Section 1 will help explain the mechanisms and systems responsible for your pain. It will also help you understand the reasoning behind the exercises and other recommendations we will make.
Section 2 will help you determine your correct exercise “dosage”. Just like with medication, it’s not only about having the right pill but taking the right amount. This section will also help you adapt your program as your back pain changes and gets better.
Section 3 is your actual exercise program. With each exercise you will find a text description of how to properly perform the motions involved as well as picture and video demonstrations.
Section 4 will include practical recommendations on how to avoid aggravating your back and how to better manage the pain in your day to day life.
Section 5 is where we take into account your personal goals. Pain is unique to those experiencing it. By getting to know the real you we can better help you solve all the problems pain has caused in your life.
A revolutionary approach to your back pain.
Section 2: Exercise Dosage
The recommended amount of exercise will be described using 3 main terms: Volume, Frequency, and Intensity.
Volume refers to how much of each individual exercise you should perform in a single session. Volume is measured in "repetitions" or "time". If an exercise is measured in repetitions you repeat the movement that many times. If an exercise is measured in time, you hold the position for that amount of time.
Repetitions and time are given in "sets". A set can be thought of as a group of repetitions. A set of repetitions should always be separated by a short break. We recommend starting with breaks that are 30 -60 seconds long.
So for example, if you are doing 2 sets of 10 repetitions, you perform the exercise 10 times, rest for 1 minute and then do another 10 repetitions for a total of 20 repetitions
Frequency refers to how many times you should complete an exercise at the recommended volume in a given amount of time. For example, you may be asked to perform the exercise at a frequency of 2 times per day, once in the morning and once before bed. If the recommended volume for this exercise was 2 sets of 10, you would do 2 sets of 10 in the morning and another 2 sets of 10 before bed.
Intensity describes what you should feel during an exercise. During some exercises you should feel your muscles get tired, in others you should feel more of a stretch. The intensity will help you know when you are doing the exercise right and how much you should be pushing yourself.
In order to get the most out of exercise you should challenge yourself, but more isn’t always better.
Before you are active or attempt an exercise you should ask yourself: “On a scale of 1-10, how much discomfort do I feel?”
A score of 10 means you are experiencing the most discomfort you can imagine and a score of 1 means you are experiencing very little discomfort. There is no right or wrong answer to this question, what 10/10 discomfort feels like is totally up to you.
The answer to this question will help you determine if you should be doing less, or doing more of the activity/ exercise in question.
Exercise and activity should not increase pain and or discomfort by more than 2 points. This increase should also not last longer than 1 minute after completing an exercise.
If your pain increases by more than 1-2 points and/ or lasts longer than 1 minute following the exercise or activity, you have pushed too far.
If you experience an increase in pain of more than 2 points or if the increase lasts longer than a minute you should rest or attempt an exercise you know makes your back pain feel better.
Once your pain has returned to the original level you may perform this exercise again but you should modify the painful exercise by reducing the number of repetitions to avoid a similar increase in pain.
If you cannot perform more than 3 repetitions without increasing your pain, reduce the exercise intensity. Most often this will mean not moving as far in each repetition.
If you cannot find a level that feels appropriate to you after modifying the volume, and intensity stop the exercise entirely and focus on the ones you can do. Avoid the exercise for 1 week, then attempt to reintroduce the painful exercise gradually still following the rules above.
If you get relief from your pain with one of the exercises, feel free to perform that exercise as many times a day with as much or as little rest in between as you see fit. It is very hard to "overdo it" with such an exercise, but if at some point an exercise that once felt good becomes painful, return to doing an amount that felt good.
If you are able to perform an exercise with ease at the recommended amount, you should attempt to advance to the second level of that exercise. But be sure to wait at least 24 hours before making any changes. Your pain may not increase until some time after an exercise is complete.
If you get to the third level of the exercise and still find it to be easy, you should increase the volume of this exercise by doing more repetitions or sets. If you are performing more than 20 repetitions or holding a position for longer than 2 minutes and you still do not feel like you are being challenged, you should now increase the frequency.
If you increase the volume and frequency at the hardest level of an exercise and still don't find the exercise challenging, you should continue it to whatever level you have the time and energy for as it will still be beneficial. However, focus on the exercises and activities you do find challenging as well as the ones that make you feel less discomfort.
Other things to consider…
Each recommended exercise has 3 alternative versions of varying difficulty so you can increase the difficulty of your program as your back gets better. Level 1 will typically be the easiest version of the exercise. However, you may actually find it to be more challenging than the other levels. If this is the case, stick with the level you find most challenging at the time.
Do not feel the need to progress the exercises all at once, it is okay to be doing level 1 of a certain exercise and level 3 of another. You also do not have to do all of your exercises in a row. You can do exercise 1 in the morning, and exercise 3 at your lunch break. Fit them in whenever is convenient for you.
You may also need to perform a specific level due to a limitation other than your back. For example, if you cannot perform and exercise with proper form and without pain due to a shoulder injury, choose the version you can do properly without aggravating your shoulder.
Lastly, some exercises will involve only one side of your body. On occasion, you will need to repeat the exercise on both sides, other times you will only perform the exercise on one side. The side you should perform the exercise on will be explained in the exercise description.