Anything actually work for low back pain?

Discussion in 'Health & Fitness' started by heycal, Feb 18, 2013.

  1. heycal

    heycal Hall of Fame

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    I've had lower back pain for about a year. MRI's show not unusual damage for a 50 year old in terms of disc and arthritis stuff. I've tried various strengthening and stretching exercises, but nothing helps. I continue to do all recreational activities and weight training I've always done, since they don't seem to aggravate the problem. (Sitting and lying down are the bigger problems.)

    Anyone here have any experience with any treatments that actually greatly helped their long term-ish low back pain? (I never did have much success trying to treat my neck for similar issues. The pain just gradually turned into a chronic stiffness.)

    I'm worried that the only thing that's going to help -- if anything does -- is time. Anyone beg to differ?
     
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  2. OHBH

    OHBH Semi-Pro

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    Because the back is so integral to everyday movement it is very difficult to give it proper rest. You need to do lots of core strengthening exercises and wear a brace or back support most of the day so that you can relax it more during the day.
     
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  3. ollinger

    ollinger Legend

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    "Time" doesn't help arthritis -- usually makes it worse. Spinal arthritis usually demands less physical activity. It's different from other joints in that the arthritic changes in the facets doesn't remodel or improve with moderate activity.
     
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  4. heycal

    heycal Hall of Fame

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    Back brace, huh? Hmm. One of the docs actually suggested this, but since he didn't seem very pumped about it, and since I was a bit skeptical, I never got around to it. Maybe I should.

    I've already done -- and still do -- a fair amount of core stuff. Doesn't help much.


    But we do know that there are people who suffer less from arthritis than they used to for one reason or another, yes? I actually have a friend who was told his arthritis would only get worse a few years back, but he actually says he feels better now. I think all he did was a few back exercises here and there. (And I only need look at myself for confirmation of this: my neck bothers me less than it did 2 years ago.)

    I'd have to say the only times my back doesn't bother are when walking, or doing a specific stretch for it. Tennis and other more strenuous activities can leave it a little sore, but not much.

    For those who know about such things, here is the summary of my MRI (my cervical and thoracic are similar or worse I believe.) I welcome any input or explanation of this:

    MRI OF THE LUMBAR SPINE

    Spondylitic changes L5-S1, with a left paracentral annular tear and small associated posterocentral disc herniation. Mild diffuse degenerative facet hypertrophy. No stenosis demonstrated.
     
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  5. OHBH

    OHBH Semi-Pro

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    I injured my back 3 years ago doing too much deadlifts. Made it impossible to do a proper serve. But I played wearing a brace just like this one http://www.amazon.com/McDavid-493R-Back-Support/dp/B000UW1MPU/ref=cm_lmf_tit_10 hit only patty cake serves and did abdominal workouts. In 3 months I was 100 percent. A little different at your age but I still think it help me recover a lot more quickly and I didn't have to stop playing tennis.
     
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  6. Bobby Jr

    Bobby Jr Legend

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    One of the best alleviators of lower back pain is walking. The cadence relaxes the hips and spine area somewhat (assuming you can walk fine).

    I've also had many troubles with lower back issues over the years and found doing the yoga child pose very helpful. Tight quads and hamstrings especially are also known to contribute to back issues.

    So far as core exercises go - they can help but many people end up worse off because the sort that help your lower back need to be done with ruthless adherence to form otherwise they'll be counter-productive and probably make the pain worse.

    One good one is the leg lift - where you lie on your back with your legs straight and lift one/both up and then and then back down to almost touching the floor.... Everyone has seen this exercise but the majority of people with sore back will make it worse doing it. Instead do it one leg at time with the other leg bent at the knee with the foot pressing on the floor near your buttock. You should also do it with the small of your back pressed onto the floor. So, hold you hands palm down with the fingers wedged in under the small of your back instead of having them simply on the floor by your side. You should be able to do the exercise with your hands being pressed down by your back - if not, you're not holding your core straight enough and probably wasting your effort with regards to addressing the back pain.

    Don't do: sit-ups, crunches or double leg lifts. No amount of doing these will alleviate lower back pain and will usually make it worse.
     
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  7. morten

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    core training never helped my lower back, a myth and marketing hype my doctor said.. my back is better now, took me seven years...
     
