Gym or no Gym for Low Back Pain?
July 7, 2009 – 9:51 pmWhile it could be assumed that people with back pain should not be exercising frequently, a new study by Robert Kell, professor of exercise physiology at the University of Alberta found that working with weights four days a week provided a significant decrease in the amount of pain and improved quality of life.
In the study, groups of 60 men and women with chronic low back pain exercised with weights in two, three or four-day weekly programs, or not at all. Their progress was measured over 16 weeks. The level of pain decreased by 28 percent in the 4-day a week group, 18 percent in the 3-day group and 14 percent in those who exercised two days a week. What do you recommend for your clients?
22 Responses to “Gym or no Gym for Low Back Pain?”
I think this confirms that movement and exercise is beneficial to everyone. There was a study at Stanford Univ. years ago that suggested that exercise was helpful for back pain patients. They were able to raise their pain tolerance and continue with physical activity.
Sounds great.
By Jody Hutchinson,nctmb on Jul 8, 2009
Yep! Looks like like I’s better hit the gym one more day a week for my low back problem.
Seriously though, I’m kinda of surprised that weightlifting significantly reduced chronic low back pain in that study unless the training was closely supervised by biomechanically-savy PTs or personal trainers. Some of the stuff I see people do to their backs in the club makes me “cringe”.
By Erik Dalton on Jul 8, 2009
I always recommend movement and exercise to clients, just adjusting the level of effort to avoid aggravating any pain.
I do advise on beneficial exercises to do and potentially harmful ones to avoid, but I think the avoidance of exercise is more problematic than its pursuit.
By Steven Rice on Jul 12, 2009
Hey Steven~
Looks like science agrees with you. I think the key phrase in your post is “adjusting the level of effort”. Some think they can work through any injury…and sometimes they can. But, longterm, I think it takes a toll on the musculoskeletal system….particularly the synovial joints.
By Erik Dalton on Jul 13, 2009
Hello Doctor Dalton
I was wondering how can I have sessions with you or a certified practitioner. I live in Toronto. I checked list of certified therapist but they are either out of Toronto or the number is not correct. I have a mild scoliosis (11.5 degree) and functional short leg syndrome and hope your techniques help me get rid of my foot pain.
Thanks
By peggy on Aug 6, 2009
working the abs are also important i tell people this all the time..
By TONY G on Sep 13, 2009
Yep…it’s amazing that so many people avoid ab work even though core stability has become a “mantra” in our society.
By Erik Dalton on Sep 14, 2009
I think the fixation on “abs” for low back pain is shifting. Check the work of Stuart McGill. Also read this article in the New York Times.
Beyond the pain issue, consider the flexion dominant posture most people already have and that most ab exercises will exacerbate excessive forward bending.
Finally, from just a strength training perspective, I recommend training the core by doing exercises involving the entire body, and having the abs perform their role as stabilizers, instead of rolling the body up into a little ball.
By Steven Rice on Sep 15, 2009
Yes Stephen, love some of McGill’s in-depth and controversial work. Just wish he’s get off the 1998 Hodges and Richardson study about the transversus abdominis timing issue…that’s a dead end street relying on info from a poorly designed study.
I’m on my way out the door to teach in Atlanta and then on to the AMTA National Convention but look forward to further discussions on this fascinating subject…best to you ~Keep the passion….ERIK
By Erik Dalton on Sep 16, 2009
Enjoy the convention, and please elaborate upon your return.
By Steven on Sep 17, 2009
Hi Erik-
I’m sure the conference was awesome. Wish I could have been there.
I’ve clients that have had a lot of pain relief with pilates for back pain, one with scoliosis. She swears by pilates.
Kat
By Kathleen Goggin Krug on Oct 7, 2009
AMTA was a lot of fun this year but hectic as usual. With 141 participants, there’s always a problem and this year we lacked enough tables. Fortunately, we were able to rent some.
Pilates is good for some and harmful to others. Stewart McGill and many top researchers are beating the core stability issue up pretty badly.
