Physical Therapy Exercises for Herniated Disc Recovery
A herniated disc or a slipped disc can be something scary to be diagnosed with – does it mean that I will have pain forever? Can it ever be cured? Is there a way to help my recovery and reduce the chances of this happening again in other parts of my spine? The answer to that is no, yes, and yes.
A ‘slipped disc’ or herniated disc is often used to describe a condition where a person’s intervertebral disc pinches on the surrounding nerves due to reasons such as a forceful load causing the disc to bulge outwards from its normal position, joint space narrowing in the spine from degeneration, or an annular tear.
But if you are diagnosed with this condition, there are exercises that can be done to prevent a herniated disc from worsening and to speed up recovery – in fact, physical therapy for herniated discs are now considered first-line treatment from the acute stage till those lasting more than 12 weeks (The Lancet). This article will help you understand how herniated discs can benefit from physical therapy exercises and why they are so important!
Why is Exercising Important to Heal Herniated Disc?
Our spinal intervertebral discs are made out of an outer layer of interlacing tough and fibrous connective tissue, called the annulus fibrosus, which gives the disc its strong and flexible properties. This means that when you bend or move a certain way, your spinal discs also bend and twist to follow those movements without getting injured.
In the middle of the disc is a soft filling called the nucleus pulposus and this helps with shock absorption. When you jump and land or even go over a bump in the car, this helps your spine absorb the forces without putting your nerves in extreme pain!
Exercise – specifically, exercises which help to strengthen the muscles around your spine and provide feedback to the connective tissues around your discs – can help with recovery and prevent future back pain. These types of exercises keep your muscles around the trunk and hips working together in balance to equally distribute loads across your entire body and not just to your spine.
What Kind of Exercises Should You Do When You Have A Herniated Disc?
So, what types of exercises can help to prevent herniated discs? Among these exercises are those which help to maintain the flexibility, strength, and stability of your spine in tandem with functional movements that you do daily.
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Stretching (Pilates and Yoga)
Exercises like pilates and yoga focus on certain principles that benefit your spine. Among them are ‘centering’, where you focus on activating certain trunk and core muscles (e.g. transversus abdominis, oblique muscles, multifidi, etc.), and performing those movements with control.
Breathing steadily during the poses and the transitional flow between movements helps to sync the deep spinal stabilisation muscles which are also involved in breathing, like the diaphragm and pelvic floor, with activation of the rest of the body. This makes it a great physical therapy exercise for herniated discs as it can improve your posture and alignment as well as strengthen the spine.
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Dynamic Lumbar Stabilisation & Directional Preference Exercises (McKenzie Exercises)
McKenzie exercises are often the first line of physical therapy exercises given to those with newly diagnosed herniated discs. These exercises have been around since the 1950s and have stayed on till today because of their focus on active self-correction which helps to ‘centralise’ pain, especially pain that shoots down the legs (sciatic pain).
When the right directional preference movements are chosen and repeated over a period of time, this helps to gently shift the spinal structures like the disc back to a less sensitive position and take the load of surrounding joints and nerves. To choose the right directional preference, you may need the help of a certified physical therapist. At Spinefit, our physiotherapists are professionally trained to assess your condition – book here for an appointment today.
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Walk, Bike, Swim
As your back pain reduces and you begin to strengthen your back, you may want to begin to dive back into sports but may not be ready to jump right into high-intensity workouts. Exercises like walking, biking, and swimming are a great way to get started.
These movements mimic activities that you may do daily while providing enough resistance to increase the intensity of your exercises without causing a flare up. Walking and biking can strengthen your legs, and swimming provides a buoyant environment that takes the load of your back.
Active Treatments in Physical Therapy
What are active treatments? Active treatments in physical therapy are any form of treatment which utilises the movements of your own individual body to support the healing process. Herniated discs benefit the most from physical therapy when there is a combination of exercises alongside other modalities such as decompression to alleviate pain. Active treatments involve core stability, flexibility, and overall muscle strengthening.
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Core stability
Core stability is important as muscles that provide stability around your back also wrap around to the front of your ‘core’, such as the transversus abdominis, oblique muscles, and diaphragm. Core stability also means being able to control your trunk muscles while you breathe in and out deeply. This syncing up of core, back, and respiratory muscles means that your back is not unnecessarily loaded over time.
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Flexibility
Flexibility means mobility – the ability to maintain the range of your muscles and joints even as you age. Over time, joint stiffness and muscle tension can reduce your ability to squat, bend over to touch your toes, or even reach up to grab something. Keeping your body limber will help in maintaining your function over time.
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Muscle strengthening
Strengthening doesn’t just have to focus on exercises for your spine or core to prevent herniated discs from happening. It also means whole body strengthening to provide your body with the adequate ability to jump, run, and walk without causing pain due to muscle imbalances. Strengthening your hips has been shown to improve outcomes of pain and disability in those with back pain.
3 Best Exercises for Herniated Discs
Knee To Chest Stretch
- How to do: Lie down on your back on a comfortable surface, and ensure that there is no pain in this position. Gently bring your right knee up to your chest, and then your left. Hug your knees to your chest and consciously relax your shoulders and back – rocking side to side may help. After 10 seconds of deep breathing, drop your right leg back down to the ground, and then your left. Repeat for 3 times.
- How it helps: Pain can result in high levels of muscle tension in the lower back, which then further aggravates pain. Performing this movement helps to reduce tension and provide a gentle stretch to your back.
Cat and Camel
- How to do: This movement will be helpful for those who are experiencing back stiffness, instead of those with sharp back pains. On your hands and knees, drop your spine downwards to the ground slowly, as if you are arching your back like a cat. Then reverse the movement and curl inwards (looking like a camel hump!), and repeat this coupled movement 10 times.
- How it helps: Stiffness can set in once the herniated disc no longer gives you much pain, or if you have a job that requires you to stay in one position for a long time. This exercise reduces spinal stiffness over time and prevents further tightness which can contribute to back pain.
Supine Adductor Squeeze
- How to do: Lying on your back, put a ball or some pillows in between your knees. Squeeze the ball/pillows gently with 30%-50% of your maximum force and hold it for 5 seconds, then relax. Repeat this movement 5 times. When you squeeze, ensure that your lower back pushes back down to the bed as well instead of arching up.
- How it helps: This movement gently activates the inner thighs, pelvic floor muscles, and core muscles without putting the lower back under too much load. This muscle activation helps to begin stabilising the trunk and back when a herniated disc has occurred and a person is not ready to start big movements yet.
*Disclaimer: The information provided in this article is not intended to be a substitute for professional medical advice, and is for informational and educational purposes only. Always seek the advice of your physician or medical professional prior to making any decisions or undertaking any actions related to health care.
Seek Professional Help at Spinefit
If these exercises do not help relieve pain, or pain intensifies, it’s time to visit a physical therapist or chiropractor. They are trained to assess your individual condition and recommend a course of treatment specific to what you need, especially exercises to help and prevent herniated discs.
Herniated discs come in a wide range of severity, locations, and involvement of nerves, which is why no back pain is always the same. An L4/L5 herniated disc for one person may look like just mild back pain after sitting for longer than an hour, and it may look like a sharp shooting pain down the leg in another.
If you are concerned with your back pain, book an appointment with one of our team today!