Back injuries are one of the most common causes of pain among patients. In fact, lower back pain is the number one cause of disability and the second most cited reason for a doctor visit. As a practitioner, you have most likely treated back injuries caused in a number of ways, including athletes who pushed just a little too far and non-athletes who pulled a back muscle doing a normal everyday activity.
Treatment of back muscle injuries varies depending on the cause and the severity of the injury, but many patients may benefit from a combination of rest, cold therapy, compression, and physical therapy exercises to strengthen and stretch the appropriate muscles.
Initial Exercises for Back Injury Patients
Immediately after a back injury, the muscles and surrounding tissues are inflamed and painful. Some patients might experience very limited range of motion and severe pain for a number of days. During this period, it’s important for the patient to try to avoid unnecessary movement and focus on controlling the pain. You might prescribe a prescription or OTC pain medication depending on how extreme the pain is. Patients may also benefit from cold therapy which can help reduce swelling and numb the area around the injury, reducing the sensation of pain.
If range of motion allows, mild stretching and strengthening exercises can be introduced, including:
- Cat/cow: Start on all fours and alternate rounding and arching the back. Keep the range of motion relatively limited during the initial phase of recovery.
- Side bend: While standing with one arm overhead, gently bend the spine to reach the arm toward the opposite side of the body.
- Partial crunches: In a supine position with feet on the floor, maintain a neutral spine and use the abdominal muscles to lift the shoulders off the ground.
- Hamstring stretches: In a supine position with feet on the floor, extend one leg toward the ceiling and slowly straighten the knee to create a gentle stretch.
- Wall sits: With feet about a foot away from a wall, press back into the wall until the knees are at a right angle, and hold the supported squat position for 10 seconds.
- Pelvic tilt: In a supine position with feet on the floor, slowly tilt the pelvis toward the ceiling and hold the position for 10 seconds.
It’s important to avoid exercises that involve lifting weight, forward bending, or cardio that causes impact, like running or jumping. Let patients, especially athletes, know that any exercises that cause pain should also be avoided.
Strengthening Exercises for Back Injury Patients
It’s a common misconception that back injuries require long periods of rest. After the initial pain and inflammation have sufficiently subsided, it’s important for patients to try and start strengthening their back muscles. This may help provide necessary support to the spine and may also help prevent future injury.
Some of the strengthening exercises to include during this phase of recovery build on the exercises above, such as:
- Prone back extension or half cobra pose
- Cat/cow with a larger range of motion
- Full crunches
- Air squats with correct form and no weight
- Bridge pose or full back bends
A Recommended Treatment Regimen
Depending on the patient, you might want to schedule several physical therapy sessions to teach the appropriate exercises to be performed at home. For patients who have experienced a back injury before, they might just need a reminder of the recommended course of treatment. You can customize this framework for each patient:
- Rest, cold therapy, and pain medication as needed or prescribed for the first few days while range of motion is limited and inflammation is at its peak
- Light strengthening and stretching exercises for 10 to 30 minutes, up to three times per day until the exercises can be performed without pain
- Ongoing strengthening exercises to improve spinal support and prevent future back muscle injuries
We have created a free tip sheet for selecting the right treatment of back muscle injuries that you can keep on hand. This resource, which you can distribute to patients, will allow you to easily provide recommendations for at-home treatment. Download it today so you have it for your next back injury patient.