Will discuss some of their findings soon but here’s some studies that have surfaced in the past couple years:
When we begin discussing the function of ‘core’ stabilizers, i.e., multifidus, respiratory diaphragm, transversus abdominis and pelvic diaphragm, we’re led down a very slippery slope beginning with the goofy 1996 study by Hodges and Richardson which kicked off the core co-contraction revolution with the transversus abdominis as the mantra. Probably need to first review the latest studies by Stuart McGill…the foremost authority (in my opinion) of this subject.
Meantime, here are some earlier studies that refute the importance and/or existence of core stability and co-contraction. (The explanations for this referenced material appears in my “Don’t Get Married article @ http://erikdalton.com/article_DontGetMarried.htm )
In Spine, 2006, Brown, et al., reported that people in an externally loaded state appear to select a natural activation pattern appropriate to sufficiently maintain spine stabilization. Any attempt to make conscious adjustments to individual muscles disrupted their natural pattern and decreased stability and the margin of safety.2
Kavic, et al’s Spine research found that no single muscle dominated in the enhancement of spine stability. Individual roles continuously changed according to specific tasks. Their advice was to focus on enhancing motor patterns that incorporate many muscles rather that targeting only a select few.3
In 2006, Mens, et al., found that increasing intra-abdominal pressure caused patients to exert potentially damaging forces on pelvic ligaments. The authors recommend teaching patients techniques to reduce intra-abdominal pressure as opposed to core stability exercises.
Dr. Tim Noakes, professor of exercise and sports science at the University of Cape Town in South Africa, stated in his research, “There is no basis to expect training effects from one exercise to transfer to any other form of exercise. Training is absolutely specific.”
In Manual Therapy, 2006, MacDonald, et al., reported that EMG studies refute the belief that the multifidus is tonically active during static posture, trunk movement or gait, making it unlikely that core stability training of the multifidus can restore normal function.4
It’s an interesting subject if we want to go down that path…
By Erik Dalton on Oct 7, 2009
• Exercise prescription for chronic back or neck pain: Who prescribes it? who gets it? What is prescribed?
• Author(s)
Freburger JK, Carey TS, Holmes GM, Wallace AS, Castel LD, Darter JD, Jackman AM
• Published
Jan, 2009
• Published In
Arthritis Rheum. 2009 Jan 29;61(2):192-200
Recent research from Australia concluded that that exercise is being underutilized as a treatment for chronic back and neck pain and, to some extent, that the amount of supervision and types of exercises prescribed do not follow current practice guidelines. Exercise prescription provided by PTs appears to be most in line with current guidelines.
When I deal with LBP clients I always assess movement patterns, soft tissue quality especially around the hips. Then design a program to challenge the weakest links. Which are commonly extreme posterior chain weakness and poor hip and ankle mobility.
By Danny Christie on Dec 18, 2009
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By Devon Green on Feb 11, 2010
Will check in to it Devon…thx for the heads-up.
[WORDPRESS HASHCASH] The poster sent us ’0 which is not a hashcash value.
By Erik Dalton on Feb 11, 2010
Going to the gym for exercise and strength is essential when dealing with back pain. It is crucial to stay active. Good article.
By kirkland chiropractor on Sep 6, 2010
Use the gym. The study clearly indicates that those who worked out more with the weights significantly improved their physical condition and felt better at the end of the study than those who didn’t.
Why? Is LBP only associated with poor muscle conditioning and lack of activity? Were the participants who did not benefit so out of shape that they needed a longer more focused conditioning program to obtain improvement?
By gary on Oct 6, 2010
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By YvonneHobbs21 on Oct 15, 2010
gym could be one of the source to stay healthy and fit.To stay away from body pain we should not take for granted our body.. exercise.. eating healthy foods and good way of living will free us from different pains.
By Neck Pain on Jan 25, 2011
Great article you have here. This will be another knowledge learn to me. Continue on sharing!
By Chiropractor Therapy on Feb 4, 2011
Overall exercising with weights is important so the patient does not get deconditioned.It’s also important that the lower back extensor muscles are specifically strengthend. They should be 50% stronger than the abs.
By Pittsburgh Chiropractor on Feb 17, 2011
Exercise can only help with back pain relief if done properly. And it’s always best to be sure to stretch out those back muscles before doing any type of lifting or exercising.
By Back Pain Expert on Feb 17, 2011