The Do's and Don'ts of Exercising With a Strained Back

Up to 80% of Americans will experience at least one episode of significant back pain in their lives. Many of these episodes are due to injuries called strains that leave people in pain and struggling to move. If you're one of them, you've probably found yourself asking, "Is exercising with a strained back even possible, or should I take it easy until I heal?"

Exercising correctly with a strained back can re-strengthen your core muscles and help relieve your pain, but improper exercise can make your pain and injury worse. This means that, along with seeking appropriate medical attention, you'll need to find alternative ways to stay active and avoid pushing yourself too hard. You can also take advantage of quite a few medication-free approaches to pain relief, including supportive lumbar braces and heat treatments.

How a Back Strain Affects Your Body

To understand the exercise limitations that come with a back strain, it's best to start by learning what a sprain is and how it affects your body.

Your back is a complex structure made up of the spinal column, muscles, tendons, ligaments, nerves, and connective tissue. This complexity is what allows us to stand upright, bend, twist, and walk on two legs. Unfortunately, the sheer number of moving parts combined with the weight our backs have to support leaves them vulnerable to injury.

The lower back—also called the lumbosacral region—is the most common location for back strains. This region contains five lumbar vertebrae and the sacrum. It's also home to muscles including the:

• internal and external obliques
• longissimus
• iliocostalis lumborum
• multifidus
• tendonous portion of the spinalis
• lower section of the latissimus dorsi

Each of these muscles also has associated tendons that connect them to bones.

Because muscles and tendons are fibrous, they're prone to tear when under too much stress. A partial in one of these essential structures is known as a strain. Not only are strains painful, but they can also cause weakness and make simple tasks difficult.

Back strains most often happen due to one of three things: overuse, misuse, and trauma. People with weak core muscles are at high risk for back strains, as are athletes who overexercise, don't prioritize warm-ups and cool-downs, or play contact sports. Even so, anyone can strain their back while doing something as simple as bending over to pick something up off the floor.

How do you know when you've strained your back? Along with a popping or tearing sensation at the time of injury, you may feel constant pain that worsens whenever you move. Spasms and cramps are also common, as are tightness and a decreased range of motion.

Can You Exercise With a Back Strain?

It may seem counterintuitive to exercise when you're hurt, but research shows that both aerobic and strength exercises are effective ways to reduce back pain.

Aerobic activity boosts circulation, bringing an influx of oxygen and nutrients to the injured tissues in your back. This can speed up your body's healing and repair processes while reducing stiffness.

Strength training, especially when focused on core muscles, helps to improve spinal stability and prevent future injuries to the area. Gentle, controlled stretching can balance out strength training by improving your flexibility and range of motion.

As if that wasn't enough, the endorphins your body releases during physical activity reduce pain by targeting the same brain receptors as narcotic pain medications.

Can Exercise Make Back Pain Worse?

Despite the many benefits of exercising with a strained back, improper exercise can cause quite a bit of harm. At best, you'll end up even more sore than you were when you started. At worst, you could do serious damage and land yourself in the emergency room, possibly needing surgical repair.

With stakes this high, it's crucial to make sure you know what you're doing when it comes to staying active while injured.

The Do's and Don'ts of Exercising With a Strained Back

The general rule of thumb when exercising with any back pain or injury, including a strain, is to avoid doing anything that makes your pain worse. However, this philosophy isn't all-inclusive, nor is it always intuitive—until it's too late.

Let's dive a bit deeper into some of the things you should and shouldn't do when jumping back into exercise after a muscle strain.

Do: Move Often

Because movement can initially make your pain increase, many people mistakenly believe that they should stay in bed until the pain goes away and then begin to exercise. In reality, prolonged bed rest can make your pain worse. Being sedentary for extended periods leads to muscle deconditioning, pain and tightness, and low mood.

Instead of sitting or laying down for long stretches of time, make movement a priority. It doesn't need to be anything intense—walking around for 10-15 minutes every two hours is enough to increase blood flow and help your tight muscles relax.

Don't: Jump Straight Into Your Normal Routine

If you're someone who's fueled and energized by working out, one of the first questions you're likely to ask following your injury is "How soon can I exercise after a sprained back?"

The answer is as soon as you feel physically able to, as long as you've cleared it with your doctor first. However, don't make the mistake of diving headfirst into your normal routine. If these common exercises are part of your normal routine, put them on hold until you're further along in recovery:

• Heavy powerlifting, especially over the head
• Running
• Leg lifts
• Toe touches
• Kettlebell swings or "windmills"
• Crunches and sit-ups
• Contact sports or combat-based exercise like boxing

Just as too much inactivity can make your pain worse, too much exercise too soon can delay the healing process longer. Instead, start slow and work your way back up to normal over a few weeks.

Do: Find Alternative Ways to Exercise

When it comes to injury recovery, all manners of exercise aren't created equal. If you speak with a doctor or physical therapist about your options for activity during healing, the question of "can I swim with a strained back?" will have a very different answer than "can I deadlift with a strained back?"

