Strengthening routines are included in most back rehabilitation programmes as muscle wasting is usually evident with Chronic Low Back Pain. Some programmes include low intensity exercise, other programmes use high intensity exercise involving costly and complex equipment. The Back-in-Rehab Programme incorporates a gradual strengthening approach, allowing you to start at a low and manageable level, steadily building up to higher levels of intensity if appropriate. No equipment is required and a road map for progressing your routine is laid out for you in the Back-in-Rehab Programme.
Strengthening should be safe, with minimal discomfort and be close to zone 1.
Sit-ups are not included in this program as they can be difficult to control and tend to increase spinal compression in flexed positions (usually in Zone 4). Most disc injuries occur with combinations of flexion and rotation of the spine; sit-ups may reinforce these movement patterns. The strengthening component in the Back-in-Rehab Programme loads the back from 4 different directions. Flexion, Extension and each side.
The aim is to be close to the mid-range position during strength training where an increased load is easier for the back to manage (usually Zone 1).
Some abdominal Strengthening exercises like the prone plank may start from Zone 3 and then move toward the mid-range position of Zone 1.