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Spinal Stenosis Exercises to Avoid and Effective Exercise Alternatives for Pain Relief

Spinal Stenosis Exercises to Avoid and Effective Exercise Alternatives for Pain Relief

Dr. Michael Derry, DPT, PT, OCS Jacksonville, Florida

Understanding Spinal Stenosis and Exercises to Avoid for a Healthy Spine

Understanding spinal stenosis is crucial for maintaining a healthy spine, particularly if you're experiencing back pain, including lumbar spinal stenosis and lower back pain. If you have been told you have spinal stenosis this information will benefit you greatly! 

Spinal stenosis occurs when the spaces within your spine begin to narrow, resulting in increased pressure on the nerves that travel through the spine and out your back. This sounds similar to degeneration or arthritis, but they do have some differences. This compression can cause pain, numbness, and weakness in various parts of your body, including your legs, arms, and back. Symptoms may be similar to those of sciatica, a common condition that affects the hip and lower back due to nerve irritation or compression. Sciatica is different than stenosis but they are often related.

When dealing with spinal stenosis, it's important to learn about the exercises to avoid in order to prevent increased discomfort. Some exercises can exacerbate spinal stenosis pain and make movement more difficult, so it's crucial to remain cautious and avoid certain movements.

One type of exercise to avoid with spinal stenosis is high-impact aerobic training such as running or jumping. These exercises can put additional stress on your spine, which may lead to increased pain and compression of nerves. Instead, consider low-impact alternatives, such as biking or swimming, which are gentler on your spine and can help alleviate pain and discomfort. That said, I have treated many clients that were able to run again with spinal stenosis. Every case is different and always benefits from a detailed examination from a physical therapists.

Extension exercises, which involve leaning backward, can also increase spinal stenosis symptoms. When bending backwards, the epidural pressure increases, potentially putting more pressure on the nerves and causing pain down your leg. To maintain a healthy spine, opt for alternative exercises that don't require backward bending, flexion exercises such as curl ups or knees to chest can strengthen the core without increasing pressure on the spine.

Lastly, avoid exercises that are high impact plyometrics such as jumping and landing with increased force as this can place unnecessary strain on your spine, potentially leading to further pain and nerve compression. Instead, work with a trainer or physical therapist to develop a safe and effective exercise plan tailored to your specific needs and spinal stenosis symptoms.

This is especially important if you are looking to avoid surgery. You may not need surgery to have long lasting relief. Here are my tips to help fix spinal stenosis without surgery.

By being aware of the exercises to avoid and incorporating effective exercise alternatives, you can take control of your spinal health and achieve better overall well-being.

Safe Exercise Alternatives for Spinal Stenosis

If you're dealing with spinal stenosis, lumbar stenosis, or recovering from post-surgical rehabilitation, it's essential to understand which exercises to avoid and which safe exercise alternatives can help improve your health. People can benefit from the expertise of their area's physical therapists, sports rehab specialists, and other rehabilitation professionals. These experts have identified safe workouts and exercises that help prevent further damage to your spine while addressing your overall health.

One key aspect of lumbar spinal stenosis exercise alternatives is finding movements that don't put excessive strain on the spine. For instance, swapping out high-impact workouts like running and jumping for low-impact activities such as swimming or biking can greatly improve your comfort and reduce the risk of injury. While you might be hesitant to change up your routine, sometimes it's the safest course of action to prevent worsening your spinal stenosis.

Strength training can still be part of your exercise regimen, but you'll need to make some modifications. Be sure to not start with heavy weightlifting, try starting small with resistance bands or bodyweight exercises that target your core, glutes, and legs without jeopardizing your spine. Slowly build your body’s resilience up for heavier lifting. Yoga and Pilates are also great workout options, as they focus on flexibility, balance, and posture—essential elements for your spinal health.

Remember, when it comes to your overall health and spinal stenosis, working with trained professionals can make a huge difference in your progress and recovery. They'll create customized exercise plans that take your specific needs into account, ensuring you stay active and healthy while managing your lumbar stenosis symptoms. Whether you're recovering from surgery, dealing with chronic pain, or exploring preventative measures, these specialists are dedicated to helping you thrive.

