Protrusion exercises: examples and set of exercises

From this article you will learn:

• What are the basic principles of physical therapy for spinal hernia
• Who is contraindicated for physical therapy for spinal hernia?
• What exercises are most effective in the treatment of hernia of the cervical, thoracic, lumbar regions
• What are the methods of Dikul and Bubnovsky in the treatment of spinal hernia
• Does swimming help with a hernia of the lumbar spine?

Spinal hernia these days is a phenomenon that often occurs not only among older people, but also among young people. Treatment includes a complex of medicinal and non-medicinal measures. The first is nothing more than taking anti-inflammatory and painkillers. Non-drug treatment is aimed at strengthening the muscle corset. Physical therapy for spinal hernia is the safest method of treatment and prevention of relapses. We will talk about it in more detail in our article.

Why do gymnastics for protrusion?

Protrusion occurs against the background of osteochondrosis, due to incorrect posture or injuries, as a result of a sedentary lifestyle or after lifting heavy objects.
The pathology usually affects the lumbar spine. It is this part of the back that is subject to systematic loads. The effectiveness of treating protrusion with exercises is explained by the fact that special movements improve blood circulation, accelerate metabolism, and strengthen muscles, including those that support the spinal column. The main goal of the complex is to stretch the spine and, with the help of this, realign the intervertebral discs, eliminate pinched nerve roots, and also reduce the load on the affected area.

The effectiveness of the classes directly depends on the diligence of the patient himself. Physiotherapy for protrusion is used to relieve inflammation and pain. To improve your condition, it is advisable to do additional swimming or running.

Basic principles of physical therapy for spinal hernia

Physical therapy for the occurrence of a herniated disc is one of the main methods of therapy. It relieves pain, helps strengthen the muscle corset, returns the spine to its natural position, and improves blood circulation. Such a complex, as a rule, consists of simple exercises such as flexion, extension and extension of the spine.

Before starting exercise therapy, you should consult your doctor. He will help you select the types of exercises and adjust the number of repetitions, taking into account the current condition of the patient and the characteristics of his illness.

At the initial stage, you should perform only those tasks in which the movements of the vertebrae are minimal. Try to avoid sharpness, do not bend deeply, protect your back from shocks and blows.

It is necessary to increase the intensity, quantity and duration of exercises gradually, as you feel better and strengthen your muscle corset. This takes time. It is impossible to restore muscle functionality in a few days. Prepare yourself for long work. The first positive changes should appear after a few weeks of regular exercise therapy.

Exercise therapy necessarily provides for preliminary preparation of the body, namely:

• Normalization of breathing.
• Warming up the muscles.

Allow at least half an hour for classes. It is best to distribute the set of exercises throughout the day so as not to overload the sore lower back.

Class restrictions

The doctor gives recommendations on what exercises can be done for spinal protrusions. The specialist meticulously examines the patient, assesses his condition (mobility, severity of pain, age, psychological state) and physical capabilities regarding whether the person can perform certain movements. In some cases, you will have to give up classes.

You cannot practice if the patient:

• is in the stage of exacerbation of protrusion;
• temperature;
• is in serious condition;
• with mental disorders;
• suffers from migraines;
• suffers from high blood pressure;
• has signs of internal bleeding;
• with diseases of the cardiovascular system.

If there is at least one of these problems, no matter how much the protrusion bothers you, physical exercise is contraindicated. Classes are started only after the condition has normalized, if this is possible in principle.

Who is Bubnovsky

Candidate of Medical Sciences Bubnovsky Sergey Mikhailovich , professor, author of books telling about alternative principles of healing the body. Bubnovsky has developed a fundamentally new physical education and health system that helps restore the musculoskeletal system without surgery or medications. In addition to performing exercises, the technique provides for a therapeutic consultation.

Dr. Bubnovsky’s methods are suitable for people of all ages

The technique involves classes with people of any age, from children to elderly patients . Bubnovsky himself once suffered a back injury and, with the help of gymnastics, completely recovered when doctors predicted immobility for him. So he developed a system of classes for other people.

