Rehabilitation - My Personal Regimen
This regimen is for someone who has always been physically active, was in relatively good physical condition before injury, and whose condition has primarily stabilized.
Your rehab should start immediately upon stabilization and go through the stages corresponding to your injury. The main rule should always be, not to sound too much like Dr. Doofus: If it hurts, don't do it.
You may find that what hurts does not show the effects until a good twelve hours later. Keep that in mind.
After you have found which positions offer less pain, you should be performing mild mobility exercises. The sole purpose of these is to prevent the back from "freezing" in a certain position. The "around the world" hip rotation, sometimes called the "hula hoop dancer's stretch" is a good one for the lower back.
From there, the next stage is mild supporting muscle strengthening, including many hot baths, epsom salts, saunas, whirlpool baths and ice packs. Loads and loads of ice -- get the reusable packs from the drugstore. Heat makes the injury feel good, and generally loosens the muscles, but it also increases swelling. Always follow heat treatment with cold packs to reduce inflammation.
Careful and gentle stretching should take place at this time. One good stretch to do: while sitting, hug your knees to your chest and try to gently arch your back in this position. Another: hang from a chinning bar or the top of a door.
Water is your friend. Visit the pool as you progress. Every day if possible. Swimming helps elongate the muscles gently and the water takes the weight of load-bearing structures.
The abdominals are the first big muscle group to work on after stabilization. DO NOT DO SITUPS! ESPECIALLY ON AN INCLINE BENCH! This exercise has long since fallen out of favor with virtually every educated sports trainer because it stresses the back and does not really isolate the abs as well as a combination of crunches, reverse crunches, leg lifts and oblique hyperextensions.
Next, develop the large leg muscles to enable you to squat to lift properly. Stairmaster equipment is available in every modern gym nowadays, but avoid extended sessions; in fact, you might want to avoid jogging and any jumping exercise which loads the spine. DONíT DO SQUATS! For obvious reasons.
When you are ready to do the regimen, begin with one set of 10-20 reps per exercise. Any library will have books showing proper form and most gyms have knowledgeable people around to show you how to do these common movements except for the "lateral exterior quadratus" exercise, which was given me by an informed sports chiropractor. Thanks, Dr. Klein.
Lie on your left side, legs straight out, your torso propped on your left elbow and forearm as if you were back in college reading a textbook on the green. Your right arm should be along your side. Keeping your knees straight, raise your hips clear of the floor so that the only thing touching the floor is your left ankle and your left forearm with elbow. Hold for a count of ten. This works a largely ignored deep muscle that helps keep the spine erect. The underside or the left side is the one being worked.
You may find this one quickly brings out the sweat. Don't do more than five on each side at first. If you can do that many.
Get a gym membership. Go every day. And I mean EVERY DAY! The sauna will work and you will thank me. In general the best rule for any program for any stage of the pain is this: IF IT HURTS, DONíT DO IT.
You will need to devise an individual program that hits all angles of the abs for it to work properly. A good reference is the Golds Gym Weight Training program book. The abdominal muscles help support the spine and strong abs will reduce stress on the lower back particularly. My routine features a solid hour of ab work divided clearly into sections that focus on the upper, the lower and the oblique muscles. I also work in motion exercises obtained from my chiropractor to prevent the back from "locking up" during rehab.
Personal Workout Regimen
WARMUP -10 minutes of cycling
Squat side to side
Drop fwd on hands from split and arch back. Twist gently to look over shoulder left then right.
Tai chi back stretch
Deep Lunge - Sartorius
Hip flexor rotation
Dead hang from chinning bar
Hug knees while seated on floor
Prone hamstring stretch
Reversed hurdlers stretch
Supine pelvic tilts
Supine abdominal hollowing
Supine Glute squeeze
Cheepie pushup back arches
Supine ankle on knee and pull knee to chest
Jiu jitsu hip/knee rotations
ABS - Lower
Supine - Reverse crunches from legs up position
Supine reverse crunches from legs down
Supine - Knee raises from legs straight out
Knee raises seated on bench
Leg lifts moderate back risk
Leg lifts alternating
Leg lifts with figure 8s and with scissors
Crunches knees up
Crunches knees down
Crunches with one leg straight up
Crunches legs up in a V
Toe touch (jacknife) gradual movement
Cable crunches (prayer position)
Side leg raises single leg
Side leg raises both legs
Side jackknife double leg
Roman chair hyperextensions
Standing side bends with and without weight
Leg overs single and double leg
Lateral exterior quatraus levate and hold
Prone hands behind back and levate to hold
Prone arms extended. Lift opposing arm and leg
Toe touches legs up in a V
Sitting, hands on floor, knees up and out
Side knee ups
BACK -Weights - moderate back risk
Reverse grip pulldown
Neutral grip pulldown
One arm barbell row
Wide grip chinup
Squat with 20# dumbell between knees
Seated cable row
Start with 25 reps each. Follow-up with 450 yards of swimming.
(this is repeated in another section)
HIP RAISES (Sometimes called "reverse crunches")
HOW TO DO
1. Lie on the floor and place hands on the floor or behind the head. Newbies should put arms along the sides to help support the back.
2. Raise the legs until the toes point to the ceiling at 90 degrees, with feet together or crossed.
3. Contract the abs to curl the hips off the floor, reaching the legs up towards the ceiling.
4. Lower and repeat for 1-3 sets of 12-16 reps.
5. It's a very small movement, so try to use your abs to lift your hips rather than swinging your legs and creating momentum.
You can add another exercise without budging from this position by doing crunches with the legs still raised. This way you avoid cheating by omitting use of the thigh muscles.
HOW TO DO
1. Lie on the ball, positioning it under the lower back.
2. Cross your arms over the chest or place them behind your head.
3. Contract your abs to lift your torso off the ball, pulling the bottom of your ribcage down toward your hips.
4. As you curl up, keep the ball stable (i.e., the ball shouldn't roll).
5. Lower back down, getting a stretch in the abs, and repeat for 1-3 sets of 12-16 reps.
Knee lifts in the "Captain's Chair" with the back supported are also good, although it is difficult for a lot of people to avoid swinging the legs to get them up while also avoiding back curl. The Captain's Chair is that thing you hang from with your forearms supported by handle-grips and pads.
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