Exercises for hernia of the lumbar spine: benefits and harms

Degenerative-dystrophic diseases of the spine affect 75%-80% of the population of socially active age (30-60 years), 80% of 100% of those examined are people diagnosed with intervertebral hernia of the lumbar or lumbosacral region.

A feeling of numbness, heaviness, nagging pain in the lower back, a feeling of pain or weakness, paresthesia in the leg - these are the main symptoms. Unpleasant sensations arise not simply due to the development of deformation in the disc, but due to the fact that herniation affects and irritates the nerve roots, which are in great abundance in the lower parts of the column.

Neurological symptoms depress not only a person’s physical abilities, but also their psychophysiological state. According to statistics, hernias are the result of advanced osteochondrosis: about 50% of people with a history of osteochondrosis experience a hernia.

It is necessary to start therapeutic measures as early as possible, before the disease reaches the stage where it will be impossible to help conservatively. The basis of any conservative therapy for a diagnosis of intervertebral hernia is physical exercise - physical therapy. It is also indicated after surgical treatment.

What exercises are recommended for people with lumbosacral hernias, how to perform them, what is the essence of popular techniques, what is strictly contraindicated to do? We have prepared comprehensive material that will become your true guide in achieving victory over the painful manifestations of the disease.

The importance of exercise

Thematic sites post video exercises, visual illustrations, and advice from Sergei Bubnovsky and his colleagues. All this, of course, is wonderful, but remember one thing: we are not all the same! Even the same disease in each individual person has its own cause of development, nature of the course, location, severity, etc.

With a hernia like the one in the picture, gymnastics will not help.

Therefore, a therapeutic and prophylactic set of exercises, intensity, frequency and duration of loads should be developed by your attending physician together with a physical therapy instructor. A kind of exercise is a simple remedy for Schmorl’s hernia of the lumbar region, dorsal, foraminal, diffuse form. But only the right gymnastics will allow you to:

reduce pressure in the area of the hernial protrusion, and the pathological effect on the nervous structures, spinal canal and vertebrae will be reduced;
activate blood circulation, eliminate and prevent congestion and inflammation in the weak part of the spine and other segments;
improve local metabolism and nutrition of intervertebral discs and joints, thereby stopping or significantly slowing down the progression;
distribute the load evenly across departments, while safely strengthening the affected area;
restore the previous mobility and flexibility of the spinal column;
strengthen the muscular-ligamentous apparatus of the back, normalize muscle tone;
prevent the appearance of pain, achieve stable remission of the pathology, perhaps even its regression;
if surgery was performed, quickly recover and return to a normal rhythm of life, prevent relapse of the disease;
restore psycho-emotional comfort, establish healthy sleep.

First, perform strictly under the supervision of a rehabilitation trainer. You can practice calmly at home later, when you have mastered the technique perfectly. There are a number of movements that are strictly forbidden to do with a lumbar disc herniation. They will be discussed in our article.

Prevention of intervertebral hernia at home

During home treatment of intervertebral hernia, it is recommended:

maintain proper nutrition;
use non-traditional remedies as a supplement - a decoction of comfrey, cinquefoil, St. John's wort;
perform therapeutic exercises.

Using simple methods you can achieve the following results:

eliminate muscle spasm;
strengthen the muscle corset;
improve blood circulation;
create a favorable environment for damaged tissue to recover faster;
prevent progression of the disease.

When the disease is in a period of exacerbation, it is recommended to completely limit physical activity. Further increases in activity should be done gradually. In the absence of pain, it is recommended to do swimming, yoga, walking and a set of therapeutic exercises.

Additionally, it is important to properly plan your diet. It should not contain the following products: baked goods, fatty, spicy, canned foods, trans fats, fast food, sausages, carbonated drinks.

The following products are useful for hernia: wholemeal bread products, fresh vegetables and fruits, bran, lean meats, gelatin-based products, low-fat dairy products.