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  8. Thepowerofchoice

    Thepowerofchoice Semi-Pro

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    I had lower back pain which started last year for the first time in my life and it scares the crap out of me (I'm 44). The pain was shooting down my butt for several days and back up to my lower back. This went on for several months.

    My friend gave me this book and swears by it.
    http://foundationtraining.com/home/

    His wife had lower-back pain for more than 20 years and this book saved her from constant nagging back pain after a few short weeks following these tough but simple exercises.

    After first week of this program and already feeling 80% better but not just my lower back. I just feel better in overall. Its hard to explain but feel more efficient on the court and almost pain free. I still do this as a warm up before my fitness routine as a warm up.

    I have many arthritis but after changing my diet to "gluten free"...I'm now pain free and feeling like I'm back in my 20's. Just my 2 cents.
     
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  9. wallabeechamp

    wallabeechamp New User

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  10. heycal

    heycal Hall of Fame

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    Good post. Thanks.

    I do like to walk because it doesn't hurt and also burns a few calories.

    The rest of your post terrifies though. I've never been one to have perfect form on exercises, and of course, people often disagree on what correct form is.

    This single leg left thing you mention is interesting. Just had a session with some trainer who suggested both legs at a time to help the lower back. So either he is right, you are right, you both are wrong, or it doesn't matter if you use one or both legs. Hmm.

    What other exercises do you like or not like for low back issues?

    I've heard this can help, and the book "Wheat Belly" contains all sorts of stories like this.

    but I'm afraid to contemplate such a thing. Gluten free? I'm not sure which is worse: back pain or giving up the main reason I like being alive: eating bread and bread type products.

    Did it religiously for a month. Nothin'. I was even a supposedly perfect candidate for it based on their symptom checklist in the book.
     
    Last edited: Feb 19, 2013
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  11. heycal

    heycal Hall of Fame

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    All hype, huh? Interesting but disturbing. I can believe it though....

    What did work for you, if anything?
     
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  12. charliefedererer

    charliefedererer Legend

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    The MRI results show some "chronic changes" and don't offer a real insight into your problem.
    Many with no back pain would have some similar MRI's.


    Several have been kind enough to post potential back exercise programs for you to consider:
    - yoga
    - leg lift
    - foundation training [the videos are in fact worth watching]
    - Mckenzie stretch technique

    PostureGuy, who frequently posts here, likely would also recommend Egoscue exercises, illustrated in the book Pain Free.



    I would have you keep an open mind about any of these "therapies" that have as their central tenet hyperextension exercises of the back.

    [​IMG]


    AAAAGGGGHHHH!!! you must be thinking looking at that horrible form in Djoker's serve photo above.

    But even in a conditioned athlete like you doing properly executed squats and deadlifts to maintain a great core and back, there can build up "tightness" that tends to keep the back in relative flexion during the course of our day.
    Or even during our tennis or weightlifting.

    The extra hyperextension exercises of the back just might/I] be the recipe of success for relieving the tendency for your back muscles to remain tight in an flexed posture.

    [​IMG]
    "Founder exercise" of foundation training

    [​IMG]
    "cats and dogs" exercise as demonstrated by Suzanna McGee aka "sixftlion", an exercise recommended by her http://www.tennisfitnesslove.com/20...ows-wrists-lower-back-and-knees/#.USOfX6WsiSo and also by Pete Egoscue in Pain Free

    [​IMG]
    - yoga back exericises
     
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  13. morten

    morten Hall of Fame

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    nothing lol, just wait and while still do sports at a lower level, sitting for longer times, especially high barstools etc, made it worse, tried chiropractors, naprapathy, fysiotherapy.. They all said different things btw, some said run, others no no, some said ride a bike others the opposite.. Excercise made it worse, even very light excercises
     
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  14. heycal

    heycal Hall of Fame

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    Thanks, Charlie. I appreciate the input. I actually already do many of these exercises and stretches several times a day. Lot of extensions as per McKenzie. Many do feel good to do and help for a short period of time, but it doesn't last long.

    This is scary, but very believable unfortunately: different people suggesting different things, and nothing really working but time itself.

    I just went through this with my neck. Hurt for well over a year, but now just feels stiff all the time, an improvement I'm happy with. I can't recall anything specific helping, and I did the shots, PT, stretching, accupuncture, etc routine.
     
