Lower back pain is clearly one of the most common complaints Manual Therapist have been treating for decades now.
And research is very clear that a graded strength programme for the lower back is a worthwhile part of any treatment plan.
Most of the time lower back pain comes down to modern lifestyle factors, which means one of two things usually.
Either the client has become weak from inactivity, or the client’s lower back can’t quite meet the demands of the activity that they are doing.
If you’re scratching your head at that last sentence then you’re not the only one.
Being weak from inactivity makes sense to most of us. But the same problem with active people? How so?
Well it comes down to similar reasons actually.
When you interview people with back pain they usually meet one of the following:
- They are inactive and have become quite weak.
- They are active but only for short bursts of time and are otherwise quite inactive.
- They are highly active and overloading the tissues.
However you slice it, these people have backs that can’t meet the demands placed on them.
So if you can help them gain the additional strength they need, alongside your manual treatments, you’ll get significant improvements in your results.
Introducing The Prone Cobra (AKA Prone Spinal Extension Isometric).
So as a Manual Therapist what would a safe starting place be to introduce a client to lower back strengthening?
Well the Prone Cobra is a great first exercise, especially if you’re a little worried about having your client flex the spine.
This exercise starts the client in spinal neutral and asks the lower back muscles to simply stabilise as the upper torso is lifted off the ground slightly.
This way the weight of the head and shoulder girdle provide an excellent amount of resistance.
You can regress this exercise down in multiple ways too
Even to merely thinking about lifting the torso if you like.
Which makes this a great starting point for those sensitive clients.
Once the client can maintain a 20-30 second hold, 3-4 times, with a minute rest between, then they are ready to move on.
You can also pair this exercise with a Prone Hip Extension to really work the lower back from both ends, if you like.
Give it a try on those clients that you feel are ready for exercise, and let us know how it goes.
You can find this exercise under the Lumbar Spine, and Thoracic Spine, Isometric sections of ExerciseLab.