Exercise sets

During gymnastics, with protrusion, move easily and smoothly, since sudden movements can damage the discs. It is especially important to listen to your feelings during the first lesson. Under no circumstances should you perform a set of exercises during protrusion through force or pain. If a feeling of discomfort appears, exercise should be stopped immediately.

The number of approaches is increased gradually. If you doubt your abilities, you can divide the proposed complex into several parts and perform it in several passes. At first, you are allowed to take a break after each exercise. The main thing is that the body is comfortable.

Considering the above, it is obvious that the answer to the question of what exercises cannot be done during protrusion will be the statement that any movements that involve overexertion are prohibited. You should not combine exercise therapy with activities designed to achieve other goals (weight loss, muscle gain). Examples of prohibited exercises for protrusion include strength complexes, prolonged static exercises for the back, twisting movements, and jumping rope. The spine area should not be allowed to overheat, that is, you should avoid visiting saunas and baths.

For exercises that are performed in a supine position, you need to prepare an orthopedic mattress. When the condition stabilizes, it can be replaced with a gymnastic mat. For classes, wear loose-fitting clothing made of breathable materials that will cover the lower back.

Before exercise therapy for protrusion, it is advisable to warm the muscles in a warm (but not hot) bath. During classes, you need to monitor your breathing, breathe evenly and calmly. You should not drink water or other liquids. After completing the complex, you can relax and lie down for about half an hour. You should not expect quick results from exercises for spinal disc protrusion; on the contrary, you need to mentally prepare for a long rehabilitation period.

Bubnovsky’s gymnastics: methods and principles of their action

Bubnovsky’s therapeutic gymnastics includes several important points that cover a set of gymnastic exercises:

• correct breathing . An important condition for the correct implementation of Bubnovsky’s exercises is deep breathing, in which all cells are sufficiently saturated with oxygen;
• proper nutrition and water balance . For the technique to be effective, a person must consume at least a liter of water per day, exclude foods rich in salts, carbohydrates, and fats;
• water procedures . They are a mandatory stage of therapeutic exercises. Provide a cool shower or wiping with a cold towel.

All Bubnovsky’s treatment methods are based on the principles of kinesitherapy - the science of movement, which includes massage, cold rubdowns or douches.

In addition, there are two types of gymnastics:

1. adaptive (for beginners) . Involves adaptation of the body to physical activity, promotes kneading of muscles, and helps eliminate pain syndromes;
2. articular _ It is the next stage when the muscles and body are able to tolerate more intense loads and complex exercises. At this stage, it is expected to increase the mobility of joints, including vertebral ones.

Muscle development in Bubnovsky style should occur in the order of warming up from bottom to top:

• the first stage is the development of the muscles of the feet, both legs, and pelvic area;
• second - warming up the abdomen, chest, back;
• the third - shoulder joints, neck, head.

The principle of such a warm-up is to force the blood to move from the legs to the head with the same activity as in the opposite direction.

Important! For each person, a special set of exercises is developed, which takes into account the characteristics of his life, type of employment, nature of pain and existing diseases.

A general set of exercises in difficult situations may not be effective enough, so personal consultation with a doctor is of great importance.

The effectiveness of exercises also depends on important factors : regularity and execution at a moderate pace. As the body adapts to exercise, the load should be gradually increased.

Video: “Bubnovsky’s technique for spinal hernia”

Work on the lumbar region

For lumbar disc protrusion, exercises are aimed at restoring and maintaining mobility and flexibility of the spine. The standard complex includes the following elements:

