Everyone has an exercise, a trick, and new device to help treat low back problems. “Do a plank while twisting like an owl in the downward Pidgeon position with your eyes squinted to make sciatica go away!” “Never bend forward.” “Never bend backwards.” With contradicting recommendations online, how do you determine which low back exercise is the best?
The best exercise is the one that improves your symptoms. When someone asks me, “I’ve been thinking of trying ‘x,’ will this be good for me?” I say “Let’s not guess, let’s try it and find out.” Then what help is it to have me around? Well, I know the rules for how to interpret whether an exercise is effecting you in a positive or negative way. And with a a few minutes of learning, you can too. The best tool for interpreting exercises is the traffic light analogy.
In the last post regarding back self treatment you learned which low back changes in symptoms are good and bad. For review check out Back Self Treatment: Good vs. Bad Changes in Symptoms. In this post you will need to pair your understanding of good vs bad changes in symptoms with completion of exercises to determine whether an exercise is good or bad for you. Check out the video below or keep reading for a written explanation of the traffic light analogy.
How to Find the Best Back Exercise For You
When you are trying a new exercise for low back pain there are two primary times you ought to pay attention to what you are feeling: During the exercise; After* the Exercise. While it’s important to track how you feel during the exercise, the most important is after.
During an exercise your symptoms might: Increase (↑), decrease (↓), or stay the same (NE or No Effect).
After an exercise, or as the result of an exercise you might feel: Better (B), Worse (W), or ultimately the same (NE or No Effect).
So now let’s learn the traffic light analogy for determining which exercises are good to keep doing and which ones are bad and should be avoided.
Red Light AKA Stop doing this exercise
The obvious: If symptoms increase during the exercise and afterward you feel worse (↑W), STOP
But it’s also true that if symptoms decrease or feel better during an exercise and afterward you feel worse (↓W), STOP. I have known people who for years. That’s right, YEARS, have been daily doing exercises which make them, overall, WORSE. Why would they do that? Sometimes it’s because while they do the exercise they actual feel better, so they assume it is good for them. They never consider how they feel afterward. Other times it’s because they do not know the rules for interpreting whether a change in back symptoms is good or bad, and they interpret a bad change as a positive one. If you are unsure if you know which low back changes in symptoms are good or bad, check out the very first post from the Back Self Treatment series.
Lastly, your symptoms might not change at all during an exercise, but still leave you feeling worse once you’re done (NE, W). Of course, STOP.
Green Light AKA This is a Good Exercise For You
The obvious: If symptoms decrease during the exercise and afterward you feel obviously better (↓B), Keep Going! You’ve found a good exercise. But if it were always this simple no one would need any help.
It’s also true that if your symptoms increase (you feel WORSE) during an exercise however afterward you feel better (↑B), Keep Going! “But it hurts!” Suck it up it’s good for you. You’ll thank me later. It’s very common for people to try an exercise and experience worsening symptoms during an exercise and so they decide it is bad before they ever consider how they feel afterward. I’m not saying worsening symptoms during an exercise means you will feel better after, I’m saying it doesn’t matter what you feel during. You have to remember to check your symptoms after and compare them to your symptoms before the exercise to determine if the exercise is good or bad.
Lastly, your symptoms might not change at all during an exercise, but still leave you feeling better once you’re doing (NE, B). Keep Going, green light.
Yellow Light AKA Huh?
This is the area many people get stuck. They attempt an exercise, they don’t know if it’s good or bad. They discontinue it since it doesn’t seem worth it, but later they can’t remember if it was helpful or not so they come back to it and try again. It’s a big unhelpful loop.
What is a yellow light exercise? Basically, during the exercise your symptoms might increase, they might decrease, but afterward you’re left with a big ol’ No Effect (NE). Your symptoms, ultimately, have not improved, or worsened, as the result of the exercise.
Too many people stop here. Don’t make this mistake.
When an exercise gives you a yellow light: Do it again. There have been times where a client has completed an exercise with subsequently no change in symptoms so I have them do it again. And once again no change in symptoms. One more time. And, all of a sudden, the exercise begins to turn green. Great, keep going! Or it begins to turn red, STOP! Either way is good because we now know, once and for all, if we should continue to discontinue an exercise. How often I have come across people with a home exercise program of 5 different exercises and the person doing them can’t even tell if they are helpful or not. Check each one. Sometimes an exercise is not beneficial unless it is completed a 3 times. If that’s true then the individual should not complete it only one time when they do it on their own, they have to complete it 3 times in a row for it to be helpful. It’s not rocket science, but you have to know the rules.
One more category in the yellow light section. This category is called question mark (?). That means your symptoms have changed but they do not clearly follow any rules indicating whether the change is good or bad. Perhaps your achy pain turned into a burning pain, but the intensity of the pain is the same. Do the exercise again, with a second or third try it will become more obvious if the exercise is good or bad. Another possibility is you THINK you feel better, or you THINK you feel worse. If your level of pain changed by only one point (decreased from 2/10 to 1/10, or increased from 2/10 to 3/10), do not be sure this is a real change. Do the exercise again and find out for certain. MANY times people have told me they THINK they feel worse by one point but on the second try they actual feel much better. Keep going until you know for sure.
Lastly, if you have tried an exercise 3-4 times and each time you get NE, NE, NE. Okay, move on to something new. Preferably progress the exercise and see what the results are now. At this point you have permission to try something else.
Stay tuned for the next topic in the Back Self Treatment series as the traffic light analogy is applied to a functional assessment of different activities and exercises! Don’t want to miss anything? Subscribe to the Baldi Movement Group YouTube channel and be sure to turn notifications on.
Did you learn anything from this article? Share it with all your family and friends who would benefit from the Back Self Treatment series.
Dr. Charles Baldi
Ortho and spine specialist
Doctor of physical therapy
Baldi Movement Group LLC
www.baldimovementgroup.com
ContactUs@baldimovementgroup.com
(610) 484-4487