This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2024. For the original video go to https://youtu.be/5dSGWgWO2So
Mike: Living with lumbar stenosis can be challenging, especially when it comes to exercise.
Brad: That's right. I personally have lumbar stenosis and we're gonna show you in this video exercises to avoid as well as exercises you can do to help it out. Guaranteed they do work.
Mike: So typically with spinal stenosis, any exercise on your back that promotes extension or going backward, can compress material in there and cause pain.
Brad: That's right. Now we're going to use Sam to give you a very good visual of what's actually going on. So lumbar stenosis, we're talking about the lower back, just above the pelvis and stenosis refers to the narrowing of a hole or a foramen. And in the back, it's where the nerves come out at each level. Now, when you go backward, just like Mike did, look what happens.
Brad: It actually squeezes down and makes the foramen even tighter. So it's already tight from the stenosis, now we even tighten it further, which creates pain and it's not good. So we're going to avoid postures and exercises that put lumbar extension into play. So inversely, what makes a lumbar stenosis feel better is actually to open up the gaps. In other words, we're going to flex the lumbar spine by leaning forward or you can do a pelvic tilt, which is a little harder to see, but it definitely does it. If we look here when we flex forward, look how the hole or the foramen opens up. Come on Sam, open it up. There we go. There's a good opening there and there.
Brad: If you do have stenosis, you'll definitely feel the difference between extension inflection in regards to comfort level.
Mike: So the first thing you want to avoid when you have lumbar stenosis is any prolonged extension pattern. So Brad is lying down, this is an extension pattern.
Mike: Standing up with a straight posture, even leaning back is an extension pattern. So oftentimes people may be standing in their kitchen reaching for a cup high in the cupboard and they're starting to get more pain because you're in an extension pattern like this, it gets very uncomfortable over time.
Mike: So try to avoid being in this position for prolonged periods of time.
Brad: Right. You know, other activities I've experienced, if you're like washing windows where it's repetition overhead, working on anything overhead on the ceiling really is uncomfortable. So lying on your stomach or prone position actually extends the lower back, particularly if it's in a soft bed, which will create pain. My back is already uncomfortable. And if you go up on your elbows, that'll exacerbate it and create pain even sooner.
Brad: Now we're going to go over some alternatives in just a bit, but we've got more exercises that you really want to avoid. Alright. Now the two exercises we're going to go over are definitely irritating to someone with stenosis. Mike's going to do them because I don't need a backache after this. Go ahead, Mike.
Mike: So oftentimes this is called the Superman exercise because it looks like you're flying through the air like Superman. So I'm actually going into spinal extension. I'm starting prone on my stomach. This is somewhat extended, but not too much. But once I lift my feet up and my arms up, I'm really extending my back.
Mike: This does strengthen your back muscles, yes. But if you have stenosis, it's probably going to cause pain and discomfort. Now this goes for many exercises you may do at the gym as well where you're extending not just in a lying down position, but even standing up.
Brad: Maybe we should show the press-up that's commonly done for people. But with stenosis, this is something you do not want to do, particularly with repetitions.
Mike: Yes, oftentimes this is an exercise prescribed for someone with a herniated disc. However, if you have stenosis, this is the opposite of what you want to be doing.
Brad: Exactly.
Mike: Now the third thing you want to avoid is walking until you have pain. Now with back pain, it is important to still walk and most people enjoy it. However, you don't want to go too far to the point where it's starting to bother you. So we'll talk about some tips later on how to alleviate this.
Brad: That's right. So again, Mike says, walking typically will irritate someone with stenosis after time. And it all depends. I was always limited, but now after doing some exercises to help it, I can walk pretty much indefinitely.
Mike: Now the first thing to try is having a pelvic tilt. Now what we mean by this is actually having your pelvis tilted in a direction. Some people just naturally will stand or walk a certain way. So this is an anterior tilt where I'm tilting my pelvis forward. And a posterior tilt is when I'm tilting my pelvis backward.
Mike: Oftentimes if you notice you're walking like this in the anterior tilt, it's probably going to cause more pain and discomfort. So if you can try and get into a neutral position or even a slightly posterior tilted pelvis position, this can help alleviate some of your pain when walking.