Effective exercises

Physical exercises should be done exclusively outside the exacerbation phase; only in the absence of pain is it possible to begin them gradually. You can't force physical. loads, deliberately increasing the pace, duration, and number of approaches. They must be dosed, feasible, performed calmly and smoothly, and not provoke a painful syndrome. The wrong approach can make you feel worse.

Goal setting: muscle development

It has been established that normal muscle tension is the leading factor in resisting pathological changes in the spinal motion segment and protecting against injury. A lot depends on the condition of the muscles. Musculo-ligamentous dysfunction negatively affects flexion/extension, turns, rotation of the back, stability of the correct position of the spinal axis and the nutrition of the intervertebral discs.

The primary task is to strengthen, normalize tone, and increase the endurance of muscle structures. The main therapeutic measures are aimed at restoring the deep layers of the muscles of the back and abdomen. And the correct body position for performing exercise therapy is of great importance, so as not to overload the patient level.

What not to do, or “red flags”

In conclusion, we list the “red flags”, or risk factors, the impact of which on the appearance of a hernia can be critical:

excess body weight;
improper lifting of weights, for example, on the shoulder and moving the load with a tilted spinal column. This results in very strong pressure on one edge of the intervertebral disc;
constant wearing of corsets, leading to wasting of the back muscles;
prolonged dehydration and fragility of cartilage, especially in the elderly;
long period of immobility;
an attempt to ignorantly repair a hernia on your own. Intervertebral hernias cannot be repaired; only surgery can help.

Finally, it should be recalled that even in a person with widespread osteochondrosis, properly organized physical activity will help better than a diligent attempt to avoid movement. If a person has a sedentary job, then the time spent with low activity must be compensated with proper increased exercise, for example, Norwegian walking and visiting the pool. Regular adherence to these simple, inexpensive and effective measures will lead to a significant improvement in the quality of life of a patient with back pain syndrome, the presence of a protrusion or hernia, and an increase in range of motion.

Correct body position

The lowest intradiscal pressure is observed in the supine position, the degree of load corresponds to 25 kg. For comparison, when a person just stands, it reaches 100 kg, and when sitting – 140 kg. With physical activity, the initial values increase significantly. In a supine position during exercise therapy, it is possible to achieve isolated strengthening of the necessary muscle elements without harming the problem area. Therefore, the main exercises for patients with lumbosacral hernias are those that will be performed in the following positions:

lying on your back;
lying on your side;
on the stomach;
On knees.

By doing gymnastics in the listed starting positions, the weak section will be unloaded, and physical training will take place in a safe and productive manner, since we will protect the lower level of the back from additional axial load and pressure above the parts of the body located above.

Of value are tasks for natural traction of the spine, performed on an inclined surface, which allow you to expand the interarticular distance and reduce mechanical compression of nerve fibers, as well as relieve swelling and inflammation, normalize blood flow and metabolic processes in the problem area.

Why do doctors prescribe therapeutic exercises?

To speed up the healing process, the spinal tissues must be actively supplied with blood. Improving blood circulation in this area is achieved through regular physical activity . In addition, proper exercise helps strengthen the muscle corset, which reduces the load on the lumbar region in the future. Since most pathological processes in the lumbar region are associated with metabolic disorders, regular physical activity in this case is a necessary component of successful treatment, especially if the patient has been diagnosed with a hernia in the lower back. Otherwise, if physical activity is not enough, the muscle fibers may atrophy, which will lead to the progression of the pathology.

Gymnastics for the lumbar spine

To fully support the spine, you need a strong muscle corset, but with muscle atrophy, deformation of the spinal discs occurs, which only worsens the clinical picture of the pathology. Without a powerful muscle corset, all loads will be transferred to cartilage and bone tissue, which will entail other unpleasant consequences.

Hernia of the lumbar spine

Prices for orthopedic corsets and posture correctors

A set of exercises for lumbar hernia

Strength loads with resistance, using additional weight, for endurance require caution. They will lead to injuries, generalization of disc prolapse, compression and damage to nerves, vascular formations, the spinal cord and other dangerous reactions. In mild stages, strength training is sometimes allowed, but only on medical advice. In case of serious displacements of the nucleus pulposus, a strict taboo is often placed on them. Be that as it may, completely avoid independent experiments, entrust the choice of any training to a doctor!