• Tilts to the right and left. The body turns as much as the back allows. While moving the body, the arms and legs should remain motionless. They should be relaxed. Repeat the movement up to 20 times.
• "Scissors". The exercise is performed on the floor, lying on your back. Without lifting your feet from the floor, you need to move them apart and connect them. The number of repetitions is 15–20.
• The “arc” is performed lying down. It is necessary to raise the pelvis as high as possible. Next you need to hold it in this position for a few seconds. Your hips and back should remain flat on the floor. The movements are repeated until you feel tired.
• The “boat” is done in reverse: you need to roll over onto your stomach, stretch your arms forward and raise them up. Next, you need to stretch, holding at the top point for 30 seconds. You need to do up to 15 approaches.
• In a lying position, raise one leg, bending it at the knee, and touch the kneecap with the palm of your hand. The right and left sides work in turn. The movement for each side is repeated 5–8 times.
• Standing on all fours, stretch out the right arm and left leg, then change them to the opposite ones. Exposure time - up to 5 seconds. Number of approaches: 5–8.

You can include moving on all fours into the complex. At the same time, the back is bent down. Class time is 3–5 minutes. You can pump up your abs using a simplified scheme: lie on the mat and tense your abdominal muscles for a couple of seconds, then release them. This is done up to 20 times in a row.

Dikul exercises for spinal hernia

Dikul’s set of physical therapy exercises belongs to kinesitherapy, the founder of which is considered to be Doctor of Medical Sciences S. M. Bubnovsky. The program was developed, one might say, from our own experience. At the age of 15, Valentin Dikul received a severe spinal cord injury as a result of multiple local injuries and a compression fracture of the spine. Doctors did not give any positive prognosis or prospects for recovery. But thanks to his own technique, Dikul was able to completely restore all functions of the spinal cord and return to his normal life. Its complex makes it possible to get rid of pain and cure pathology.

In the process of treating patients with intervertebral hernias, special simulators are used, personally developed by Valentin Ivanovich. The training program is selected individually for each patient. Before starting training, exercises are discussed with your doctor and possible contraindications are identified.

The complex for the lumbar spine, which Dikul proposed, helps solve several problems at once:

• strengthens the muscle corset, forms correct posture;
• reduces pain syndromes of paravertebral muscles and spinal cord nerves;
• eliminates muscle spasms and swelling;
• normalizes blood circulation and lymph movement in lymphatic vessels;
• works the deep-lying paravertebral muscles and restores normal muscle tension.

Valentin Dikul is sure: for classes to be effective, it is necessary to strictly follow the rules that he prepared for stable development of neurophysiological indicators and better adaptation of the body to new loads.

These rules read:

• Never change the sequence of exercises in the treatment complex on your own. This order must always be maintained.
• Classes should be regular, three to four times a week for 40–50 minutes. If training has stopped for any reason, then it is necessary to start it from the first stage, since muscle tissue very quickly adapts to the intensity of the current load.
• A set of exercises should be selected in consultation with a specialist.
• Gradually increase the load as the spinal muscles strengthen.
• Focus on your feelings during physical therapy exercises. If you experience discomfort, then you should stop training.

The duration of treatment depends on factors such as the condition of the muscles and the severity of the disease.

The Dikul training complex includes three stages:

1. First, it is necessary to prepare for stress, especially for those patients who lead a sedentary lifestyle and have weakened muscles.
2. The second stage is aimed at strengthening joints and ligaments.
3. The third includes a therapeutic set of exercises to develop flexibility, mobility, and strengthen the spine.

The starting position for the main part of the exercises is lying on your back, on a hard surface. Some tasks may require additional equipment to complete. Physical therapy for lumbar spinal hernia includes exercises such as:

• Start with a warm-up to warm up your muscles (smooth stretches, turns, bends).
• Lie on your back. Cross your arms at the chest area. Take ten incremental steps, first to the left, then to the right. Make sure your legs and upper torso do not leave the floor.
• The starting position remains the same. Perform ten bends in each direction, sliding along the floor. The lower part of the body should remain motionless.
• The starting position is the same, bend your legs. Slowly draw your knees towards your sternum. Perform 7–10 times.
• Starting position – standing. Lower your hands, take a gymnastic stick. Keeping your back straight, bend down 7-10 times. For convenience, your legs need to be slightly bent.
• Take a rubber band in your left hand and secure the end of the projectile with your foot under your toe. Make five slow bends to the right. The patient must overcome the resistance of the elastic material. In this case, the right hand should be placed on the back of the head. Repeat to the left five times.

