of these aches and pains can be alleviated once the cause is found. And, they often result from knotted muscles that cause extreme pain.

If the problem feels more like a muscle issue than a joint, it probably is. Trigger points, as they are more often referred to, can cause tremendous pain and take an incredibly long period of time to relieve themselves. These sensitive areas can bring a grown man to his knees. The fact is, trigger points can exist for years if not properly treated, leading to unnecessary chronic pain and suffering.

Identify your trigger points

The good news: Trigger points are easily treated. By you. You don’t need a specialist or costly equipment. Just a knowledge of what trigger points create pain in other areas of the body. An excellent book on the topic is TheTrigger point Therapy Workbook.

If you get a chance to read this great self-help book you’ll find you can rid yourself of a great deal of stiffness, pain, and frustration. And, you’ll be able to move and exercise more easily and comfortably. You’ll learn where the most common trigger points are for problematic areas of the body. Remember, a pain in the arm may be coming from a trigger point in the back or neck. Treating the arm is not going to get rid of the pain or the cause.

How to treat your trigger points

The idea is to squeeze, roll, probe or otherwise manipulate the affected knot until the pain lessens. For example, you feel like you’ve torn the Achilles muscle, located at the base of your ankle at the back of the foot. The pain is horrendous and you’re not sure what to do. Probing around a little can help you find the true cause if it’s a muscular pull. By taking a rolling pin and rolling over the calve, you may feel a few bumps that cause a lot of pain. Interestingly, these bumps are not located near the painful area you’re trying to help. Still, these knots and lumps may actually be the true root causing referred pain. Massaging them away will alleviate the chronic Achilles condition and get rid of the discomfort.

Is it a muscle spasm or a tear?

All right, so how can you tell the difference between a muscle in spasm or a more serious strain or tear? Look for inflammation. If you feel or see the area inflamed, it’s a sign of trauma. The body produces swelling as a way to cushion itself and protect from further damage. Swelling reduces the ability to move freely and prevents the area from healing. If you feel swelling is the culprit, follow the RICE procedure. Rest the area, Ice it, Compress and Elevate. If you still have pain or aren’t sure, consult your physician.