Lie on your back, bend your knees. The feet are completely on the surface, arms along the body. As you inhale, draw in your stomach, tensing your abdominal muscles. Having reached the maximum point of retraction, record this result for 10 seconds. As you exhale, relax your stomach. Repeat 8-10 times.
I.p. the same. Raise your upper body about 30 degrees (you can put your hands behind your head for convenience). Stay in this position for 7-10 seconds, then smoothly return back. Rest for the same number of seconds, then complete the task again. The number of repetitions is similar to exercise. No. 1.
Lying on your back, bend your lower limbs at the knees. Very carefully and smoothly pull your knees to your stomach one by one, helping yourself with your hands. When you feel muscle tension in your back, fix the pose, and on the count of ten, return to i. p. Do 10 times with each limb.
The starting position is the same. Raise one limb up, straightening it at the knee joint. Keep your straight leg up for about 7 seconds. Then we slowly lower it, returning it to the original position of the bent knee with support on the foot. Perform identical actions with the opposite leg. Repetition frequency – 8-10 times.
Lie on your stomach. Hands are pressed to the outer thigh. Raise your head and chest above the surface to a distance that is acceptable for you. Hold this position for about 8 seconds. Slowly lower yourself to the floor and relax. After a 10-second break, repeat. Number of sets – up to 10 times.
I.p. - lying on your stomach. Arms extended forward, legs together. Lift your right arm and left leg off the floor at the same time. Pull the toes of the foot back, the tips of the fingers of the palm forward for about 10 seconds. The chest is raised, do not throw your head back. We perform a similar action with the left leg and right arm.
Get on all fours. Support in the legs: on the knees and the front of the legs. Support in the hands: on the palms, arms straight. This type of charging is similar to the previous one. Raise your straightened right arm and, on the opposite side, your left lower limb so that they are level with your back. We pull the toe (back) and hand (front) in different directions. Do not raise your chest or head.
It is useful for lumbar intervertebral hernia to walk around the room on all fours for several minutes. Keep your back level (do not bend or bend), make sure that your arms do not bend when moving.
Exercising in the pool has a beneficial effect. This could be aqua gymnastics or swimming. There are practically no restrictions on such activity in water, but the value is great: the lower back is unloaded and the spine is tactfully stretched, at the same time blood circulation is restored, metabolic processes are activated and the muscles are strengthened non-traumatically. But know that it is preferable for you to swim on your back or crawl style; it is not advisable to use other types.

Features of training

Follow the basic rules of training to achieve maximum therapeutic effect:

perform special exercises daily . In this case, only regular gymnastics will strengthen the spine;
in order not to aggravate the situation, all exercises must be performed carefully and smoothly . Avoid putting excessive stress on your lower back;
the range of movements during exercises, as well as the duration of the procedure itself, should increase gradually .

Back muscle training

On a note! Upon completion of a daily set of physical exercises, fatigue should be mild - only in this case the patient’s body receives maximum benefit from therapeutic exercises. It is necessary to avoid severe physical fatigue so that the body has time to recover.

Be sure to focus on how you feel - if you experience pain in the spine area, you should stop training. Also, during exercise therapy, other symptoms may occur, for example, a feeling of pins and needles on the skin of the legs, numbness of the lower extremities, or discomfort. In such cases, you should seek help from a doctor as soon as possible.

Numb feet

Choosing a rehabilitation center

The domestic rehabilitation system is in a deteriorating state. In Russia there is very little assistance in the physical rehabilitation of such patients. Accordingly, the indicators of positive dynamics are too low, and our doctors do not even deny this. Not everything is going well with conservative and surgical therapy either. In this regard, a flow of people travels abroad for treatment. The Czech Republic inspires particular confidence, where the field of orthopedics and traumatology is developed on a global scale.

In the Czech Republic, prices are the most affordable abroad, and the quality of any medical service is excellent.

Basic principles of hernia treatment

Treatment methods are selected taking into account the symptoms of the disease, the patient’s condition and the presence of other musculoskeletal pathologies. Treatment should begin at the first painful signs of the disease.