Read the material on the topic: MRI of the shoulder joint: indications and contraindications for its implementation

Sacral section

If dorsal protrusion appears in the sacral region, it is worth adding exercises to the legs. You need to stand up straight and lift one of your legs 25 cm from the floor, hold it for 10 seconds, and then change your leg. The element is repeated several more times.

The next stage is done on all fours. You need to get on all fours and lower your pelvis down onto the mat, turning it to the right and then to the left. Then you need to lie on your back and pull your toes towards you, and then vice versa. The joints are fixed for 3–7 seconds. The movement is repeated 7–10 times.

Also lying down, the legs are stretched so that the toes are raised up. Then gently bend your knees. The heels will begin to move closer to the pelvis. The feet are pressed to the floor. Then, remaining in the same position, touch the chest with the knee of the right leg. Your shoulders and back should lie flat on the floor. A similar movement is repeated with the left leg.

A “bicycle” and “scissors” can be a good addition to this complex. When performing the last exercise, you need to raise your legs 20–30 cm.

How to remove widow's hump on the back: surgical techniques

For men and women who are bothered by a dowager's hump or withers, a plastic surgeon can help. The contour of the upper back can be corrected through liposuction or surgery. Before starting treatment, the doctor will determine how to most effectively and safely break the widow’s hump:

• remove widow's hump with lipolytics;
• perform an operation;
• remove widow's hump with laser lipolysis.

Using specialized liposuction techniques, the surgeon can significantly reduce or remove problematic fat and fibrous tissue to create a slimmer, desired aesthetic with a natural-looking result.

In addition to creating a more aesthetically pleasing contour of the upper back and lower neck, surgical removal of the widow's hump is helpful in relieving the neck and back discomfort often associated with this condition. In addition, full neck mobility can also be restored in patients with limited neck movement caused by excess fatty and fibrous tissue. When the fat pad extends from the jawline to the front of the neck, surgical fat removal and/or tissue excision techniques can smooth and restructure the affected areas so they appear slimmer.

Exercise therapy for the cervical region

The cervical region is one of the most sensitive and delicate. You need to work especially carefully in this area: the slightest overexertion causes a reflex muscle contraction and, as a result, pain. Exercises for the neck with protrusion:

• In a standing position, you need to rotate your arms alternately forward and backward.
• While in the same position, take small weights (200–500 g dumbbells). Extend your arms to the sides at shoulder level and hold them there for 5-10 seconds. This is how they achieve improved sensitivity and mobility in the target area.
• You need to stand up or sit down. Place your hands along the body. Next, lower your head down alternately forward, backward, right, left. In each position you need to stop for a few seconds, trying to touch your chest and shoulders. The torso should remain motionless.
• Standing on all fours, you need to look forward, then smoothly lower your head, relaxing your neck muscles. After about a minute, you can complete the manipulations. Such movements will help relieve excess stress.
• You need to get down on the floor, put your arms along your body and relax. Then you need to raise your head and hold it there for 3-10 seconds. This strengthens the muscles of the collar area and shoulders.

The described classes are aimed at stimulating blood circulation in the brain and cervical spine and solving problems such as limited neck mobility, headaches, and auditory discomfort.

How the procedure works and patient preparation

There are several traction options:

• dry vertical;
• dry horizontal;
• inclined;
• underwater spinal traction (vertical or horizontal), which is carried out using weights in heated water (it promotes better relaxation and elimination of muscle tension).

Neck traction for a hernia, as well as traction procedures at other locations, require proper preparation. Initially, the patient needs special manipulations to relax the muscles. Massage or water procedures do an excellent job with this task.

Stretching the spine for hernia and other health problems is a smooth procedure in which the traction force increases gradually and then also gradually decreases. Thanks to this, patients do not feel obvious discomfort.

