Lab 8: Exercise Prescription for Low Back Pain and Sacroiliac Discomfort

Tyler Hyvarinen, Allison Pruys & Aaron Ruberto

Low Back Pain

  • Back symptoms are the most common cause of disability for persons under the age of 45 years (Oldridge & Stoll, 1997).
  • Although there is inconclusive scientific research to support the effectiveness of exercise in the treatment of low back pain it is generally understood that physical inactivity (ex. bed rest) is contraindicated and thus conservative exercise and therapeutic programs are utilized to restore and preserve functional capacity and exercise tolerance (Oldridge & Stoll, 1993).
  • A therapeutic exercise program for the back typically has many components including instruction on posture and stability as well as exercises for flexibility, strength and muscle endurance (Houglum, 2005).

Sacroiliac (SI) Discomfort

  • Pain in the low back can be related to SI joint dysfunctions as back pain has been shown to refer into the sacroiliac region (Houglum, 2005).
  • When SI joint discomfort is being treated, the low back and hip areas should also be addressed to eliminate other sites of pain referral (Houglum, 2005).
  • A combination of flexibility and strengthening exercises has shown to be beneficial in the treatment and rehabilitation of back pain and sacroiliac discomfort (Houglum, 2005).

Contraindications for People who Suffer from Low Back Pain and SI Discomfort

  • High-impact exercise such as running
  • Physical inactivity (bed rest)
  • Excessive flexion, extension and torsion motions within first few weeks of initial onset of back pain

(Oldridge & Stoll, 1997)

Recommendations for Exercise Programming

-Although the benefits of exercise in the treatment of low back pain and SI discomfort are not well know, some general recommendations for exercise prescription can be made:

  • Aerobic exercise that minimally stresses the back such as walking, swimming and cycling can be started during the first two weeks of acute low back problems for most clients (Oldridge & Stoll, 1997).
  • Conditioning of the trunk and core muscles (Oldridge & Stoll, 1997).
  • Spinal injuries and conditions respond well to Swiss ball, foam roller and aquatic exercise (Houglum, 2005).
  • The abdominals and spine extensors are key muscle groups that provide support and stability to the spine, so strength exercises for these groups should be included in an exercise program (Houglum, 2005).
  • Hip tightness is often correlated with low back pain and thus flexibility exercises for the hip along with those for the low back and pelvis should be included in an exercise program (Houglum, 2005).

-It is important to note that the goal of exercise programs for clients with low back problems is to prevent debilitation due to inactivity and to improve endurance and exercise tolerance, strength and flexibility so that clients may regain optimal level of functioning as soon as possible.

References

Houglum, P.A. (2005). Therapeutic Exercise for Musculoskeletal Injuries (2nd ed.).

Windsor: Human Kinetics.

Oldridge, N.B., & Stoll, J.E. (1997). Low Back Pain Syndrome. In J.L. Durstine (Ed.),

ACSM’s Exercise Management for Persons with Chronic Diseases and

Disabilities (pp. 155-60). Windsor: Human Kinetics.

Oldridge, N.B., & Stoll, J.E. (1993). Spinal Disorders and Low Back Pain. In J.S. Skinner

(Ed.), Exercise Testing and Exercise Prescription for Special Cases (2nd ed.) (pp. 139-52). Windsor: Human Kinetics.