Pain in the area of the lumbar spine and sacrum is given to the modern lifestyle more and more frequent problem. Often times are these pains mild, and they do not restrict us, therefore we overlook them. Even these mild problems are from the start are important information for us, that there is overloading and therefore also damaging of certain structures. It is necessary to do everything to prevent the continuous overloading. If we ignore these warning signals, the overloading deepens, which results in gradual degenerative disorder of the spine mobility. The goal of this article is to describe you the basic exercises which can remove the pain from the lumbar and sacral area of the spine, and at the same time, they should serve as a prevention against these problems.
If we want to affect the pain in the lower back area, we have to realize that the lower back is closely related to the position of the pelvic area, activity of the pelvic floor, activity of the diaphragm, but just as important is the position and muscle cooperation in the hip joint. Therefore the exercise alone is not activating just the lower back and abdominal muscles, but it is important to adjust the general position of the back and hip joints. It is necessary to take into account that the longer we ignored the pain overlooked the warning signals, the longer the regeneration will take. Please, be therefore patient with the exercises, and you will be satisfied with the result.
CORRECTING THE POSITION OF PELVIS WHILE LAYING ON THE STOMACH
Lay down on your stomach, rest your head on your forehead, place your arms alongside your body. Keep your legs relaxed, if you want to relax your buttocks it is ideal to rotate your toes inwardly and your heels outwardly. Our goal is to eliminate the curvature in the lumbar spine and tilting of the pelvis, which causes overloading of the lumbar vertebrae and ligaments surrounding the spine. Therefore try to move your pelvis beneath your trunk, clench your deep abdominal muscles (try to expand your abdomen as much as possible to the sides and towards the pelvis) and stay in this position and keep breathing (pay attention that you wouldn’t release the activity of the abdominal muscles with exhale or drop the pelvis). During a correct performance you should feel, that the support from the pelvis is coming from the pubic bone area (not the front side of the thighs).
The exercise is performed incorrectly, if we tilted the pelvis by activating the buttocks muscles or the back thigh muscles. Also pay attention to not pull your belly button or upper stomach inwardly - that would activate the rectus abdominis muscle which is also not ideal.
Number of repetitions:
Try to stay approximately one minute in the position, repeat it 5x (it is important that you feel you are doing it correctly). If you feel like you are activating incorrect muscles, it is better if you end with the exercise and try to rest. In an ideal case, repeat it several times a day.
RELEASING THE SACROILIAC JOINT ACCORDING TO MOJŽÍŠOVÁ
Lay on your stomach, place your arms horizontally, and your legs should be straight. Bend one knee to a right angle and slowly push it outwardly towards your arm (the knee is constantly in contact with the ground), in a final phase, we can help the knee with our arm. Keep your pelvis in this phase relaxed, let it drop down by its own weight, keep breathing. Slowly move the knee back to the default position.
The exercise has to start with bending the knee to a 90 degree angle, if not, the exercise will not be effective. Avoid doing it to fast and excessive bending in the lumbar spine.
Number of repetitions:
Repeat on both legs, 5x on each leg.
ACTIVATION OF THE CORRECT BREATHING STEREOTYPE ACCORDING TO KOLÁŘ
For a correct position and function of the spine, the cooperation of the pelvic floor and diaphragm is very important. If these muscles do not co-work, it will lead to tilting of the pelvis and rib flaring. This position results in overloading of the lumbar vertebrae.
Lay down on your back, place your legs on the chair, straighten your head in the cervical spine (you can place your head on a smaller pillow). Keep your arms alongside your body, shoulders are relaxed. It is necessary to release your rib cage. Do not push your rib cage anywhere, just use the gravitational force and relax the chest (pay attention to not bend your head). Correct position of the chest enables to optimally activate the diaphragm, therefore if its not activated, do not continue in the exercise. Breathing is important during the whole time, in order to keep this position of the chest, and the ribs wouldn’t escape you upwardly. The inhale is directed deep down and to the sides of the pelvis and hip bones. Imagine the belly button wanting to “look down” on the feet. Simply said, the breathing is similar to when you are on the toilet.
You should not breathe into the upper part of the chest along with moving the lower ribs. Do not bend the cervical spine and keep your shoulders freely placed on the ground. The lumbar spine should not bend excessively, but at the same time there shouldn’t be any strong pressure coming from the lower back against the mat. Abdominal muscles are relaxed - don´t activate it.
Number or repetitions:
It cannot be exactly defined. During this exercise the quality is more important than the quantity. There is a general rule, that it is better to exercise for a shorter period of time but more precisely, several times a day, then just once, for a longer time and incorrectly.
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Author: Mgr. Iva Bílková, FYZIOklinika fyzioterapie Ltd, Prague, Czech Republic