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Low Back Pain

Joe Sweeney
Overview
Lower back anatomy
Sign/symptoms and risk factors for low
back pain
Common lower back injuries
Training individuals with lower back pain
Lower back Anatomy
Lumbar Vertebrae, L1-L5
Intervertebral Discs
Spinal Nerves
Lower Back Pain Facts
Avoid prolonged bed rest and return to
normal ADL (Exercise, 2004)
Increase with age
Low back pain in childhood typically
proceeds into adulthood
In most cases, want to avoid surgery
Effects men and women the same (Low
Back, 2015)
Lower Back Pain Facts
Low back pain is most common
workplace injury
80% of adults will have an episode of low
back pain (Back Pain, 2015)
31 million Americans experience low back
pain in a year
Low back pain results in $50 Million
dollars a year in medical expenses
Signs and Symptoms
Pain can range in Decreased
intensity, duration, flexibility
and frequency Difficulty sleeping
Radiating pain Difficulty with
Numbness weight-bearing
Lower extremity activities or certain
weakness movements and
positions
(Ehrman,2013)
Risk Factors
Obesity Sedentary lifestyle
Smoking Heavy lifting and
Genetics poor posture
Age (Metcalf, 2015)
Acute vs Chronic Low Back Pain
Acute Chronic
Pain lasts 4-12 Pain lasts more
weeks than 12 weeks
Heals on its own (Low Back, 2015)
No lasting pain or Pain is persistent
impairment
Acute vs Chronic
Common Low Back Injuries
Muscle soreness
Spinal stenosis Sciatica
Ankylosing Degenerative Disc
spondylitis (Ehrman, Disease
2013) Herniated disc
Lumbar
radiculopathy (Low
Back, 2015)
Sciatica
Sciatic Nerve
What Sciatica does
Can be caused by
a herniated disc or
spinal stenosis
Piriformis syndrome
(Piriformis, 2015)
Herniated Disc

(Herniated Disc, 2014)


Degenerative Disc Disease

(Nordqvist, 2014) (Bohinski, 2015)


Diagnosis and Exercise Testing
Medical History Evaluation
Physical Exam (Ehrman, 2013)
ACSM recommends low back pain can be
tested in the same way as healthy
individuals.
ACSM recommends if other
comorbidities are present then testing
should follow guidelines for that
comorbidity.
Exercise Prescription:
Cardiovascular Training
No direct positive effect on low back pain
ACSM guidelines should be followed
Safe Cardiovascular Exercises: Walking,
Swimming, Elliptical machines
Avoid jogging, biking.
Exercise Prescription: Resistance
Training
Weak core muscles NCHPAD
-Strengthening core
Avoid loading spine
-Stabilizing trunk
Good Exercises:
-Age under 50
crunches, side 10-15 reps /day
-Age above 50
planks, BW good 8-12 Reps/ day for 2
mornings, lunges, or more days/week

Lat pulldowns.
Exercise Prescription: Flexibility
Balance of back flexion and extension
stretches
Include hip, hamstring, and quadriceps
stretches as well
Case Study
My client is a 48 year old male who lives a
sedentary lifestyle and is a regular smoker.
He has had occurrences of acute low
back pain in the past. He has recently
been experiencing constant and sharp
pain in his lower back. The pain radiates
down to his upper leg, and was brought
on by doing continuous heavy lifting at his
job.
Risk Stratification
My client is at a moderate risk level
because he is a male over 45 with 2 risk
factors. The risk factors are a sedentary
lifestyle and smoking.
Diagnosis
Past history of back pain
Lack of flexibility, sharp pain, and muscle
weakness
Herniated disc, which led to sciatica
Prescribed ketoprofen (Low Back, 2015)
Exercise Testing: Cardiovascular
Testing
Exercise Testing: Muscular
Endurance and Flexibility
My Exercise Prescription:
Cardiovascular Training

