©2019 Portland Pain Institute LLC

Essential self-care: low back stabilization

The causes of chronic low back pain include traumatic injury, surgery, pregnancy, too much exercise, not enough exercise, excessive stretching, poor posture, awkward movement, emotional stress, smoking, caffeine, and so on. Why so many causes for the same problem? The common denominator is midsection stress response. Some degree of stress response (body contraction) occurs in reaction to anything uncomfortable, injurious, or noxious to the body.

For low back pain relief and ongoing independence, it is important to understand 1) the effect of biological stress response on the body’s midsection, and 2) the simple remedy that reverses that effect, even when stress continues. When low back pain becomes chronic, with or without structural damage, it means that the stress response has cancelled muscle coordination in the midsection.

Most low back strength is a product of coordination in the stabilizing muscles of the midsection and hips. Coordination of stability is a factor separate from coordination of movement. Whenever the body moves, the moving parts must be supported by muscles that tense without moving, thus providing a stable platform for the moving parts. For example, when one stands upright, muscles of the legs and trunk must tense in a coordinated manner in order to hold the skeleton upright and stable. Then, when an arm is lifted, even more coordination prevents the body from falling over. More complex movements demand more coordinated stability.

The low back can be visualized as a hinge between legs and trunk. Almost all movement—even lifting an arm—places strain on that hinge. To handle all that strain, the low back must be extra strong. Therefore, the body is designed to coordinate the effort of many muscles in the midsection. Unity of muscle effort affords more strength than that of individual muscles struggling independently. Unfortunately, the stress response cancels exactly that motor nerve integration, leaving the low back vulnerable to jarring movement, fatigue, muscle tears, and spasm. Without coordinated stability, the low back is effectively weaker. One could have strong muscles, but also pain due to uncoordinated effort of those muscles. Or, one could have weak muscles, yet eliminate back pain with improved coordination.

When stress response cancels midsection coordination, lack of coordination causes even more discomfort, stress response, and cancelled coordination. A vicious circle is created. Without coordination, minor irritations can snowball into acute or chronic muscle spasm. In turn, muscle spasms can pull vertebrae out of alignment, compress vertebral discs, and cause disc herniation or other degenerative condition. The vicious circle is stopped only by spontaneous or intentional restoration of coordination.

Importantly, muscles tense from stress response are less forgiving of muscle stretching. Poor posture, or sleeping in the same position for too long, can stretch and irritate those tense low back and hip muscles, provoking spasm. Stretching is appropriate for muscles shortened by vigorous exercise, but generally should be avoided for painful muscle spasms.

Midsection coordination is easy to regain and develop with coordination exercises. Every therapeutic low back exercise affects the same variable, including old-fashioned sit-ups, the Feldencrais clock, posture exercises, etc. However, the explanation for their benefit is usually incomplete. For example, it is commonly assumed that strengthening abdominal muscles with sit-ups will help the low back. When it helps, the primary (or only) low back benefit of a sit-up is the muscle coordination demanded by the exercise. Fortunately, one need not wait for abdominal muscles to strengthen before low back pain will stop. Moreover, not everyone can perform sit-ups, due to injury, weakness, pregnancy, etc. Like sit-ups, most low back exercises are unnecessarily strenuous or complicated, which means that they miss the central issue and the ease of relief.

If one could extract the active ingredient from all other therapeutic low back exercises, then render that ingredient in a single, quick, enjoyable, effortless exercise that anyone can use, with unsurpassed benefits, one would have the Arneson low back stability exercise. The exercise provides nervous system stimulation that triggers both relaxation and coordination. It is neither strengthening nor stretching, yet the low back is instantly stronger and more flexible due to new coordination. The effect is immediate, but also cumulative. Eventually, the exercise can be abandoned, or used occasionally when the low back feels weak or mildly painful. The exercise can be used safely everyday, as needed. It is very low impact, and therefore safe for severe injuries and pregnancy. The exercise restores coordination even when various low back stresses continue.