After the end of the therapy session, the person must remain in a static position for 30 minutes to 1.5 hours or wear a special support corset (for cervical traction, a Shants collar).

Modern clinics, rehabilitation centers and health resorts practice dry spinal traction using computer technology. During this procedure, the patient is on a special traction table and the entire process is controlled by a computer program. The computer regulates the strength and mode of traction, influences the degree of load increase and decrease. Thanks to this, it is possible to prevent excessive stretching and overload of the spinal column, all its structural parts are subject to a gentle impact.

The course of treatment usually consists of 10 traction procedures, which are carried out daily or at intervals of a day. The duration of one session is about 20-25 minutes, if the cervical spine is subjected to traction - no more than a quarter of an hour.

Thoracic spine

If there are problems in this area, classes begin in a sitting position. You need to put a chair with a high back and sit on it. Then you need to put your hands behind your head and clasp your fingers. Next, you should press yourself against the back of the chair and slowly lean forward. The exercise is done 5 times.

The following exercises for protrusion of the thoracic region are performed on a mat. You need to sit on it and hug your knees with your hands. In this position, bend your back forward and then back 10 times in each direction.

You need to get down on the mat and lie on your back. Then you need to bring your knees to your chest and gradually raise your head until you can touch your kneecaps with your forehead, and then lower it down. The movement should be repeated 10 times.

Next, you need to roll over onto your stomach, placing a small soft cushion under your chest. Place your hands behind your head again. As you inhale, bend back, and as you exhale, lie down and relax. The algorithm is repeated up to 5 times.

When finishing your classes, you need to take the fetal position and try to relax. From time to time you need to strain your spine so that you feel its stretch.

Characteristics of pain

A hernia of the lumbar spine is characterized by severe pain. It can be aching or dull in nature. The pain can be so severe that body movements are severely limited, pain intensifies when coughing, standing or sitting. Relief occurs only in a lying position, when there is no load.

When making any movements in the presence of a herniated spine, for example, changing body position or sudden movements, acute shooting pain occurs in the lumbar region.

If the fifth lumbar vertebra is damaged, the pain syndrome is localized in the big toe of the lower limb. If the hernial protrusion is located between the sacral and lumbar vertebrae, then the pain is localized in the sacral region, the back of the leg.

Sacrolumbar hernia is very dangerous for women, since the pelvic organs are located nearby. If a hernia of the lumbar spine occurs, circulatory problems in these organs may begin, which can subsequently lead to disruption of the menstrual cycle, as well as chronic diseases of the uterus.

Due to the pathology of the spine, the smooth muscles of this area are very tense. With prolonged stress, curvature of the spine is possible.

With an intervertebral hernia of the lumbar region, compression of the nerve roots occurs. This leads to loss of skin sensitivity, which is manifested by dry skin.

The pain syndrome increases over time, and the mobility of the torso decreases sharply. Sometimes, the problem is so serious that a person’s knee reflex may temporarily disappear and the sensitivity of the big toe may disappear. In the future, the disease can lead to paralysis of the lower limbs.

Other hernia symptoms

Clinical manifestations of degenerative changes in the intervertebral disc in the lumbosacral spine:

• local pain in the projection area of ​​the affected disc - in the lumbosacral region (lumbodynia), intensifying with exercise;
• pain radiating to the buttock, along the posterior, posterior surface of the thigh and lower leg on the affected side (ischalgia), numbness and tingling in the area of ​​innervation of the affected roots, weakness in the lower limb;
• weakness and loss of sensation in both legs;
• dysfunction of the pelvic organs - urination, defecation and potency, numbness in the perianogenital area.

Clinical manifestations of degenerative changes in the cervical spine:

• pain radiating to the shoulder or arm;
• dizziness;
• rises in blood pressure;
• a combination of headaches with high blood pressure and dizziness;
• numbness of fingers.

Clinical manifestations of degenerative changes in the thoracic spine:

• constant pain in the thoracic region when working in a forced position;
• a combination of pain in the thoracic spine with scoliosis or kyphoscoliosis.