Alleviating Pain and Improving Back Health through Spinal Stenosis Exercise Modifications

If you're suffering from spinal stenosis, back or leg pain can become an unwelcome part of your daily life. While it's important to remain active for your overall health, some stenosis exercises could worsen your pain. That's where spinal stenosis exercise modifications come in. By making simple changes to your exercise routine, you can alleviate pain, improve back health, and maintain an active lifestyle.

Lumbar spinal stenosis is a condition where the spinal cord narrows, causing compression on the nerves. This can lead to symptoms such as lower back pain, sciatica, and even problems with your feet. As a result, it's important to be aware of the exercises that could exacerbate your spinal stenosis and make these modifications to avoid further damage.

One of the most important steps to alleviate pain from spinal stenosis is to work with a physical therapist. These experts can guide you through safe exercises and help you modify them to protect your spine and reduce pain. They can also offer personalized advice on maintaining a healthy lifestyle with spinal stenosis.

One of the key exercise modifications for spinal stenosis patients is to avoid high-impact activities. Instead of running or jumping, try low-impact exercise alternatives such as swimming or cycling. These can provide a great workout without putting stress on your spine and exacerbating your pain.

Another essential modification is to ensure proper form during exercises. Improper back alignment can worsen spinal stenosis pain, so it's crucial to perform exercises with correct posture. Your physical therapist can help you develop good habits that will reduce your pain and promote a healthier back.

Finally, stretching and strengthening exercises are crucial for reducing pain from spinal stenosis. Focus on activities that target the muscles around the affected area – this can help alleviate pressure on the nerves and improve your overall back health. Yoga and pilates are both great options for spinal stenosis patients, as they build strength and flexibility in a safe and controlled manner.

By incorporating these spinal stenosis exercise modifications into your routine, you can enjoy better health, reduced pain, and a more active lifestyle..

How to Manage Spinal Stenosis and Movement

Spinal stenosis can make movement scary for many individuals. A process begins to occur where there are movements that hurt, and then those movements are avoided. Unfortunately this doesn’t help solve the problem and can lead to functional deficits. Many people who suffer from spinal stenosis find that standing for prolonged periods of time as well as walking can cause their pain to increase. Walking difficulties are not uncommon for those wiht spinal stenosis. Physical therapists often tell their patients that leaning forward or flexing their spine can help with the symptoms that run down the legs.

The most common issues I hear from patients are difficulties with standing or walking. Many people who suffer from lumbar stenosis state that it feels better to sit down or slump over. In fact, having immediate relief when you sit is a hallmark sign of lumbar spinal stenosis. This posture will typically reduce the symptoms down the legs and allow walking or standing to resume. If you are working in the kitchen be sure to keep a chair nearby so that you are able to sit down if pain starts to run down the legs.

Tips for Managing Pain and Maintaining an Active Lifestyle with Spinal Stenosis

The most important point to remember when dealing with the symptoms related to lumbar stenosis is that movement is our friend, no foe.

As stated earlier, there are certain movements that feel better than others. Typically with lumbar stenosis, a flexed posture will be a relieving position. We can use this to our advantage when selecting exercises. Regardless of what physical condition you are dealing with, it is important to find a way to move.

Movement will help maintain the integrity of our joints, keep the cardiovascular system running, and help to maintain a high quality of life. Stationary bikes or elliptical machines can be a great way to take advantage of the preferred flexed posture associated with lumbar stenosis. Bikes put the body in an optimal position for the stenotic spine. Biking will keep your legs strong, work the heart, and can improve quality of life.

Charles Swindoll once said, “life is 10 percent of what happens to you and 90 percent how you react to it.”

We are all dealt with things in life that are out of our control. How we choose to deal with it will determine if those things make us stronger or bring us down. Lumbar stenosis is usually a genetically inherited trait. It can be painful and difficult to navigate, but there are ways to work around it. We first need to keep a positive mindset. Think more of what you CAN do rather than what you CANNOT.