Seek out low-impact movement that doesn't involve heavy lifting, twisting, or hyperextension of your back. Some of the best exercises for a strained back include:

• Swimming and water aerobics
• Walking on a treadmill, elliptical, or outside
• Yoga and Pilates (with modifications)
• Isometric core exercises, like wall sits and planks
• Hamstring stretches
• "Superman" pose
• Squats and lunges
• Modified push-ups
• Abdominal workouts with an exercise ball
• Balance and stability exercises

Keep in mind that depending on the severity of your injury, the items on this list may not all work for you. Even gentle, low-impact exercises may require modification for you to do them safely. Seek the help of a licensed physical therapist or sports medicine coach if you have questions about adjusting your workout routine.

Don't: Skip Warm-Ups and Cool-Downs

What you do before and after your workout is as important as the exercises in between. Whether you're recovering from a back strain or not, never skip warm-ups or cool-downs when exercising.

"Cold" muscles, aka muscles that haven't been warmed up via plyometric exercise, are at a higher risk of injury. Do some arm circles, walk briskly, and do active stretches like the cat-cow to get your blood flowing and increase flexibility before a workout. When you're finished, do a series of long, slow stretches accompanied by deep breathing to relax activated muscles.

It's tempting to start right in on your strength training when you get to the gym and head home as soon as you're done, but the consequences aren't worth it. Spending the extra few minutes to warm up and cool down just may save yourself from a world of hurt.

Do: See a Medical Professional

Perhaps the worst thing you can do for any type of back injury, strains included, is to push through the pain and hope it goes away on its own. Some back injuries may seem like a strain at first but are actually the result of a more serious condition. Seeing a doctor soon after your injury will help you confirm the cause of your pain and give you guidelines for recovery.

Your doctor may also recommend that you attend physical therapy appointments for rehabilitation. Physical therapists are an excellent resource for musculoskeletal injuries. They'll work with you to design a custom exercise program that strengthens your body without causing any further harm.

Keep in mind that physical therapy only works if you stick with the program. That said, make sure you're showing up to all your appointments, doing your at-home exercises, and being honest with your therapist about your progress.

Don't: Rely on Pain Medicine Alone

A bad back strain can leave you in agony for days or weeks. This makes it easy to reach for narcotics and over-the-counter pain medications to help you function.

NSAIDs, muscle relaxers, and prescription painkillers do have their place. Your doctor may even recommend that you take them in the early stages of recovery. To avoid becoming dependent on them, though, try using alternative pain remedies to relieve discomfort before, during, and after a workout.

For the first 48 hours following your injury, use cold therapy to reduce pain and inflammation in the affected area. Wrap an ice pack in a thin towel or pillowcase and apply it in a cycle of 20 minutes on, 20 minutes off.

After the first two days, make the switch to heat therapy. Warm temperatures boost circulation, calm spasms, and release tight muscles. An electric heating pad makes it easy to treat your pain in bed, at home, at work, or anywhere else you have an outlet.

If you're dealing with a lot of tightness, cramping, and stiffness in your back, a decompression back belt may also help. This device provides light spinal traction while stabilizing your low back.

Many people also find that massage, electrical stimulation (e-stim), and acupuncture make a difference in their pain.

Do: Use Lumbar Support Belts When Exercising With a Strained Back

Sometimes getting back into an exercise program requires a bit of extra support. That's where lumbar belts and braces come in. These flexible orthopedic devices provide support for your spine and muscles, taking pressure off your back while still letting you move around.

When choosing a lumbar brace or support belt, make sure to find one that's both adjustable and made of breathable material. You may choose to wear it for most of the day or only while you're exercising. To avoid muscle deconditioning in your core, progressively decrease the amount of time you spend wearing the brace as you heal.

Don't: Fall Back Into Bad Habits

Recovering from a back strain takes a lot of hard work. The last thing you want to do is engage in self-sabotage by falling into the bad habits that injured you in the first place.

From now on, make a special effort to avoid potentially dangerous activities like improper lifting. Learn about the principles of ergonomics and apply them to your life both at home and in the workplace. Finally, make physical activity a regular part of your life, not something that's reserved for the weekends.

These efforts will pay off both in speeding up your healing and preventing injuries in the future. Before you know it, you'll be living a lifestyle that keeps your back healthy without a second thought.

Finding Ways to Safely Exercise With a Strained Back

Exercising with a strained back is more than possible, it's required for a full recovery. You'll need to be smart about how you approach it, though.

Take things slowly at the beginning and follow the do's and don'ts listed above. This will allow you to rebuild your strength while letting your tissues heal. You may even be surprised by how much you enjoy the alternative forms of exercise you try out and decide to make them part of your normal routine!

For more insight on keeping your core and spine healthy, make sure to check in with the Back Bible regularly. While you're at it, visit our shop for lumbar support braces, decompression belts, and all your other orthopedic equipment needs.