Back pain happens. Even though the pain is constant, sometimes life just has to move on. Because life is an Olympic event, staying fit is the best way to stay healthy. But how does one safely exercise with a pain in the back? Some may say that such a feat is impossible without causing further injury or worsening pain. Others have found that by following some simple rules, exercising despite chronic low back pain is possible.

Here are ten rules for developing a workout with back pain.

1)    All the movement should come from the hips not the back. When exercising on a treadmill, stationary bike or other equipment that uses the legs, one should be mindful to keep the back still while the hip joints do the work. If the lumbar spine gets too involved in the movement of the legs, this is called lumbar compensatory movement because the low back is trying to compensate for the inadequate action in the lower legs. Learning to separate the movement of the lower extremities from the lumbar spine, through improved lumbar-hip coordination, serves a back patient well during exercise activity and life activities.

2)    Find a sustainable pace. Pushing the body too hard, too fast, without adequate recovery time, will only add more pain to the low back fire. Even world class athletes have to learn how to set a sustainable pace. This concept not only applies to the actual time spent during the workout, but also to the entire program as the weeks, months and years goes by. Sustainable means that the pace can be maintained without interruption or weakening during the allotted time or distance.

3)    Find your baseline amount of exercise that will not cause a flare-up. Along with the need for a sustainable pace, one with back pain also needs to find the baseline amount of exercise that will not cause a major flare-up that lasts more than two or three days. From this baseline, the programmed amount can build. For example, a walking program may get off on the wrong foot if one suddenly decides to start the program by walking for one hour. That one hour can cause a huge increase of pain that lasts for weeks if one is not used to walking, benign as walking may seem. Walking is not benign to a painful low back; so, starting with five minutes might be a more appropriate baseline. Remember, mountain climbers who climb Mount Everest do not start by climbing Mount Everest. All mountain climbers should start small and aim big.

4)    Avoid reaching. The lumbar spine experiences so much stress picking up a five pound weight with a fully outstretched arm. A better way to exercise is by reducing the reaching and picking up objects with the hands close to the body.  Those who remember some principles of physics will remember the concept called a lever arm force. The use of lever forces can accomplish great things like building pyramids. On the other hand, the lever arm created with an outstretched arm really torques the low back, especially if the person who is reaching does not have good core strength.