Events are being held:

Quiet bed rest.
The use of anti-inflammatory non-steroidal drugs (Diclofenac).
Anti-inflammatory steroids (Prednisone).
Use of painkillers (sometimes narcotic analgesics).
Physiotherapy.
Therapeutic exercises.
Manual therapy.

The course of treatment is long, up to 3 months. If there is no positive dynamics, then a decision is made on surgical intervention.

Prohibited exercises for lumbar disc herniation

“Clean” vertical hanging and pull-ups on the bar. Since the spine will experience a significant load of body weight, due to the weakness of the ligamentous apparatus, pathological stretching may occur, which will have the opposite effect.
Work with additional weight on the lower limbs and lower torso. Lifting weights with your legs, pressing limbs against resistance, squats and bends with dumbbells, kettlebells, or lifting heavy equipment from the floor with your hands. The danger lies in overstraining the spinal and abdominal muscles and increasing compression in the lumbosacral region.
Torso twisting. To put it simply, it is forbidden to pump the press in any way. When performing a crunch, the lumbar region is critically overworked in your case. Moreover, twisting can displace the hernia and cause pinched nerves and compression of the spinal canal.
Run, jump. You should avoid all situations where you need to run, jump or jump from some elevated object. Fast walking is also not recommended. The listed types of activity reduce the depreciation resource of the intervertebral discs, and, therefore, are fraught with aggravation of their morphological condition and the appearance of pain.

It is worth warning you against trying to do swings with the lower limbs, “mill” with the arms, all kinds of lunges on one leg, deep bends of the body down and to the sides from a standing position, circular rotations at the waist.

General principles of healthy eating

Additionally, it is necessary to follow the principles of a healthy diet that will maintain normal body weight. After all, excess weight is one of the most important factors in the appearance of protrusions and hernias. This:

drinking plenty of clean water;
limiting fast carbohydrates, focusing on slow carbohydrates with a low glycemic index;
the use of fiber, which has sorbing properties without nutritional value;
the use of easily digestible foods containing calcium and phosphorus. These are seafood, fish, milk, cheese, fermented milk products, legumes.
inclusion of sources of magnesium, manganese, and quickly digestible proteins in food;
to improve the trophism of nerve roots, sources of B vitamins are desirable, these are whole grain bread, cereals, bran;
ascorbic acid, vitamin P are important for capillaries. Yes, there are no capillaries in cartilage, but a well-developed capillary network of the deep back muscles allows you to quickly resolve the secondary spasm that has arisen, and ideally, prevent its occurrence;
normal concentration in the blood of microelements such as magnesium, calcium, and the source of the same chondroitin sulfate is red fish: salmon and salmon;
ῳ-3 unsaturated fatty acids.

It is advisable to avoid refined foods, canned food, sausages, spicy seasonings, sweet soda, fast food, and alcohol.

The food of a healthy person, in terms of its acid-base reserve, should be slightly alkaline, and improper nutrition constantly shifts the pH of the blood to the acidic side. Excess meat products leads to an increase in the concentration of purines and uric acid in the blood plasma, which causes the deposition of urate crystals in the joints, including in the small joints of the vertebrae.

Yoga for lumbar hernia

It is worth taking into account that all these unconventional tactics for the spinal system should not be regarded as the main treatment, since they are not recognized by official medicine. And after removing the pathological formation, don’t even think about them at all; operated patients are not restored using dubious methods! Well, now let’s briefly look at each of the popular methods.

All non-traditional tactics should not be regarded as the main treatment, since they are not recognized by official medicine. And after removing the pathological formation, don’t even think about them at all. Yoga will in no way renew already degraded cartilage tissue, will not resolve the hernia and will not set it back. But it can relieve stress, increase flexibility and stabilize the spine.