Our mindset is the foundation for how well people end up doing with physical therapy. Remaining positive and searching for ways to move will pay dividends with managing low back pain. If you can maintain this positive mind set the interventions will come easy.

Customized Spinal Stenosis Exercise Programs that have worked real patients

Disclaimer: 

Spinal stenosis is characterized by leg pain that is usually down one or both legs and is worse when standing up right or walking. The symptoms down the leg can range from intense pain to numbness that can reach to the toes.

Exercises are typically geared towards relieving these symptoms by allowing the spine to flex forward. In addition to this it is important to stay active.

Studies have shown that low to moderate levels of aerobic exercise can lead to a decrease in back pain and improve quality of life. The challenge with lumbar stenosis is to find a form of aerobic exercise that doesn’t make the symptoms worse. As discussed, walking can be an aggravating movement. Aerobic exercise such as biking or water aerobics are great alternative to walking that can help build up the cardiovascular system, reduce back pain, and improve quality of life.

3 Easy spinal stenosis exercises for pain relief: 

1. Standing lumbar flexion

Standing lumbar flexion for stenosis relief
Standing lumbar flexion for stenosis

Standing lumbar flexion can be performed just about anywhere. Since most people who are experiencing lumbar stenosis have relief with bending over, this exercise does just that. Simply stand with the feet just wider than shoulder width. Allow the body to fold over slowly reaching towards the floor as far as you can comfortably go. You can stay down there for as long as it feels good before returning to the starting position. Repeat this as many times as necessary for the symptoms to come down. I find that people can do 1-2 of these and feel so much better, especially when they are standing in line at the store!

2. Piriformis stretch

Female laying down completing piriformis stretch
Piriformis stretch for lumbar spinal stenosis

The piriformis attaches the pelvis to the hip and can be a pesky muscle that can cause low back pain. Stretching this muscle involves flexing the spine and can help reduce the pain associated with lumbar stenosis. This stretch can also be done in the sitting position. Lay down with the knees bent and feet flat on the floor. Take one leg up and place the outside of the ankle on the top of the knee of the leg that is still on the floor. This should create a figure four as you look down. From there grab behind your knee and pull your leg up. You should feel this stretch in the back side of the hip. Hold this stretch for 10-20 seconds. Repeat a few times if warranted.

3. Lower trunk rotations

young female completing lumbar rotations laying down
Lumbar trunk rotations for spinal stenosis

The lower trunk rotation is a great way to promote gentle mobilization to the lumbar spine while not causing back pain to increase. This stretch/mobilization can be pushed as far as the body will tolerate in either direction. Simply start by laying on your back with the knees bent to around 90 degrees. From there, just let the knees fall together towards the one side then let them fall to the opposite side. You can hold it or just go back and forth depending on your level of tissue irritability.

In conclusion, lumbar stenosis is far from a death sentence and should be treated as an obstacle to overcome rather than a road block. By modifying your movements, you can return to doing the things that you love to do. As with any form of low back pain, movement is our friend and should be the end goal of any program.

Using what we know from the research, most people like flexion based exercises to help reduce the symptoms of central canal stenosis. Using these exercises can increase your ability to get outside and enjoy life! Build your team, learn your body, and keep moving.

Revision Health Services offers physical therapy and wellness in Jacksonville, Nocatee, and St. Johns, Florida. To find out if our services could be the best fit for you, reach out and let's chat!

Reference:

George, S. Z., Fritz, J. M., Silfies, S. P., Schneider, M. J., Beneciuk, J. M., Lentz, T. A., Gilliam, J. R., Hendren, S., & Norman, K. S. (2021). Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. The Journal of orthopaedic and sports physical therapy, 51(11), CPG1–CPG60. https://doi.org/10.2519/jospt.2021.0304

Dr. Michael Derry is a Doctor of Physical Therapy and board certified in orthopedics. He is very passionate about treating lower back pain and helping people build their resiliency. He has spent time assisting at universities as well as managing large clinics before starting his own practice in Jacksonville, FL.

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