How to Keep Your Back Healthy | Back Pain Exercises


To increase spine flexibility, make sure to stretch your spine six ways each day: left and right twist, forward and backward, and side bends.

Last month, in part I, we looked at how the back and spinal cord play a much greater role for our health than currently recognized in Western health models. We saw how the health of the back affects both the structure and function of the body. Firstly, loss of structural integrity can cause back problems, disability, and in some cases even accelerated mortality with advancing age. Further, structural imbalances may also interfere with the flow of information from the delicate strands of nerves exiting from the spinal cord, potentially affecting the functional health of the organs and glands.

The good news is that there is a lot you can do to counteract the age-related deterioration of the back and spine and also retain greater vitality through life.

Understanding the Soft Tissues

Most of the degenerative changes in the spine that cause long-term back issues have a common origin: They arise in response to imbalances and distortions in the soft tissues as the body seeks to compensate for them and restore some measure of structural integrity.

The soft tissues are all the parts of your musculoskeletal system other than bones, including muscles, tendons, ligaments, cartilage, connective tissue, and the intervertebral discs. The declining integrity of the soft tissues lies at the root of most of the musculoskeletal issues we face as we get older, like back pain, hip problems, generalized stiffness, and loss of mobility.

Imbalances in the soft tissues arise for two reasons: firstly, the soft tissues weaken with age. Secondly, trauma, injuries, and misuse can lead to chronic distortional patterns and structural imbalances. The two interact, and the more both risk factors are present, the greater the chance you will develop back problems.

To fully understand how to counteract the age-related changes of the back, it is useful to understand how the soft tissues weaken with advancing age.

Soft Tissue Aging

There are three main processes involved in soft tissue aging: loss of strength, loss of hydration, and loss of flexibility.

Loss of Strength. As we get older, we begin to lose muscle mass. From age 25, muscle mass declines at an average rate of 4 percent per decade. Once you reach your 50s, this process speeds up considerably; the rate of loss increases to about 1 percent per year, or 10 percent per decade. In some elderly with low levels of growth hormone in the blood, the loss of muscle mass may be as high as 35 percent per decade.

Between the age of 30 and 80 years, the strength of the muscles in your back decreases by as much as 60 percent. You don’t have to be a structural engineer to realize what will happen as the muscles of the spine and trunk begin to lose strength. The whole structure will have a propensity to collapse onto itself!

This progressive loss of muscle strength seriously challenges the back’s structural integrity. The process is further exacerbated by the changes that happen in the intervertebral discs.

Loss of Hydration and Nutrition. With age, the soft tissues tend to dry out and lose elasticity. In addition, cells lose metabolic efficiency, causing cellular waste products to accumulate. This in turn interferes with the blood supply and flow of nutrients to the soft tissue cells.

This process most pronounced in the discs, which serve as protective pads between the vertebrae. Researchers describe the intervertebral discs as the most “nutritionally challenged” tissues in the body. The discs lack a blood supply of their own and are therefore particularly vulnerable to loss of hydration and nutrition. As a result, no part of the soft tissues undergoes more dramatic changes with advancing age than the intervertebral discs.

The discs tend to dry out and shrink with age. If you are over 40 and notice that you have lost some height, chances are  it’s because your discs have begun to lose hydration.

As the discs begin to shrink, it leaves you more vulnerable to painful disc conditions like bulging or ruptures. In addition, as the spine begins to lose its protective padding, it further contributes to the loss of structural health. To restore stability, the body often compensates by laying down reinforcing tissue or bone mass, leading to bone spurs other degenerative changes. If injuries, chronic tension, or other distortional patterns are present, this process is often accelerated even further.

Loss of Flexibility. If you’re over 40, you have likely already experienced some loss of flexibility. There are many mechanisms involved in the progressive loss of flexibility as we get older, but a main one is cross-linking of collagen fibers.

We all know that collagen is good for avoiding wrinkles, but there’s a lot more to this little protein. As the primary supportive protein molecule in our bodies, collagen is a main component of the connective tissue, which provides structure and support for organs and joints.

When we are young, collagen fibers are laid down in a parallel formation, which is conducive to stretching and lengthening as the soft tissues move in different directions. Over time, collagen fibers begin to lose this parallel orientation, and cross-linking becomes more apparent. This cross-linking “stiffens” the tissues and is a major culprit in the age-related weakening of soft tissues.

The progressive weakening of the soft tissues doesn’t just challenge the body’s structural integrity. The greater the distortional patterns in the spinal column, the greater the chance that nerve interference will be present, compromising your vitality and energy.

How to Slow Aging of the Soft Tissues  

While you can’t halt the deterioration of the body’s structural integrity entirely, there is much you can do to change the pace with which it progresses: through movement, bodywork, and nutrition. We are focusing on movement here because it’s your most important weapon against soft-tissue aging (click here to read more about bodywork and nutrition for spine health). Exercise stimulates the production of various hormones, increases protein and bone synthesis, and combats the loss of muscle and bone as we age.

Increasing strength. Strength training is one important part of building muscle mass. However, generally speaking, your body should be exposed to many different types of movement to get the most benefits from exercise. Unfortunately, most forms of fitness work on the extremities and do very little to work the spine. The muscles of the spine need to be strengthened as well, and for this, they need varied types of movement. Core training activities, such as pilates and yoga, are important to make sure that the spine gets the support it needs from strong core muscles.

Increasing hydration and nutrition. The spine needs movement to support the health of the soft tissues surrounding the spine, particularly the intervertebral discs. Without a blood supply of their own, the discs rely on a process called imbibition, which is sort of like squeezing the water out of a sponge, and then allowing it to fill back up. Imbibition occurs naturally with with spinal movement. The problem is that most of us don’t move the spine very much, particularly as we get older and lose flexibility.

For spinal health and revitalization, move the spine many varied ways throughout the day. The spine has six primary movements: left and right twists; forward and backward, and side bends to the left and right. At the very least, the spine should be moved in all six directions every day, several times a day. This will not just strengthen the muscles and bring blood flow to the intervertebral discs, it will also enhance the flow of nerve information throughout the body, increasing your well-being and vitality.

For a simple exercise, sit on a balance ball and bounce up and down on it while watching TV. Start with a very gentle bouncing for a minute or two and then work your way up over time. At any sign of discomfort, back off and reduce the load on your spine.

If you have disc issues or suffer from osteoporosis, back exercises should be introduced slowly and with caution; work with a professional if you suffer from specific issues. As always with any form of exercise, consult with your doctor or other trained health professional first.

Increasing Flexibility. Stretching, of course, is the sine qua non to counteract the gradual stiffening of the body as you get older. Flexibility training returns the muscles back to their normal length, improves postural balance, and prevents joint stress and injury.

Just as important, stretching exercises improve blood circulation and counteract soft tissue aging by increasing the flow of oxygen-rich blood and nutrients to the muscles and enhancing the removal of waste products. Tight muscles have less blood flow and therefore easily become nutritionally starved, reducing their performance and healing capabilities and accelerating aging.

Staying limber can offset age-related stiffness, improve athletic performance, and optimize functional movement in daily life. The American College of Sports Medicine recommends stretching exercises for the major muscle groups two to three days per week.

Bodyworkers and movement therapists Terry Smith, Ph.D., LMT, and Eva Norlyk Smith, Ph.D, LMT, are co-founders of the Healthy Back, Healthy Body program, which focuses on restoring balance and fluidity to the spine.

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