Specific exercise for non-specific low back pain
Continuing our discussion on the importance of restoration of lumbar extension (low back backward bending) and lordosis (S-curve) for non-specific low back pain, physiotherapists have always been looking for specific exercises to achieve normal mobility and alignment. Traditionally, we would give "specific" instructions to patients to perform say 3 times a day, 5 sets of 10 second stretches or 2 sets of 10 motions. Such instructions appear clear and familiar as instructions to take medications. Little do we know that exercises have little or no continual and lasting effect as taking medications! Unfortunately, patients and even most physiotherapists misunderstand that performing such sets of exercises is enough to recall our muscle memory to maintain our lordosis all day.
Personally, I am not able to achieve such ideal muscle memory to maintain my lumbar lordosis without continually reminding myself to do so (perhaps with less effort for an "expert" like myself)! I therefore suggest simple lumbar hollowing or pelvic tilting as illustrated in the diagram as a constant reminder. Normal lumbar lordosis in standing or sitting is about 85% into full extension. The best pelvic tilting movement is at the range of 75% to 95% into extension. We should perform such movement constantly throughout the day. It could be slightly faster with obvious movement if possible but should be so slow most times that nobody would notice the movement. Do not regard this as exercise. This is "breathing" and "circulation" of the lumbar spine. How often do we "breath"? We should pelvic tilt gently and smoothly with small range of movements (75% to 95% into extension) as much as possible like shallow breathing all day.
Luck LI
Musculoskeletal Physiotherapist
Personally, I am not able to achieve such ideal muscle memory to maintain my lumbar lordosis without continually reminding myself to do so (perhaps with less effort for an "expert" like myself)! I therefore suggest simple lumbar hollowing or pelvic tilting as illustrated in the diagram as a constant reminder. Normal lumbar lordosis in standing or sitting is about 85% into full extension. The best pelvic tilting movement is at the range of 75% to 95% into extension. We should perform such movement constantly throughout the day. It could be slightly faster with obvious movement if possible but should be so slow most times that nobody would notice the movement. Do not regard this as exercise. This is "breathing" and "circulation" of the lumbar spine. How often do we "breath"? We should pelvic tilt gently and smoothly with small range of movements (75% to 95% into extension) as much as possible like shallow breathing all day.
Luck LI
Musculoskeletal Physiotherapist