What should patients with chronic low back pain pay attention to in daily life? Are flying swallow exercises and plank support training suitable for them?

Author: Xiao Jing, Chief Physician, Xiyuan Hospital, China Academy of Chinese Medical Sciences

Reviewer: Zhang Zhihai, Chief Physician, Guang'anmen Hospital, China Academy of Chinese Medical Sciences

Low back pain that persists for 12 weeks, or occurs intermittently or repeatedly within 12 weeks is called chronic low back pain. Most low back pains have no particularly clear cause and are called chronic nonspecific low back pain.

Although the cause of chronic low back pain cannot be fully identified in most cases, a considerable part of it is related to living environment, working style, exercise method, etc. For example, there is a need to sit at a desk for a long time; sports enthusiasts often play tennis, badminton, and basketball. This relatively fixed posture or exercise pattern will cause corresponding problems in the waist if accumulated over a long period of time.

Patients with chronic low back pain should first combine work and rest, and avoid maintaining a fixed posture for a long time. If you need to sit or stand for a long time to work, you must first sit in the right posture. Adjust the chair to a height that suits your body structure. The length of your calf when your knees are bent at 90 degrees is a more appropriate seat height; the entire chair should fully support your thighs and buttocks; there should be a relatively ample space between your body and the table, and your body should not lean forward too much, or get too close to the keyboard and computer monitor; place a support behind your waist to provide adequate support for your waist, so that the weight of your waist is evenly distributed to the support; the chair should preferably have armrests that can just support your elbows, so that your hands can be naturally placed flat on the desk, thereby reducing the pressure on your wrist joints. It is generally recommended to sit for forty minutes, or up to an hour, and then get up and move around.

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Second, there should be a variety of sports and entertainment. Third, when exercising, you should do a full warm-up under the guidance of professionals and learn sports skills, including muscle relaxation after exercise.

In addition, in daily life, many people like to cross their legs. Crossing legs in one direction for a long time will cause spinal twisting. When the left leg crosses the right leg or the right leg crosses the left leg, the pelvis is rotated and the spine is twisted, so that part of the spinal joints are in a state of continuous compression and the other part of the spinal joints are in a state of stretching. The compressed part of the spinal joints will accelerate degeneration over time, leading to disc herniation. In addition, the twisted posture of crossing legs makes the gluteal muscles in a state of tension for a long time, which will cause gluteal muscle damage, and then affect the muscles of one side of the thigh or calf, causing numbness, dullness, and muscle weakness. Therefore, it is recommended not to cross your legs for too long each time. Ten minutes should not be a problem. Don't always cross your legs in one direction, but alternate your legs. After crossing your legs, stand up and swing your legs backwards, push the ground, arch your waist backwards, and increase the contraction of the gluteal muscles, which can offset the adverse effects of crossing your legs.

For patients with chronic low back pain, rehabilitation training is a very important part of treatment.

Rehabilitation training should be focused on ensuring that muscle activity does not cause pain.

When patients with chronic low back pain do rehabilitation training, they must first identify bad postures and avoid bad stimulation. In addition, a screening should be done for specific physical conditions to find weak links. For example, lumbar muscle strain is a very common cause of chronic low back pain. Lumbar muscle strain is not actually a problem for all muscles. The insufficient and weak part of the muscle is not used in daily work, life, and exercise. This part of the muscle is not relied on, and over-reliance is placed on other muscles, resulting in overuse of other muscles, excessive loads, and symptoms. If you find the weak muscles and do a strengthening training to improve the stability and coordination of the waist, so that the local muscles of the waist tend to be balanced, the low back pain can be continuously relieved and will not recur.

There are many common exercise methods for chronic low back pain rehabilitation training, and each rehabilitation movement has clear indications. The most basic principle is to move in reverse or reverse order. For example, when working in front of a computer, you usually bend your waist, flex your hips, and lean forward. In fact, this posture puts a lot of pressure on the waist joints. After sitting for a while, you should stand up and stretch, swing your back, kick your legs back, and do this reverse activity, that is, the opposite of the usual movement, to activate muscles and joints that are not usually used.

Can patients with chronic low back pain do flying swallow exercises and plank training?

The flying swallow exercise is to train the back muscles, erector spinae, and gluteal muscles. However, many patients with chronic low back pain do not have weak back muscles and gluteal muscles, but the small paraspinal muscle groups are not usually involved in activities, resulting in overuse of the back muscles, erector spinae, and gluteal muscles. It is inappropriate to train the back muscles at this time, which will make the over-fatigued muscles more fatigued. For example, if you have lumbar disc herniation or osteoarthritis, doing the flying swallow exercise will increase the pressure on the spine, which will make the pain worse. Many patients will feel uncomfortable when doing the flying swallow exercise. If it hurts, don't do it.

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Plank is an exercise that tests the body's core stability and core muscle strength. Strictly speaking, it is not a recommended rehabilitation exercise. If the core strength is insufficient, forcing yourself to do plank, not doing it properly, may increase local muscle damage, increase local muscle load, and cause injury. It is recommended to first perform gentler exercises to strengthen the core muscle group, and then gradually introduce plank and other exercises after the muscle strength is gradually improved.

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For patients with chronic low back pain, they should choose a rehabilitation training method that suits them under the guidance of a doctor, follow the principle of gradual progress, continuously strengthen muscle strength, and form muscle memory, so as to truly benefit.