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  15. morten

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    good luck heycal! it could be over in a few weeks or a couple of months too..
     
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  16. heycal

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    Thanks, Morten. We shall see....

    When you said your doctor said all that core stuff was a myth, what DID he think would work if anything?
     
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  17. heycal

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    Anyone else want to weigh in on the double vs. single leg lifts, and why one might be better or more harmful than the other? Curious about that one.
     
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  18. morten

    morten Hall of Fame

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    time or surgery, i could do surgery but did not dare.... there seems to be a lot of different reasons, treatments and symptoms of lower back pain, you and me probably have different pain.. the so called experts say different things and and "guess" things imo. some even say it`s mental, well it became mental that`s for sure lol... :) I went from competitive nationally ranked both tennis and squash, to dropping a couple of levels :( lost interrest in competing, as i said it is better now, but stiffer than before. I got my pain from sitting a lot in front of the computer. I think core excercises are good for preventing pain, but once you get it i don`t know... now i have some foot bain, inside side of the ankle, a torn tendon, have not played for months :( but that`s a different story..
     
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  19. heycal

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    I think sitting at a computer and elsewhere and doing most everything else with bad posture for decades was a big cause of mine too.
     
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  20. Bobby Jr

    Bobby Jr Legend

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    Good stuff re: the walking.

    My experience started when I played squash years ago. I saw the person who was then the Aussie Olympic doctor. He thought surgery was an option - although my issue was confined to L5 and L4 so not quite as extensive as you. We opted to try mild therapy and a few set exercises and, surprisingly, I got to a level I could live with relatively quickly. I've had flare-ups, especially when I spend a lot of time sitting at a desk or do something like kayaking but can get back to manageable levels within a short period.

    One thing I most definitely do not agree with re: your trainer is the double leg lift. He is dead wrong and every time you do it you're probably making your back worse - fyi this is straight from the mouth of a Dr who treated many dozens of gold medal winning athletes.

    There is simply no way - unless done with solid form - for it not to cause additional stresses on the lower back. Think about it - when you lift your legs all the pressure and weight of your legs gets focussed into the pivot point, which presses your hips into the floor as the load increases. To compensate for the weight as you raise/lower your legs your back will naturally arch (unless you have super light legs :p ). This massively increases the force on the bones in the lower back. Hence the one leg idea - you use the other leg to brace properly and reduce the weight by half. But, keeping the small of your back as flat on the floor as much as possible is key.

    I'm very surprised your PT hasn't explained this (or has he?). Without keeping your lumbar region as flat on the floor as you can manage this exercise is 100% pointless.

    A note on this: start this exercise is with the leg skywards, not on the floor. It means you can focus on the flat back thing better and then lower your leg. Doing it from the floor up you start at the point of highest weight/pressure so will be harder to find good form initially.

    Someone else posted some other exercises - cats & dog and the pic of the yoga exercises. I do a few of them daily and they seem to be good for easing annoying muscle tension and strengthening without loading up the lower back as many normal core exercises do. That is what you're trying to achieve.

    It's worth considering that the bottom of the spine has all of the weight of the body above it pushing down on it. Most of the pain (assuming it's not skeletal injury) will be down to chronically tight or inflamed muscles and connective tissue - not lack of strength. So, on one hand you're trying to find a way to ease the load on the back by improving the torso muscles, but you also need to ease all the tight muscles/connective tissues around the spine/hips which are likely giving you the pain - not making them tighter by overworking them more, especially with poor form. When you have a sore back they're in an almost constant state of tension and mild probably inflammation too. If you find yourself at your desk holding your abs tight to alleviate your lower back pain then this is a good demonstration of it - even sitting or lying down they can be overworked.
     
    Last edited: Feb 19, 2013
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  21. Kevin T

    Kevin T Professional

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    Agree 100%. No double leg lifts per multiple PTs I've worked with (my best friend is a PT that practices clinically and teaches-also works for the group that works with the Chargers and Padres in San Diego). I've tried it all over nearly 20 years with multiple L4-L5 herniations and ruptures and rest/time and not getting aggressive too quickly have worked best. I stopped lifting weights and stopped crunches and most core exercises 2-3 years ago. I do a crossfit-style routine of pull-ups, push ups, dips and lunges 3-4 days/week. The only core specific work I do is planks. I also do the McKenzie extensions regularly, particularly if I feel a twinge. Egoscue helped some but I think the McKenzie program works best for me. I play tennis or squash 2-3 times/week. Knock on wood, I haven't had a flare up in 2 1/2 years when I used to have a flare every 4 months like clock work.
     
