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Planning Retirement Online

Home Exercise and Rehab

June 2014


Gina John

Gina John is a Pilates Practitioner and Registered Osteopath who has spent many years offering help and advice, especially to the over 50 age group.

She is founder of The Osprey Clinic in the St. Johns Wood area of London and now specialises in Home Exercise and Rehabilitation Programmes. For further advice on exercising safely, and a selection of exercise films for general fitness and medical conditions, visit the website:



This month: Stiffness and weakness in the lower back.


Q: Having increased walking recently with the improvement in the weather, my low back feels tight and weak in the evenings and again in the mornings, on waking. Overall, I do feel better for walking but would you please advise me on how to improve this stiffness and fatigue?

A: Symptoms of stiffness and weakness in the low back muscles are common after a period of inactivity. When we place a higher demand on our back muscles without specific strengthening exercise to prepare them for the increased workload, it is likely that they will complain.

Each vertebrae along the length of the spine has two facet joints, located either side of the main vertebral body. As a consequence of wear and tear of the discs, the spinal vertebrae sit closer together, thereby approximating their facet joints. This may cause soft-tissue inflammation around the facet joints and over time, small changes in the shape of the bone itself may occur. Stiffness after walking is a common symptom of this problem, since the facet joints in the lumbar region, articulate as we move the legs and pelvis with walking.

Inflammation associated with spinal arthritis which may also be termed ‘spondylitis’ or ‘spondylodiscitis’, leads to chronic stiffness or pain in the low back and hip region. Symptoms are usually worse first thing in the morning but improve with gentle movement or exercise. For many patients, symptoms are referred from the spine to the outer hip area and front of the thigh via the nervous system. In others, the pain is much more localised to the lumbar area.

If your symptoms are not resolved by gentle exercise, it is prudent to visit your GP to determine any other possible causes. Anti-inflammatory drugs and gels are available on prescription, and ‘over the counter’ at chemists. These will ease inflammation in the lumbar spine, but if you choose to avoid medication, an ice pack is a natural alternative and should be applied to the low back area on waking and in the evening. Apply the ice pack for 10 minutes, and repeat 3 times at 10-minute intervals. Also, it is inadvisable to remain sitting for long periods of time, i.e. more than 30 minutes, as inflammation tends to settle in one area, causing greater discomfort and the back muscles may become weaker.
In addition to exercise and anti-inflammatory treatment, it is important to ensure that your footwear provides adequate arch support. Especially, if you have flat feet, dropped arches or high arches you should seek consultation for orthotics. These are inserts for the shoes which provide support for the medial arch of the foot and help to control the biomechanical forces passing through the feet and towards the spine.
Orthotics are fitted by podiatrists as well as some osteopaths and physiotherapists. The therapist will evaluate your symptoms, take measurements of your feet and weight bearing and take account of your lifestyle and the demands on your feet. You will then be advised on which type of orthotics will be most appropriate. It is inadvisable to buy orthotics from high street chemists if you have low back or other symptoms, associates with walking, as it is likely that proper evaluation of your condition and a bespoke solution will be required to resolve the problem.
The following exercises will help to avoid stiffness when practised regularly, and strengthen your low back muscles.

Spine Curls
Lie face up on the floor or a firm bed with your knees bent and your feet in line with your hip joints. Press a cushion gently between your knees. Pull in your abdominal muscles with maximum effort, while you exhale to lift the pelvis and spine, no further than the shoulder blades, to form a bridge position. Inhale as you hold the position and exhale as you lower your body again. Try to wheel the spine, vertebra by vertebra, back to the start position. Repeat 10-15 times.

Diamond Press
Lie face down on the floor or a firm bed and place a pillow under your abdomen.
Start by placing your hands beneath your forehead with your elbows pointing out to the sides.
Draw back your abdominal muscles firmly, by scooping in the navel towards the spine.
Exhale as you lift your head from your hands, while trying to squeeze your shoulder blades towards the back of your waist. Inhale to hold the lifted position and exhale as you lower your forehead back to your hands again. Repeat up to 15 times.

Back Stretch
On waking, lie on your back and pull your knees in towards your chest. Make a circle with your knees 10 times clockwise and 10 times anticlockwise. Feel that you are massaging your low back gently into the mattress.

Buttock Stretch:
Lie on your back, with your knees bent and feet on the floor.
Pull up the right leg towards your chest, keeping the right knee angled to the side, so you feel a stretch through the right buttock and hip area. Hold the stretch for 20 seconds, and repeat the stretch to the left buttock and hip.

Hip and Front of Thigh Stretch
Kneel down at the side of your bed with your right knee on a pillow and the left foot flat on the floor in front. Keep your body upright, and take your weight forwards towards the left knee to feel the stretch at the front of the right hip. Hold the position for 20 seconds, using the side of the bed for support. Repeat the stretch for the left hip.


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