Preparing for gymnastics at home

In order for therapeutic training to bring the desired effect, you need to follow a number of rules:

1. Exercises should be done regularly.
2. Start classes no earlier than 2 hours after eating.
3. It is necessary to stretch the muscles and joints before starting classes (rubbing, circular movements of the body).
4. After completing the workout, take a shower and rest for about half an hour.
5. When doing gymnastics, breathe deeply and evenly, without holding your breath for long.

Exercises against night pain

Sometimes the pain syndrome may not bother you throughout the day, but before going to bed, aching pain appears in the lower back.

Bubnovsky exercise with back bending

Next, for the lesson you will need an expander. Attach an expander to the wall and sit under it. Pull the free end of the exercise machine, securing it to your leg.

Repeat cyclic exercises. With the right leg – lift – bend – straighten – lower. Repeat the same with the other leg. Perform 10 times on each limb.

Diagnostics

If you have symptoms that raise suspicion of a lumbar disc hernia, you should consult a neurologist. The doctor collects anamnesis to determine the possible causes of the disease.

An X-ray examination will not provide an accurate picture of the disease, so patients are referred to undergo magnetic resonance imaging.

MRI allows you to determine the size of the hernial protrusion, the width of the intervertebral canal, the presence of protrusions, inflammatory changes and other pathologies of the spinal column.

Making an accurate diagnosis will allow you to determine treatment tactics in the future.

Recommendations and rules

Before starting therapeutic training, you must adhere to the rules for their implementation:

1. Gymnastics should be done daily, preferably several times a day.
2. Perform all movements correctly, avoid sudden movements, jumps and jerks.
3. Gradually increase the duration, intensity and number of repetitions during exercise.
4. Avoid excessive fatigue during exercise.
5. When performing gymnastics, you need to concentrate on the location of the hernia. If pain intensifies during exercise, or a feeling of numbness appears in the lower back, you should stop exercising and consult a doctor.

Types of vertebral hernias

Spinal hernias, like most neoplasms, have their own classification.

The location of hernias depending on the part of the spine, the cause and size of the hernial protrusion

The following groups are distinguished:

Division in relation to the parts of the spinal column in which the hernial protrusions are located:

• lumbar region – 65%;
• ore department -31%;
• cervical region - 4%.

The frequency of a hernia in a specific location is determined by the load carried by a certain segment of the spine, as well as its mobility.

Primary and secondary hernial protrusions:

In this section, the division of hernias is determined by the cause of their occurrence.

• Primary hernias occur due to traumatic injury, as well as excessive physical exertion.
• Secondary hernial protrusions are formed due to degenerative changes in the intervertebral discs and destruction of their structure.

According to the size of the fragment protruding beyond the intervertebral space:

Hernias can protrude beyond the space between the vertebrae.

• Protrusion – disc protrusion up to 1-3 mm.
• Prolapse – disc prolapse up to 3-6 mm.
• Hernia developed up to 15 mm.

It is necessary to take into account that the same size of hernia has a different clinical formulation when it is located in different parts of the spinal column:

• in the cervical region, the hernia is considered small up to 2 mm, in the lumbar region - up to 4 mm.
• medium size - up to 4 mm in the cervical and up to 7 mm in the lumbar.
• large size - up to 6 mm in the cervical and up to 9 mm in the lumbar.
• huge size - up to 8 mm in the cervical and up to 9 mm in the lumbar.

According to anatomical classification:

The anatomical division of hernias is determined by their effect on neighboring organs, spinal tissues or nerve endings.

Free hernia

When part of the contents of the intervertebral disc penetrates the posterior longitudinal ligament, which supports the spinal column in an upright position, but the connection with the disc remains.

Vagal hernia

A deformity in which the connection between the protruding fragment and the intervertebral disc is lost. A hernia is dangerous because if it is present, autoimmune inflammation may develop due to the compressive effect on the spinal cord tissue.