Day Exercise Time

Monday Walking on treadmill 45 mins

Wednesday Swimming exercises 30 mins

Friday Elliptical machine 30 mins

Saturday Walking on treadmill 60 mins


My Exercise Prescription: Resistance
Training
Day Exercise Reps Sets

Tuesday Lunges holding dumbells 10 3

Body weight box step-ups 12 3

Leg extension machine 15 3

Calf raises 15 3

Crunches 10 3

Thursday Bench Press 10 3

Lat Pulldowns 10 3

Hammer curls 15 3

Tricep close-grip bench press 12 3

Side planks hold for 20 secs 3


My Exercise Prescription: Flexibility
Training Hamstring
Piriformis
Hip
Flexor

Back Extension Back Flexion


Conclusion
Take care of yourself!
Spread awareness
Proper lifting techniques and posture
References
ACSM Issues New Recommendations on Quantity and Quality of Exercise. (2015). Retrieved November 7, 2015.
from http://www.acsm.org/about-acsm/media-room/news-releases/2011/08/01/acsm-issues-new-
recommendations-on-quantity-and-quality-of-exercise
Are You Sitting Down? (Stretches for Hip Flexibility). (2015, February 23). Retrieved November 8, 2015,
from http://victoryfitnesscenter.net/sitting-at-a-desk-you-need-these-stretches/
Back Pain Facts & Statistics. (2015). Retrieved November 9, 2015, from
http://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68
Blahd, W., & Riggs, J. (2014, June 4). Proper Lifting Technique. Retrieved November 9, 2015, from
http://www.webmd.com/back-pain/proper-lifting-technique
Bohinski, R. (n.d.). degenerative disc disease (spondylosis). Retrieved November 7, 2015. from
http://www.mayfieldclinic.com/PE-DDD.htm#.Vj_Ran6rTIW
Ehrman, J., Gordon, P., Visich, P., & Keteyian, S. (2013). Nonspecific Low Back Pain. In Clinical Exercise Physiology
(Third ed., pp. 461-482). Champaign, Illinois: Human Kinetics.
Exercises For SciaticaHamstring Stretching Exercises For Sciatica Pain Relief. (2014, October 30). Retrieved
November 8, 2015, from http://exercisesforsciaticapuhnesh.blogspot.com/2014/10/hamstring-
stretching-exercises-for.html
Exercise Prescription for Healthy Populations with Special Considerations and Environmental Considerations.
(2004). In L. Pescatello (Ed.), ACSM's Guidelines for Exercise Testing and Prescription (Ninth ed., pp. 211-214).
Philadelphia, Pennsylvania: Wolters Kluwer
Fitzgordon, J. (2015, June 1). Compressing The Lumbar Spine All Day Long. Retrieved November 7, 2015. from
http://corewalking.com/compressing-the-lumbar-spine-all-day-long
References
Green, J. (2015). Exercise Guidelines for Clients with Lower Back Pain : NCHPAD - Building Inclusive Communities.
Retrieved November 8, 2015. from
http://www.nchpad.org/887/5010/Exercise~Guidelines~for~Clients~with~Lower~Back~Pain
Herniated Disc. (2014, July 1). Retrieved November 8, 2015. from
http://www.aans.org/patient%20information/conditions%20and%20treatments/herniated%20disc.aspx
Kosmahl, E. (2015). Orthopaedic: OBJECTIVE CLINICAL EVALUATION OF PHYSICAL IMPAIRMENT.
Retrieved November 8, 2015. from
http://www.scranton.edu/faculty/kosmahl/courses/ortho/lecturenotes/pages/obj-clin-evalu-w2.shtml
Low Back Pain Fact Sheet. (2015, November 3). Retrieved November 7, 2015. from
http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm
Low Back Pain in Asheville. (2010, July 13). Retrieved November 7, 2015. from
http://www.biltmoreparkchiropractic.com/tag/herniated-disc/
Metcalf, A. (2014, May 13). Back on Track Understanding and Preventing Back Pain. Retrieved November 9,
2015, from https://www.fix.com/blog/avoiding-back-pain/
Nordqvist, C. (2014, September 26). What is degenerative disc disease? Retrieved November 7, 2015. from
http://www.medicalnewstoday.com/articles/266630.php#what_is_degenerative_disc_disease
Piriformis Syndrome. (2015, February 9). Retrieved November 8, 2015, from
http://shawchiroandsport.com/piriformis-syndrome
Quinn, E. (2015). The Bruce Treadmill Test Protocol. Retrieved November 8, 2015, from
http://sportsmedicine.about.com/od/fitnessevalandassessment/a/Bruce_Protocol.htm
Schierling, R. (2012). Disc Degeneration. Retrieved November 7, 2015. from
http://www.spinaldecompressionmissouri.com/blog/tell-me-more-about-degenerative-discs
Sciatica Exercises. (2011, January 20). Retrieved November 8, 2015, from
http://spinalstenosis.org/blog/sciatica-exercises
Von der Muhll, A. (2014). Getting cardio exercise--even when you have neck or back pain. Retrieved November
7, 2015. from http://www.santacruzacupunctureclinic.com/neck-pain/64
Witte, A. (2015). Treatment Options in Managing Chronic Low Back Pain. Retrieved November 9, 2015, from
http://www.uspharmacist.com/continuing_education/ceviewtest/lessonid/107595/#tbl1