Arneson low back stability exercise

The exercise should be performed on a firm, yet comfortable surface, such as a carpet. One lies facing up, with the knees bent. Bending the knees flattens the low back against the floor. The legs should be balanced comfortably. Then, using very little effort, one presses the low back down towards the floor. Light tension in the abdominal muscles presses the back downward. Muscles should not be tensed to the point of causing pain or even the slightest irritation. If any discomfort is experienced, one needs to adjust the exercise until it feels enjoyable. The exercise is guided strictly by one’s subjective sense of comfort. It is not a rigid formula that entails a count of ten, special breathing, or other standardized procedure. The goal is merely a satisfying sensation in the low back and abdomen. I recommend having a friend read the description below when first learning the exercise.

Three variables must be monitored subjectively:

 

1. The angle at which the low back presses the floor. One carefully rolls the low back (i.e. north to south, 12 o’clock to 6 o’clock) and feels for the angle that is most satisfying, which may be a matter of the slightest adjustment. The best angle can also change day to day. For example, the best angle might sometimes require rolling the tailbone slightly or entirely off the floor. One might even lift the low back completely off the floor. When the best angle is found, for that particular day, one simply holds the position while enjoying the sensation. Also, one can try gently squeezing the knees and ankles together while tensing the midsection.

2. The amount of effort exerted when tensing the abdomen. If the exercise feels uncomfortable, it usually means that either the angle is not right, or the amount of effort is too much. Discomfort provokes the stress response, which counteracts the exercise’s benefits. Users should remember that this is not a strengthening exercise; more effort is pointless and/or counterproductive.

3. The amount of time that the midsection is tensed. The amount of time required may range from ten seconds to two minutes, depending purely on one’s subjective sense of enjoyment. When the exercise no longer feels satisfying, it means that the effect has been achieved and the user is ready to stand up and walk around. To continue beyond the point of satisfaction is not productive, and could cause discomfort. That being said, when first regaining coordination, one may need to stop, rest, then do a second round until the exercise feels finished.

Done properly, this simple exercise invites immediate relaxation of the midsection muscles and overall stress level, as well as a marked improvement in leg and midsection control. When the user stands to walk, new coordination will be perceived as a distinct presence and aliveness in the midsection and legs. One feels connected to the legs and stronger overall. Movement feels safer. First-time users are usually shocked at the unmistakable difference.

The Arneson exercise is gentle enough to be used during recovery from tissue damage, such as a herniated disc. The same conditions of stability and relaxation are necessary for both pain prevention and injury healing. If damage is accompanied by pain, it can be assumed that coordination has been cancelled by stress response. To regain stability can only improve one’s prognosis.

On the other hand, the exercise should not be expected to provide instant relief when there is acute pain or spinal subluxation in the low back. Minor pain and misalignments may be relieved by stabilization alone, which supports relaxation, but acute pain requires preliminary relaxation and realignment. In Arneson Method sessions, lumbar misalignments have relaxed back into place consistently (auto-adjustment), affording deep relief. The stability exercise is taught as the final step to independence.

In a pinch, variations of the exercise can be improvised while sitting upright or even standing, following the same principles. The user should pursue strictly enjoyable sensation, which ensures 1) relaxation of stress response and 2) gentle, integrated muscle effort that restores coordination.

I first devised this exercise when I noticed a striking disconnection of midsection from legs in a woman who recently had her third baby. She had been receiving frequent chiropractic adjustments for persistent low back pain, for three months, with virtually no benefit. When asked to describe her midsection, she replied that it felt “dead,” and that she felt disconnected from her legs—indicating a severe midsection stress response and loss of motor nerve coordination. After a few minutes of my new procedure, she noted that the deadness and pain were gone. She immediately discontinued her chiropractic visits. Despite her severe condition, she did not need to discharge trauma memory or pain.

The Arneson low back stability exercise can be analyzed in terms of mechanical behavior science. The exercise invites enjoyable feelings and immediate relaxation, which means that effective behavior is the procedure’s active ingredient. Which of the nine behavior functions is responsible? The exercise targets primarily the work function (the awareness function secondarily). The distinct satisfaction that one feels is similar to that of walking after sitting all day. The body needs and enjoys physical effort, which is one of the many types of work. However, if one tries too hard, works too hard, the exercise no longer feels good to perform, and loses its benefits.

Rigid variations of this exercise have been used by the occasional vocal coach and physical therapist. However, attention to enjoyable sensation dramatically improves the coordination effect and ensures relaxation.