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  22. heycal

    heycal Hall of Fame

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    Ok, gentlemen, I'm sold: no more double leg lifts. I will switch to single.

    But did someone say their problem was "not as bad" as mine? I was feeling hopeful because Charliefederer said my MRI sounded fairly routine.
     
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  23. Bobby Jr

    Bobby Jr Legend

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    This ^.. I have trouble with heycal's trainer apparently not knowing that double leg lifts can put a huge amount of strain on the lower back.

    This ^. I do more stretching on my core - as per some of the yoga stretches posted earlier, and no crunches/sit-ups at all. Like you I do planks quite often though. They seem to be quite low stress on the lower back and, in theory, are a static exercise so the chance for tweaking something is lower than with movements.
     
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  24. boramiNYC

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    I'd say more like a marketing for your doctors business really.

    check out this book by a renowned spine surgeon called 'the 7 minute back pain solution'. and guess what it's all about, carefully executed core stretches and strength training.
    I'm not really a back pain sufferer but I read these stuff for fun and the book is nothing ground breaking but basic and solid information from a highly reputable source. if followed carefully the book should help most lower back pain sufferers.

    for the best long term results despite serious commitment to rehabilitate your back, I think Alexander technique is by far the best.
     
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  25. wallabeechamp

    wallabeechamp New User

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    heycal, Have you ever tried/looked in to spinal decompression or cold laser therapy. These work for me.

    hth
     
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  26. heycal

    heycal Hall of Fame

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    I have not, no. Haven't tried a chiropractor or accupuncturist either. still feeling burned after I desperately tried accupuncture for my neck. A thousand bucks equaled = zero results.
     
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  27. heycal

    heycal Hall of Fame

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    Speaking of good and bad exercises for lower back, what do you guys think of bending over and touching your toes or the floor in front of you? Seems like some say avoid it, while others say you should do it. You really do feel a stretch in the lower back -- but is that a good thing or a bad thing?

    McKenzie recommends some of this, for one, and it seems like it shows up in various yoga moves too. But I've come across cautions against it as well. What's the verdict?
     
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  28. comeback

    comeback Professional

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    I am 62 a certified trainer and tennis teaching pro and tournament player
    5'9" 170lbs in very good shape. I have had back problems the last 20 years (my Mri is 2 pages long) but continue to try and learn. I have had success with these therapy's below. Sitting at a computer will kill your back (check out the nada chair belt below for that)..One thing i learned in this forum and other places is that certain stretches/yoga will feel good at the time but will weaken your back in the long run,,Sometimes it's better to stabilize it with specific exercises. An example of a stabilizing exercise are reverse situps and crunches but emphasizing your lower back being flat on the floor. Also stabalize your back when you serve . I played on hard courts until the last 3 years. Now i'm mosly on clay and it helps.


    http://www.rebuildyourback.com/


    https://www.youtube.com/watch?v=X7DEbG6S04I


    http://www.nadachair.com/how_it_works.html


    https://www.youtube.com/watch?v=P2jBYrSm9g8&NR=1&feature=endscreen
     
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  29. charliefedererer

    charliefedererer Legend

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    Compared to the forces involved in serving or doing a deadlift, bending over and touching your toes wood seem okay - as long as you can do it fairly easily.
    For most though, it is the opposite motion - reasonably hyperextending the back - that seems to relieve the chronic tendency to have too rounded a back (from us spending so much time sitting and standing.)

    I would think the main thing would be to follow Kevin T's advice and cut back on the most stressful activites like weight lifting (and maybe even serving) - at least for a while.

    If you can just "get over the hump" of getting through a phase of imflammation/pain, I meant to imply that on your back MRI there is no structural reason to say you are really stuck with having long term back pain.

    It is well known that areas already experiencing inflammation will continue to produce more inflammatory mediators in response to heavy exercise.
    (While it is just the opposite with healthy tissues - more mediators will be produced to promote strengthening and end the inflammation.)
     
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  30. heycal

    heycal Hall of Fame

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    Which specific exercises fall into this category in your opinion?

