Is your client having low back pain?

Here are a few facts that you should be aware of and what you can suggest.

1) The spinal discs rehydrate during a night’s sleep. In other words, fluid is passed back into the intervertebral discs filling them up like a tire. When this happens the connective tissue and the surrounding ligaments become taut. Upon rising in the morning, this fluid starts to migrate out of the discs throughout the day. Research has shown up to 90% of this new fluid is gone out of the disc after the first two hours. This is what makes bending over in the morning more difficult versus at night.

So, what to do with this info?

- Educate your clients/patients that bending excessively from the waist in the morning can put the discs and ligaments at risk of injury.

- When training your client first thing in the morning be aware of exercises that involve heavy loads.

- If they have a stretching routine that they perform in the morning have them get out of bed and move around normally first. Be aware of stretches that involve lumbar flexion such as both knees to the chest while lying on back. With an individual that has a spinal disc issue this stretch and others like it would be contraindicated at any time of the day, especially in the morning.

Things that you can have them do in the morning:

- Prone press ups – lie on your stomach and press your upper body off the floor while keeping the hips on the floor. Only press up to a range that is comfortable and pain free.

- Gentle hamstring stretches with spine in neutral position while standing (no flexing from the spine).

- Gentle hip flexor stretching with both hands over head while standing.

- When stretching or strengthening make sure the motion comes from the hips and the thoracic spine not the lumbar spine.