Combatting Back Pain For The Older Generation- Stretches That Will Help!
Every parent dreams about playing with their children or grandchildren, throwing a football back and forth at a nice thanksgiving dinner. However, one day that football might be too far away to bend down and pick up due to back pain. This article will go over common causes of back pain, how you can minimize your risk of it, and exercises you can do to make your back feel better so that you can keep on playing with your loved ones.
What is Back Pain and Why is it Common in the Aging Population?
Back pain is a common problem that affects millions of Canadians. It can range from a mild discomfort to a sharp pain, it can also be caused by repeated minor stressors that build over years, or a one time incident. It is a specific problem for the older population as there are many years of wear and tear that eventually start to cause problems, usually after the age of 50.
Symptoms of lower back pain:
Rigid/stiff back
Pain when moving the back
Pain in buttocks, legs or abdomen
Pain that may get worse when standing, sitting, or lying down
Pain when twisting your body
Common Causes Of Back Pain in the Aging Population
Facet Joint Osteoarthritis: This is the slow degeneration of parts of the spine, where the cartilage that attaches the rib’s facet joints to the spine starts to lose stability. The cartilage’s degeneration is a part of the natural aging process, however, it can be amplified by poor posture, traumatic injury to the back, or improper nutrition. As the joints degenerate, there is an increase in friction at the joints, which can cause pain and stiffness in the back, which are the two biggest symptoms. However, the pain may spread to the buttocks and hips, and even radiate down the leg to the feet.
Exercises for Facet Joint Osteoarthritis:
To begin, we will start with a stretch that is very common in back pain, the knee to chest stretch.
Start by lying on your back with your hips knees bent at a roughly 90 degree angle
Place your hands behind your thigh, behind your knee
Gently pull your knees as close as you can to your chest and feel the stretch in your lower back. Remember not to force yourself, you are looking for a stretching sensation, not a painful one
Hold for 30 seconds
Repeat 2-3 more times
This stretch may be too difficult or painful for some, hence there are some easier variations that you can use to progress.
Variation 1: Do the aforementioned stretch, however do the exercise with one leg at a time, using both hands to grab and pull your knee to your chest. Alternate to the other leg after you have completed the stretch
Variation 2: If you are unable to reach behind your knees, sling a towel under your knee, and use it to help pull your knee to your chest. Use a timer to ensure you are holding for 30 seconds, and remember to alternate legs and not to push yourself to discomfort.
This stretch will be amazing in helping alleviate some of your back pain, however, it is also important to strengthen your body to help reduce and prevent back pain. For starters, living an active lifestyle is great not only at preventing back pain, but it is a crucial ingredient to living a healthy lifestyle. To further these benefits, there are three main exercises that will also help strengthen the body and help with back pain.
Bird Dog:
Start this exercise by going onto all fours, have your arms directly in line with your shoulders
Elevate your right arm and left leg as to make it a straight line from your hand to your foot
Alternate to the left arm and right leg and do each side for 3 sets of 8-12 reps
Bringing both your arm and leg at the same time may be challenging for some, in that case, do one at a time, elevating your right arm by itself, then left leg, then left arm, and finally right leg
Iso Crunch:
Lie on your back with your feet bent, and your hands under your lower back
Lift your head and shoulders a few centimeters off of the ground. Be sure not to flex your head forward (try keeping your neck as straight as possible).
Hold this position for 10 seconds and repeat for 10 repetitions, resting between each rep.
Side Plank
For this exercise, lean on your forearm and plant your feet on the ground. An easier variation of this is instead of using your feet, use your knees as a second point of contact with the ground.
Then ensure that your hips are elevated so that you engage oblique muscles
Hold this position for 30 seconds and then repeat using your other forearm
Repeat for 2-3 more reps each side.
Lumbar Spinal Stenosis: Throughout your spine, there are several little holes for nerves to travel through, when these holes become compressed, there can be pressure on the nerves, causing pain. Women are more at risk of lumbar spinal stenosis, however, everyone’s risk of it and risk increases as they age. In fact, lumbar spinal stenosis can often be caused by osteoarthritis, hence, these two conditions often come hand in hand. Symptoms of lumbar spinal stenosis include: pain in back, buttocks, or legs, including any combination of the three, loss of sensation in feet, numbness in the legs, and loss of sexual function. Another common sign is pain during back extension, in other words when you are standing or walking. Hence, people with lumbar spinal stenosis typically have their pain alleviated at the grocery store when pushing their cart (since they are leaning forwards) and when they are sitting. Thus, when rehabilitating this condition, the goal is to improve back flexion based stretches, and avoid extension movements until the pain dissipates.
Exercises to help with lumbar spinal stenosis:
The aforementioned, knee to chest stretch is also extremely beneficial for lumbar spinal stenosis as it takes some pressure away from those nerves that are being compressed. It will also be helpful to do the bird dog, iso crunch, and side plank exercises to strengthen the body. Uniquely with lumbar spinal stenosis, is the possibility of tight external rotation of the hip, not everybody with this condition will experience this, but if you do, some helpful stretches are:
Figure 4 Stretch:
The first variation of this exercise involves sitting on a chair, and placing the ankle of one leg over the knee of the other, in a figure 4 formation.
With the same side hand as the hip that is being stretched, gently push your knee downwards to the ground. You should feel the stretch on the outside of your hip.
Hold for 30 seconds and switch to the other leg
Repeat 2-3 more times
You can get a great stretch from both of the variations, it all depends on your personal preference. For this variation, lie on your back and bend both knees and hips. Place your ankle over the other knee
With the same side hand as the hip that is being stretched, gently push your knee forward so that your hip rotates, and you can feel a stretch in your outer hip
Hold for 30 seconds and then repeat for your other hip
Repeat 2-3 more times
Piriformis Stretch
Lie flat on your back with your legs extended
Bend one hip and knee to 90 degrees.
Using the hand on the opposite side of your body, pull your knee to its opposite side towards the chest
Hold for 30 seconds and repeat with the other leg
Do this 2-3 more times
Please note that these stretches and exercises are simply methods that have been proven to help with some cases of lower back pain, but may not work for everyone, as each person is in their own unique situation. Do not put too much stress on your body when doing these exercises, stay within a generally comfortable range when performing them.
Dickerman, R. (2022, March 22). Low back pain in older adults. Spine Health. Retrieved June 16, 2022, from https://www.spine-health.com/conditions/lower-back-pain/low-back-pain-older-adults#:~:text=Adults%20aged%2050%20years%20and,pain%2C%20such%20as%20muscle%20strain
Sacroiliac Joint Dysfunction: Often caused by a traumatic event, however, aging increases the risk of sacroiliac joint dysfunction. This is often caused by too little or too much movement of the joint. This is the joint that connects the bottom of the spine to the hip bone, hence too much movement can cause it to feel unstable, and too little movement can cause it to be tense and rigid. Direct trauma or lots of microtraumas to the joint can also cause it to be dysfunctional.
Degenerative Spondylolisthesis: Similar to lumbar spinal stenosis, degenerative spondylolisthesis is when a vertebrae slips from its natural position, which can put pressure on nerves. This is again, caused by an aging spine, which causes the spine to lose its natural posture.
Accident/Injury: A way that a person’s back pain can jumpstart out of nowhere is through trauma to the back. This can be as simple as improperly lifting a heavy object, which puts too much stress on the spine, to something more extreme such as falling down the stairs or getting hit from behind. This is especially prevalent in older adults as their stability and balance is not as strong as it used to be, increasing the risk of a slip or fall.
Joel Burgess, Physiotherapy Assistant