    Both flexion and extension seem to produce temporary alleviation/improvement of pain. If anything, flexion perhaps a bit more. But I do realize extension is supposedly the key, at least according to McKenzie and some others.

    I do weightlift once very 3 days for 15 minutes, but I don't notice any pain during or after that, so I'm loathe to give that up. (I gave it for a few months when I was battling similar neck issues, but it didn't seem to help.)

    The biggest "activities" that cause discomfort are sitting and sleeping. Hard to avoid those unfortunately.
     
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  31. Bobby Jr

    Bobby Jr Legend

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    If sitting/lying down are the worst of it then your issue is almost certainly a chronic inflammation - caused by something you keep doing. Even very mild inflammation around the lumbar/hips region can compound with sitting/lying down - especially reclining on a couch to watch tv.

    I seriously suggest you try walking as a starting point and see if it helps loosen up/ease some of the tightness in that area and move you towards feeling better.
     
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  32. comeback

    comeback Professional

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    Bending over to touch toes:feels great, blood flow goes to your head etc BUT it might just be a question of overdoing it..combine stretches with strength/stability stuff. Sometimes it's not the exercises but the COMBINATION and FREQUENCY...some exercises are good for health but maybe not good for tennis since it is an uneven unbalanced activity...
    It took me years to find the right formula. I'm still working on it and have only about 2-3 flareups a year

    Sleeping: sleep with a pillow between your legs
    Sitting/computer: the worst for your back,use the nada chair brace http://www.nadachair.com/how_it_works.html
    Watching TV: use a recliner or lay flat,do stabilizing while on the floor

    Playing tennis: learn to stabilize before every shot, stay controlled, don't play wildly, get better technically and end points. Flat serves are less strenuous than trying to twist your body for a kick serve. I use a slightly longer racket and hold my serve grip off the buttcap to get maximum leverage on a flat serve without painfully reaching..I spin serve with wrist only (no contorted twisting).. make the other guy run.don't be a retriever.

    I do not believe in chiropractors..i went to many over the years and it never helped. Sometimes they made it worse

    I take ibuprofen before a match to reduce inflamation.(i know this controversial)
     
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  33. heycal

    heycal Hall of Fame

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    As I think i mentioned, I do walk a fair amount, about one hour 4 times a week. Other activities include mild swimming a couple of times a week, and 15 minutes of weight lifting every 3 days. Not much tennis at the moment, so that's not an issue.

    I can easily believe it's something I'm doing that makes my back worst. Always had bad posture and sitting habits and it probably caught up with it.

    I have a recliner, which doesn't always feel great. That suggests it's either the wrong recliner for me, all recliners are bad for the lower back, or it doesn't really matter what I'm sitting at this point -- it's gonna hurt.

    Sleeping on my stomach, with a thin pillow beneath my hips/pelvis, is the most comfortable way I've found. Of course, it's not great for the neck, but I'm doing triage here. Side sleeping, with or without pillow beneath my legs, is not as comfortable.
     
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  34. Povl Carstensen

    Povl Carstensen Legend

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    If I remember correctly, McKenzie only recommends this after you are doing reasonably well, before that it is backward bending. As for sitting, I strongly recommend the wedge pillows for your office/computer chairs and other chairs you use regularily. If your office chair seat can tilt forwards, you do not need the pillow.
    Edit: I would say it looks much more simple and functional than the nadachair
     
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  35. heycal

    heycal Hall of Fame

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    Right, it's an advanced exercise re McKenzie. But since it doesn't bother me and feels ok, i do it now and then.

    I often work with a laptop in my mind while sitting in a recliner. Probably with bad posture, and in a perhaps not great recliner. Sometimes I sit at a regular desk, but often my posture is bad there as well. Hard to break those habits.

    I also notice I cross my legs a lot when sitting in my recliner or some other chairs. I don't know, but I guess I do it because it feels temporarily more comfortable. Not even aware of it most of the time.

    That nadachair looks like a headache, so I'm not sure I want to drop 70 bucks to try it. Plus, it's seems like between the neck and back, I'm always buying pillows and devices that never really solves the problem.
     
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  36. Povl Carstensen

    Povl Carstensen Legend

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    If the recliner supportes the lower back, it is not so bad. To me, the wedged pillow is a simple, comfortable way to make you break the bad habit, almost forcing you to do it, without really noticing.
     
