What is the biggest reason exercise programs fail? Patients don't enjoy them and fail to stick with them. Motivating patients to stick with their exercise programs is one of the biggest challenges I face. Louisa and I go to the gym once a week together and we challenge each other to do a little more each week. Understanding how the exercises you are doing work for you then you are more likely to follow them. Remember though it takes 6 weeks for muscle to show signs of strengthening.
There are several ways to make sure my patients carry out the exercises I have given. First, I establish clear goals, what do I want my client to achieve? Secondly, explain how muscles and joints respond to exercise and most importantly, make exercise simple and fun. If you have not exercise for a while doing some simple body weight exercises, and cardiovascular will be quite sufficient. Initially make the cardiovascular exercise a brisk walk or a jog on a treadmill. Do not use the cross trainer as they have a tendency to tighten your hips and hence place more strain on your back.
This is a one legged squat. It strengthens muscles in the hips and pelvis and therefore is an excellent back pain preventer. You are better doing these than sit ups! This is how not to do it. Notice Louisa's pelvis is not level. This is because a muscle in her right hip is weak and can't hold the pelvis level. Her right leg is also collapsing inwardly a little, again a sure sign of muscle weakness in the pelvis.
In this photo, Louisa's pelvis is more level and her left leg is not leaning inwards quite so much. The level pelvis means she has good hip muscle strength on her left side.
These are good exercises to do at home or in the gym if you wish. When doing these exercises, go for quality not quantity. Stand on a step nor more than a foot high. Hang one leg over the edge and bend the opposite knee, as you bend it more your straight leg will almost touch the floor. Doing these well is not easy but well worth the effort to help prevent back pain, and lower leg injuries.
You can see from the diagram on the left how the hip muscles support the body above it, keeping us level, and taking the strain away from the lumbar spine. These can be performed in the gym easily. They also benefit the joints from the hip to foot by maintaining there mobility. A very important exercise.
The lunge is the other exercise I like patients doing, except it has to be performed properly. When doing one you must;
Do 4 or 6 strides at a time, walk back and then do them again ! Then do exactly the same thing but sideways.
Lead with your left leg and then lead with your right, and the same as above, make the leading leg do all the work.
While still fresh you should do some core work, rather when you are tired. In actual fact the one legged squat and the lunges are also core work. Here is a 'Bridge', these are excellent and can be very revealing if you can't do them, as they will show up muscle weaknesses in your core. So to make these effective you must be able to do them, even one would be good. Make sure your pelvis is level and hip / lower back slightly arched upwards.
Start and finish your gym session with a run. It does not have to be a long one just do what you can, but build up to 15 to 20 mins ( I would prefer 20mins !). At the start make sure you warm up a little. A good way is to walk on the treadmill first, maybe for 10 or 15 mins. Walk briskly and take as long a stride as you can. Put the treadmill gradually on an incline of 1.5 to 2, this will stretch out your leg muscles and joints. From here I would lower the incline to 0.5 to 1 and start running at 6.5 to 7.5 Km/hour. When you have finished your workout go for a nice easy run / brisk walk of say 10 mins, at 0 incline and say at 4 to 6 km/hour.