Brad: Right now, if you're walking, you want to make sure you stop before the pain gets too bad. Now, one thing I always did, and it worked very well, was my back would start to hurt, I'd either sit down if there was a place to sit or I'd simply crouch and that would immediately relieve that back pain. It would feel good.
Brad: I would hold there and stretch a little bit. I'm talking for 15 to 30 seconds, get up and start walking. Oftentimes I could extend my walk in a pain-free manner. Do not push through the pain and think that no pain, no gain, it's going to go away because it'll just irritate it. So that's a nice little clue there for you. Walking, walking.
Mike: Another tip for walking is if you are unable to go for long durations outside or distances like you used to, you may want to use a walker when you're outside. You can use a standard walker if you have a one or four-wheeled walker. Brad will show some of the benefits of a four-wheeled walker. But when you're able to use a walker, sometimes you can slightly flex your spine, which normally feels better, putting pressure through the walker.
Mike: If you notice when you're shopping and leaning forward on a shopping cart relieves your back pain, a walker might be a good option when you're out and about. Now, when you're inside, if you don't want to use it, you just certainly don't have to. But if you want to increase your distance walking, this could be a good option.
Brad: So if you find walking outside is something you really want to do and you do want to go longer distances, getting a four-wheeled walker will definitely be the way to go. They're very nice. They have one of the big benefits is, is if you get tired, you simply lock the brakes, turn around, and sit down, and it'll make your back feel better. There's a little backrest there. Rest and then back up again and continue walking. With larger wheels, you will be able to walk over uneven surfaces where there are cracks in the sidewalks, et cetera. It will really allow you to walk as far as you want and be comfortable when you need to sit.
Brad: Alright, now there's a technique called decompression. Now what you're going to need for this is a solid surface. Now we're using the back of a chair. Mike needs to sit on it so it is solid. If there's a park bench where you're walking and there's a solid bench, you can use that, perhaps a fence or rail, whatever is solid. And it cannot be too low. It needs to be about belt level, maybe a little bit lower. If it's too low and I have to reach over, that will not work. It actually will extend your back and be irritating. So we find that proper level, good, solid bench, and you're going to try and straighten your elbows out because it's a little easier and you take the weight off of your legs and that actually decompresses or puts a little traction on your lower back. That opens up those foramen, those gaps that we talked about earlier. And you just relax.
Brad: This takes a little bit of practice. Now, if I do this and I lean forward slightly, round my back a little, it feels good. It really makes a big difference. Everyone's a little different. Sometimes I will actually add a little rotation on my hips. It feels good. I'm a happy person. I could do this for another 20 seconds.
Mike: I bet, you're dancing.
Brad: My arms are getting a little bit tired.
Mike: You can also do this on a countertop if you're at home.
Brad: That's right.
Mike: It's a good option.
Brad: Now, if for some reason, you really like to lie on your stomach for doing an exercise or for resting, the option is, take a pillow, a little bit thicker one like this one, and put it right about at your belt line, at your waist, and then lie on it. And you'll notice that's much more comfortable on your back. You may have to use two pillows. It's going to depend on what fits your body the best. So there you go. That's a good option there.
Brad: Typically, lying on your back with your feet up really makes a big difference and gives you some good comfort there.
Brad: You can put a pillow, typically two or three pillows to get your legs up higher, will also be a nice way to relax, get your back to feel good, and get some rest.
Mike: So this is a good option if you're doing a lot of standing and overhead work like we talked about earlier, you're going to need to take frequent breaks. And sometimes getting in the opposite position like Brad was just showing will help. Maybe lie there for 10 minutes and then go back to work.
Brad: I've done it many times. It really is a good solution.
Mike: You want to clean my windows?
Brad: No.
Mike: Oh.
Brad: Wonderful. Alright, so with your lumbar stenosis, guaranteed some of these things are going to work for you. Some may not be as much. So pick and choose, you'll know, 'cause it's gonna make your back feel better. And we also have another video that will be helpful. Mike, take it away.
Mike: Yeah, so check out "Spinal Stenosis Exercises That Help Immediately." The exercise options in this are different than what we showed.
Brad: Very nice, very nice.
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