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  37. heycal

    heycal Hall of Fame

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    This thread prompted me to follow up on the back brace yesterday, and should have it next week.

    Thanks for the thoughts, guys. Keep 'em coming!
     
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  38. charliefedererer

    charliefedererer Legend

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    I would think the back brace is a means to keep you from "rounding your back".

    In YOU, this may be a valuable addition to your stretches and exercise.

    (In others who do not stretch/exercise, a back brace only leads to weaker and weaker muscles as it allows for too much rest for the already weak muscles.)
     
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  39. heycal

    heycal Hall of Fame

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    Let's hope so. I think if I can improve my bad habits, it could go a long way towards helping.
     
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  40. maleyoyo

    maleyoyo Rookie

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    Bedroom activities could have detrimental effect on your lower back.
    You are not 25 anymore heycal; can’t be that baseline basher forever. Maybe it’s time to refine your technique and your game just like tennis.
    Just saying
     
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  41. corners

    corners Legend

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    Walking is the best medicine for backs. Lots of scientific evidence to support this. Half hour per day does wonders for most people. Cheaper and more effective than chiropractic, says my grandfather, who is a chiropractor.
     
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  42. Bud

    Bud Bionic Poster

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    You may want to research something called the Melt Method. It's basically a new twist on Trager bodywork - which uses gentle rocking movement, light pressure and stretching to relax the body's connective tissue. The only tools used are some soft rubber balls and one of those 3' long x 6" diameter cylindrical foam 'rollers'.

    I tried some of the exercises today and it definitely releases body tension and feels great.

    - - -

    As many others stated - walking - probably the best exercise you can do for your body.
     
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  43. heycal

    heycal Hall of Fame

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    Well, you gotta give the people what they want.

    In any case, my neck suffers from bedroom activities much more than my back does. Movement seems good for the back, remember?

    Thanks, I'll check it out. And continue my 4 hours plus a week walking. Glad I'm doing something right!

    One thing I don't understand when I read about all this stuff is flat back versus neutral spine stuff. So many exercises and stretches call for flat back, touching the floor, but I thought a natural curve in the back was the ideal posture. So what's the connection between the two?
     
    #43
  44. Povl Carstensen

    Povl Carstensen Legend

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    I never felt playing tennis worsened my back problems. I would never consider using a back brace. Perhaps just being a bit more aware of my posture on the court. My 2 c.
     
    #44
  45. comeback

    comeback Professional

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    Hey cal, you will love the brace if it's the nada chair..It's great for prolonged use where it is very difficult to keep your back in an upright position.The belt will keep you anatomically correct without weakening your back..keep it on your computer chair. it easily folds up to carry. And i even wear it in restaurants, even airlines. There are many good therapies recommended here. But as in any recipe, all the ingredients are good, but too much or too little of one ingredient will ruin the dish..It's finding the right combination formula for you.
     
    #45
  46. heycal

    heycal Hall of Fame

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    It's actually not the nadachair, but a more conventional brace.
     
    #46
  47. comeback

    comeback Professional

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    ok if that's what you desire but a brace that constricts your stomach might actually weaken your back and it's very difficult to keep it on for any extended periods:)
     
    #47
  48. heycal

    heycal Hall of Fame

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    It's not what I "desire", it's what I'm going to try after a year of pain and no improvement, and after being prescribed one by a doctor, and after having been endorsed by others in this thread who say they've been helped by them. I can easily see it not helping, yes, but it's hard to see it doing much harm since I'm not required to continue wearing it, and can stop if no improvement or worsening of symptoms.
     
    #48
  49. heycal

    heycal Hall of Fame

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    why flat back?

    Anyone know why we're supposed to keep our back flat on the floor whilst doing these various exercises? I thought a flat and/or rounded back was the enemy here, and that we were after a natural curvature.
     
    #49
  50. comeback

    comeback Professional

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    sure i understand, no problem, just want you to get better.. it's just that i have gone thru many braces and have a box full of them and other apparatus..The nada chair is the best thing i ever got ..I actually turned a lot of people on to it. Contrary to what some others say here. They have never tried it (the nada chair) and don't understand it. i didn't see anyone endorse a another brace unless i missed it..I usually trust people more if they have experienced something themselves..
     
    #50

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