Eighty percent of Americans will suffer back pain at some time in their lives. Back pain often develops without a cause that shows up in a test or imaging study. According the Mayo Clinic, risk factors for back pain include age, lack of exercise, excess weight, diseases such as arthritis and cancer, and improper lifting. People prone to depression and anxiety and smokers have an increased risk of back pain. Regular low impact aerobics and abdominal and back muscle exercises that strengthen the core can help keep the back healthy and strong.
Exercises that improve posture is a good place to start. Bring the neck into alignment with chin tucks. Put a finger on your chin and, keeping your chin level, pull it away from your finger. Some people have trouble with this exercise and tend to pull the chin down. Another way to cue the exercise is to say “lift the sternum” which accomplishes the same thing. Next relax the shoulders and bring the shoulder blades down. Turning the palms forward can help accomplish this. When you stand, stand tall with your body weight evenly distributed between both feet and the knees pointing forward. When you sit, keep both feet on the floor with the knees bent at hip level or below,
Exercises to improve posture are exercises that strengthen the core. Although many people associate crunches with core exercises, the core includes all the muscles of the trunk. The pool is the perfect place to work the core because immersion in water activates the core muscles. It is a discreet but constant activation, and you do not feel it the same way as an abdominal crunch. The core muscles most in need of strengthening for good posture are the muscles of the upper back, the erector spinae and the glutes. Always stabilize the core before moving the arms and legs. The best exercise to strengthen the posterior muscles is to travel backwards in the pool. Some other exercises to try in the pool are:
- Upright row. Cup the hands and pull the water toward you. You can also use webbed gloves, drag equipment or kickboards.
- Lat pull-down. Hold resistance tubing overhead and pull the ends down to the sides. Or do jumping jacks with foam dumbbells or drag equipment.
- Rear delt fly. Hold resistance tubing chest high and pull the ends apart.
- Shoulder external rotation. Rotator cuff sweep out with thumbs up.
- Straddle a noodle with the end of the noodle between the thighs; adjust the height of the knees to find the difference between extension, neutral and flexed.
- Abdominal pike and spine extension. Go only 45 degrees to the back to avoid hyperextending the back. Use a deep-water belt. Do not try this exercise with just foam dumbbells. (See the previous post on the shoulders.)
- Back rotation. Upper body twist or hula hoop.
- Squats with feet hip distance apart or a narrow stance.
- Hip extension. Skate kick or cross-country ski.
In addition to strengthening the core, there are some cautions to help you avoid an injury. When running in deep water, maintain the spine in neutral alignment. In this position the spine is off-loaded because of the buoyancy of the water. However, people often lean forward which reduces the frontal resistance and allows them to travel faster, but this position also causes spinal compression even though there is no lower body impact.
It is also important to maintain good posture in shallow water. Other things to avoid include prone flutter kicks at the wall. This compromises the grip, the neck, and the lumbar spine. Do not hang on the wall and do double leg lifts; this overloads the lumbar spine. Wall-hanging sit-ups do not exercise the abdominals and it is too difficult for many water exercise participants to get into that position. The risks outweigh any benefit. Crunches in a supine position put stress on the neck and use the hip flexors instead of the abdominals. Do not do rotation and forward flexion at the same time (opposite elbow to knee) as it puts stress on the lumbar spine. Participants with compressed discs or osteoporosis should avoid trunk flexion. It is better to work on core stabilization by bracing the core and emphasizing good posture.
Working on good posture and strengthening your core muscles are good ways to take care of your spine and reduce your risk of back pain in the future.
Ruth Sova, MS – Backs Mini Session 9-1-22
Pauline Ivens, MS & Catherine Holder, PT Do No Harm 2011
See you in the pool!