By Barbara A. Brehm, Ed.D.

You have had a back problem, but your doctor says it's OK to exercise now. You have resolved to get back into a program of regular exercise because you know staying in shape may help prevent future back problems.

You have told your instructors that you are getting over a back injury, and that there may be times when you can't do everything that they are doing. They know you have your physician's clearance to exercise and they welcome you to the class, urging you to go slowly, do less than you want to, stretch gently and modify exercises as necessary. They watch you carefully to make sure you are in the correct position for all of the exercises.

Now the rest is up to you! You are the one who must be careful to not overdo it. You can learn to be receptive to the messages your back is sending you during your workouts and throughout the day. With your help, your body will gradually become stronger more flexible and more resistant to future injury.

Will exercise really help my back get better?

Exercise is not a cure-all for back pain, but it can help. There are many kinds of back problems, and you need to learn as much as you can about yours. It is very important for you to follow the advice of your physician and physical therapist. No single exercise prescription can be right for all back problems. Stick to the program designed for you. Jumping into a vigorous exercise program before you are ready is a good way to end up back in the doctor's office.

It is important to try to find the source of your back problem. You may be feeling fine now, but if the problem goes uncorrected, you are likely to develop more pain someday. For example, if your back pain were caused by poor sitting posture, and you are still sitting the same way while you work all day at your desk. The wear and tear on your back will continue.

Chronic muscle tension often leads to the development or worsening of back pain. Learning to decrease muscle tension by practicing stress-management and relaxation exercises can provide relief.

Once your back has healed, and you are practicing good body mechanics, you many find that staying in shape will help keep your back (and the rest of your body) supple and strong. Aerobic exercise can also help you to maintain a reasonable weight. Excess weight, especially in the form of a “pot belly,” can stress your back.

What is the best kind of exercise for people with back problems?

The right kind of exercise varies from person to person. But in general, if your doctor has told you not to jog, you should probably avoid other high-impact activities as well. Low-impact or non-impact aerobics might be fine. Many former back patients walk, hike and swim, although some avoid swimming strokes performed in a prone position, such as the crawl or breaststroke. Cycling is an excellent aerobic activity, but watch for tension in your back, especially if you are not riding in an upright position.

Many back care specialist recommend avoiding activities that involve a percussive twist: golf, tennis and other racquet sports. Rowing puts some stress on the back because it is like lifting a weight in the horizontal plane. Correct mechanics make rowing safer. You do not want to be doing all of the work with your back. Use those strong muscles in your legs to help your back and arms pull back the oars.

Some people with back problems as been told to avoid weight training altogether. If your doctor says you may lift weights, go easy. Always be sure you are in the correct position, and never lift weights that are too heavy. If your back pain is due to muscle tightness, you should be especially careful. Warm up before lifting, and do plenty of stretching after your workout.

Some conditioning classes, which emphasize exercises for strength and flexibility, can be very helpful, but don't overdo it. Classes that include a relaxation section are terrific for teaching those tight back muscles to let go.

An there some exercises I should avoid?

Again, this depends on your back. Ask your doctor. Some exercises require a great deal of abdominal and back strength, and should be avoided unless you are in top shape. These include straight-leg sit-ups and exercises in which you are lying on your back and lifting your legs. Doing too many repetitions of any kind of abdominal exercise is a sure way to encourage injury. Exercises that involve extreme arching of the back may send sensitive back muscles into spasm.

It is important to exercise regularly. Weekend athletes are especially prone to injury. Realize that the care you give your body by exercising is a worthwhile investment in a pain-free future.