One of the best part of working in this field for a long time has been trying to figure out for patients which exercises are good and which exercises are bad for their condition. There's millions of exercises, there's just so many to count, and unfortunately it really does depend on the condition that the patient is coming in for, if they are having a spine problem or disorder.
But by and large, if you're having a mechanical problem in the back, and you're stressing your back out with too much bending and sitting and lifting, it's playing a role on your pain and on your suffering, there is a very good chance that there is going to be certain exercises that are going to be bad for your back, and the reason is you're going to move your spine in the same sort of direction, creating the same kinds of pressures on the tissue as your day-to-day functional tasks, you know, require, so I can't take away those activities, I can't tell you not to go to work or, you know, put your shoes and socks on, but if you're going to then choose some exercises, you better know which ones to be doing for it.
And so for instance, if you're doing exercises bringing your knees into your chest, where you're doing exercises lifting your legs up into the air, lying on your back trying to stretch out your buttock muscles or your hamstring muscles, as good as it might feel during the stretch, potentially you're harming the tissue and moving your spine in the direction that's very similar to what caused the problem in the first place. It's a challenge for patients to understand that, and it usually requires a clinical assessment, you know, with me or others to know which ones are bad, and it definitely depends on what is wrong with the patient.
But there are bad ones, and it's usually the flexion exercises, flexion being defined as bringing your knees into your chest, or your chest down into your knees, or anything that looks similar to that. By contrast, moving your spine into extension is often indicated in these conditions, and it's something that usually isn't thought of right away when a patient is trying to deal with their problem. They're often researching and finding some flexion options, thinking that it's a muscle problem, for instance, and trying to alleviate the stress in the muscle.
There are a number of bad ones, but flexion-based exercises in the presence of a mechanical back problem is often the bad ones. Flexion is defined as when the spine or the body is moving forward, hips are moving closer to the shoulders, or shoulders are moving closer to the hips. Extension is defined as the body moving back or shoulders further away from the hips and the knees.