Asanas consist of twisting the body, deep flexion and extension of the body, which is strictly contraindicated for this medical problem. Breathing and meditation tactics are allowed. Safe asanas:

Lie on your back. Arms along the body, lower limbs lie freely. We bring our feet together, pull our toes toward ourselves, and push our heels back. Then, while inhaling, we slowly raise our arms up, moving them as far behind the head as possible, opening them slightly wider than the shoulder line. At the same time, we try to press the lower back with our stomach to the surface of the floor. Fix the pose for 3 seconds, continuing to pull your hands and heels in different directions. As you exhale, release the tension and return to the starting position, relaxing all parts of the body.
Sit on all fours, standing on your knees and straight arms. Inhaling, slowly lower your head, pointing it towards the pelvis. At the same time, round your back like a cat. When you reach the highest point of the deflection, a short fixation of the pose is required, we return the head to i. p., straighten the back and bend it in the thoracic region. In the second approach, do not overextend your lower back and do not throw your head back.

Non-standard poses with insufficient flexibility of the musculoskeletal frame can end badly, even leading to complete paralysis of the legs. Especially with extrusion or with a sequestered form of protrusion, “turn on” your mind, these workouts are not for you. When using this approach for protrusions, monitor the sensations very carefully! Don't do anything that forces you past your fitness threshold. If you feel increased paresthesia or pain, even of a mild nature, retreat from the idea of training in a non-trivial way, and urgently notify your orthopedic doctor.

Attention! The long-term hernia of Schmorl L1 and others extremely thins the bone tissue of the vertebrae. Having done the asana, it is possible that a compression fracture of the vertebral body will follow. This outcome will add even more physical suffering and difficulties in treating the spine.

Yoga classes

When treating a lumbar hernia, doctors often prescribe yoga classes. This eastern practice helps improve the flexibility of the spine, eliminate spasms and pain, and normalize metabolic processes in affected tissues. Not all techniques are equally useful; the following 5 approaches are mainly used:

Urdhvottanasana. You need to stand up straight, place your feet shoulder-width apart. At the same time, you must keep your back straight. Hands go behind your head and form a lock. Slowly change their position so that first the knuckles are looking up, then the palms. It is important to control your breathing during the process, not to relax your stomach, and to constantly keep it tense.
"Downward facing dog." Extend your arms and fix your fingers at the foot. Legs are level and straight. Move forward a little so that your body forms a right angle. Hold the position for a few minutes and then return to the starting position.
Urdhva savasana. Stand straight, feet shoulder-width apart. Gradually roll from toes to heel and in the opposite direction.
"Butterfly". Lie on the floor, spread your arms and legs apart, bend your knees. As you inhale, lift them up, and as you exhale, lower them to the floor.
Shavasana. The exercise is aimed at eliminating stiffness in the muscles. The patient will need to lie on his stomach, stretch his arms along the body and try to relax as much as possible.

Techniques are selected individually, so consultation with a doctor is required. Some asanas are quite complex and can cause complications if the rules of execution are violated. Therefore, it is not recommended to practice yoga on your own at home, without a sufficient level of training.

Pilates technique

The fashionable fitness trend is actively promoted on the Internet as a remedy for disc herniation. Experts are not against such classes, but they warn that they should only be taken under the guidance of a trainer with a higher medical education who understands what is good and what is bad for you. The principles of Pilates for the sacral and lumbar segment are completely different than for the neck or dorsal region.

Even if you choose the simplest exercise in terms of technical understanding, for example, the plank, keep in mind that its incorrect variation and inaccurate execution will not end well.

A plank from this fitness category is often recommended for protrusions and hernias. This is a static exercise, that is, you need to take an immobilized position and hold in the desired position. This technique has a comprehensive effect on the condition of the back, maintaining elasticity and tension of the muscle-ligamentous fibers, straightening and stretching the spine along its entire axis.

Example:

take a pose as for push-ups from the floor (stand with outstretched arms);
hands should be positioned strictly shoulder-width apart, legs at hip level, legs resting on the toes of the feet, heels do not touch the surface;
the back is straight, the lower and upper limbs are straight;
the pelvis, head, neck, lower limbs coincide with the line of the spine, hence the name of the “plank” technique (imagine that they are connected by one even string);
hold the position as long as your endurance allows it (physically strong people are allowed to stay in this position for 30-60 seconds);
most importantly, do not allow your back to sag, then most of the load will shift to the lumbar and sacral area, that is, the epicenter of gravity will be concentrated in the most vulnerable place.

