People suffer from back pain on a daily basis. A lot of people will undergo some surgical procedure, and it will be important to maintain or increase their strength in order to improve their chances of a successful recovery. The goal of pre and post surgery exercises are to limit pain, decrease muscular spasms, and increase spine stability via proper movements and improved strength.

When thinking about exercises for the back, people automatically focus on the abdominal region, and the superficial back muscles. It is important to realize the role that the legs, "butt" muscles, and deep abdominal/back muscles play in helping to stabilize and strengthen the back. Many are afraid to do any exercises and use the presence of back pain as a crutch for their inactivity. Care must be taken when undergoing an exercise program, but some form of activity should be attempted.

The exercise session should begin with a cardiovascular component in order to increase body temperature, improve blood flow, and help decrease tightness. The cardio should not aggravate any existing conditions (ex: sitting on a bicycle may elicit pain, so walking may be necessary) and should last at least 5-10 minutes. The goal is not to get a cardiovascular workout, so it is okay to be at a level that does not promote a great amount of breathlessness. 

Continuing with the promotion of blood flow and increasing mild activity, we will turn our attention to the lower body. Many leg muscles have attachments to either the pelvis, and even the spine, so they can directly affect the stability and strength of the spine. It is important to use these muscles to promote a healthy spine. Marching can be done while standing straight and simply raising one knee up at a time. The upper body should be tall, and the eyes looking forward, not down. Starting with the right knee, raise it as high as is comfortable, but not higher than waist level (thigh should be parallel with the ground). Slowly lower the leg and repeat with the left leg. This can be done for 10-30 seconds. It is okay to be near a wall or sturdy object to grasp in case balance is a concern. After a few sessions of marching, a focus can begin on keeping the abdominal and back engaged. Throughout the marching, the goal is to try to bring the belly-button back towards the spine. It will feel like you are sucking in your stomach, but you should still be able to breathe. 

Hip extension works the glute and hamstring muscles. These muscles are crucial in providing stability of the pelvis, which in turn aids in providing spine stability. Using the same standing erect posture that was used for marching, hip extensions are done by bringing the leg back as if you were trying to hit someone behind you with your heel. The movement should come from the hip area, while the knee stays straight. Care must be taken, because it is easy to create excessive back extension with this exercise. The back extension may cause some pain. Again, do the exercise in a pain free range, monitor the height of the kick back, and the amount of back bend that the exercise promotes. Attempt the ‘belly towards the spine’ movement that was mentioned earlier. Start with 1 set of 12 on each side and progress to 2x10, 2x12, 3x10,3x12.  

Clamshells also work on primary pelvis stabilizers and hip rotators. Lay on your right side with your knees bent. Ensure that your hips and ankles are stacked on top of one another and that your spine is in a straight line. Feel free to support your head with your right hand. Now, think of your legs as clams that will open and close. The open/close movement will occur at the knees, while the ankles should remain in contact with one another. Place the left hand on the left glute muscle to ensure these are the muscles being activated to perform the movement. Your clam should only open enough to activate the glutes and not so much that you feel your back arching. Repeat on the other side. Ensure proper form throughout, and expect to feel a little bit of a muscular burn during this exercise. Start with 1 set of 10 on each side and progress to 2x8, 2x10, 3x8,3x10.

Disclaimer: The material presented is for informational purposes only. It is not intended to treat, diagnose, or cure any condition or ailment. It does not replace nor supersede guidance from qualified medical professionals. Reader assumes any and all risk if they choose to perform any of the activities presented.