There are other poses, for example, creating support in your hands on your forearms. Every day, increase the duration of the emphasis by a few seconds, as a result, stop at a maximum of 2-3 minutes.

Contraindications

Therapeutic exercises are prohibited for acute pain syndrome that cannot be relieved by medications. At this time, doctors recommend completely eliminating physical activity and maintaining bed rest. Therapeutic exercises will do more harm than good to people suffering from epilepsy, infectious diseases, heart problems, or cancer. Therefore, before starting training, all patients are recommended to undergo a comprehensive examination.

A hernia in the cervical spine is a serious pathological condition. It develops as a result of a sedentary lifestyle. If detected, the doctor prescribes complex treatment, which includes special gymnastics. A correctly selected complex allows you to recover faster, eliminate compression of nerve endings and compression of the spinal cord, and get rid of discomfort. There are no universal exercises; they are selected based on the individual characteristics of the individual patient’s body.

Bubnovsky's exercises

A famous doctor says that it is necessary to treat the cause, not the consequences of the pathology. The problem is shortening, weakness and tightness of the muscles of the body, due to which the spinal elements do not receive the necessary nutrition, and the vertebral chain is destabilized and degenerative changes occur. Frankly speaking, this is not news for orthopedics, and all rehabilitation specialists offer exercise therapy based specifically on working out muscles and ligaments.

The well-known Shamil physical education technique or Dikul gymnastics also involve working with muscles, when the spinal column is aligned, the distance between the vertebrae increases, the load balance is adjusted, disc decompression and, as a result, neurological signs disappear. We present for your information Bubnovsky’s program, which, as a specialist says, will help you forget about a hernia without surgery or medications. But it is advisable only for non-advanced forms of pathogenesis. It is also useful as a good prevention of the development of degenerative diseases.

Exercises to do at home:

Lie on your back, bend your legs at the knee joint. The soles of the feet are completely on the floor, arms along the body. Leaning on your shoulders and feet, while inhaling, raise your pelvis high. As you exhale, slowly lower your pelvis to the floor.
Take a horizontal position, stomach up. Place the palms of your hands under your head, pressing your chin to your chest. Point your elbows up and at the same time bend your knees.
Let's complicate the previous task. We try to reach our bent knees with our elbows, raising our head and upper back.
Sit on the floor. Legs straightened, hands clasped at the back of the head. We bend the knee with each leg in turn, then extend it in an elevated position and lift the straight limb to the maximum distance from the surface.
Lying on your back, spin the “bicycle.” Leg movements should be measured, without sudden jerks, breathing should be uniform.
Sit on the floor, cross your arms behind your head. Lifting your buttocks one by one, move forward. Now we need to go back using a similar principle.

If you have already been recommended surgery, it is naive to think that physical education, whatever it may be, will replace it. Perhaps it will help delay the time before surgery for a short time. There are no other ways to solve the problem of large disc protrusion, which pinches the neurovascular plexuses to a critical level and ultimately compresses the spinal cord. By delaying the removal of herniation, you risk becoming wheelchair-bound due to the death of nerve tissue and damage to the main organ of the central nervous system - the spinal cord. And then surgery will no longer be effective.

General execution rules

The formation of a hernial protrusion causes numerous neurological disorders. Their nature and intensity are necessarily taken into account by the physical therapy doctor when drawing up an individual treatment complex. The first classes must take place under his guidance. He shows how to properly perform exercises and dose the resulting loads. Then patients are allowed to train at home in compliance with all medical recommendations:

if painful sensations appear during exercise, you should rest for 1-2 hours;
At the initial stage, technically complex exercises should not be attempted with the maximum number of approaches;
Physical therapy should be combined with morning exercises and walks in the fresh air.

Before class, it is necessary to ventilate the room. It is better to train in clothes made from natural materials that absorb moisture well.