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Aerobic Exercise

How Does Aerobic Exercise Help Back Pain?

Aerobic exercise increases core muscle endurance, which helps reduce the incidence of back pain.

Weight bearing aerobics (legs supporting weight of body) such as brisk walking or using an elliptical trainer prevent bone loss in the legs, hips and lower spine as well as tone and increase muscular endurance of the legs and the core (hips, buttocks, abs, and lower back).

Aerobic activities can also help relieve back pain by reducing muscular tension, improving sleep, and relieving stress and depression (moderate aerobic exercise appears to be effective in relieving depression, high-intensity aerobic activity may actually worsen mood in some people).

Aerobics increase circulation, delivering more oxygen and nutrients to the entire body, and helps lubricate the joints. Aerobic activity helps keep body weight down, which relieves lower back pain that is aggravated by excess weight on the abdomen.

What is Aerobic Activity?

Aerobic activity is any activity that involves the continuous, rhythmic movement of large muscle groups, which increases the working muscles demand for oxygen and causes the heart and lungs to work harder to meet the demand. Aerobic exercise strengthens the heart and lungs and circulatory system. Aerobic exercise also increases muscular endurance of the muscles being used.

Aerobic activity includes everyday activities such as walking, raking the yard, mowing the lawn, vacuuming, and going up and down stairs as well as walking, running, cycling, swimming, rowing, etc. - though at least 10 minutes in one bout is the minimum needed to improve aerobic fitness (150 minutes per week of moderate aerobic activity or 75 minutes of vigorous aerobic activity is the minimum amount of aerobic exercise recommended by experts for significant health benefits.)

Aerobic exercise/activity is also referred to as endurance exercise, stamina exercise, cardiovascular exercise, cardiorespiratory exercise or simply cardio.

Note: Gradually increase amount and intensity of aerobic exercise so that your body is able to adapt to the increased demands without incurring injury and/or symptoms of overtraining (see Safety Tips further down on page).

High-Impact Aerobic Exercise

High-impact aerobic exercise (where both feet leave the ground at the same time) such as jumping rope, or jogging or running puts more stress on your lower back than low-impact aerobics. When your feet hit the ground extra stress is placed on the intervertebral discs and joints of the spine.

If you suffer from lower back pain or have arthritis, stick to low-impact activities. If you have been inactive, it is safer to start with low-impact exercise and gradually introduce high-impact (if you wish to do high-impact activities) after your body has adapted to the demands of low-impact aerobics.

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Low-Impact Aerobic Exercise

Low-impact aerobic exercise (one foot is always on the ground) causes minimal stress to the lower back, hips, knees, and feet. Low impact aerobic activity includes brisk walking or using a treadmill; walking is also weight-bearing exercise, which helps improve or maintain bone density. Using an elliptical trainer is almost no-impact but is a weight-bearing exercise. Cycling and swimming are no-impact and are not weight-bearing (cycling can be weight-bearing if you stand on the pedals).

The main goal of aerobic activity is to improve cardiorespiratory fitness. Though regularly performing any type of aerobic activity will accomplish this goal, there are additional benefits to various forms of aerobic activity.

Walking: Brisk walking (can be done on a treadmill) is a good moderate intensity aerobic exercise that is safe for almost everyone. Walking improves endurance of the core (lower back, abs, hips) as well as the legs and improves balance. It is also weight-bearing and improves bones density in the lower spine, hips, and legs.

Maintain proper posture while walking. Shoulders should be relaxed, down (away from the ears) and back. Head should be upright, chin level with the ground. Look straight ahead; looking downward strains the back of the neck.

Elliptical Trainer: An elliptical trainer is often easier on the knees than walking as the impact is minimal. Using an elliptical trainer almost no-impact, but is a weight-bearing exercise. It is very easy to get your heart rate up on an elliptical trainer by increasing speed and/or resistance of the machine. In fact, many people are surprised to find they are working much harder than they have too on an elliptical machine and must learn to pace themselves.

elliptical trainer

Recumbent stationary bike: A stationary bike can provide a good aerobic workout, and tones the legs and hips. It is no-impact so it is easy on the knees. A stationary bike is a good choice for people who have knee pain from walking. Using a stationary bike strengthens the quadriceps, which support the knee joint. As the quadriceps become stronger, walking becomes less painful.

Using a recumbent stationary bike does not engage the core (as the upper body is supported by the backrest) or improve balance; alternate with walking or using a treadmill or an elliptical if possible and/or do some core exercises (see back exercises page).

Choose standing exercises over sitting exercises for Back Health - if possible. Standing exercises engage the core and improve balance.

Swimming and water exercises done in deep water are especially beneficial for those with arthritis or disc problems. The buoyancy of the water supports the body weight, taking pressure off the joints and intervertebral discs. The pressure the water exerts on the body prevents an injured joint from further inflammation. The resistant properties of water make the muscles work harder to perform movements such as walking, marching, or other water exercises. You can strengthen the muscles that support the joints without increasing stress to the joints.

Swimming strengthens the core but does not prevent bone loss as it is non weight-bearing. Exercises done standing in shallow (often waist-high) water may benefit bone health as not all the body weight is supported by the water. Be sure to do strengthening exercises for the major muscle groups (such as the plank, the bridge, squat), which strengthen bones as well as muscles if swimming is your main form of exercise.

girl swimming
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How Much Aerobic Activity is enough

Recommendations (based on the Physical Activity Guidelines for Americans and Canadian Physical Activity Guidelines, as well as in the World Health Organization's Global Recommendations on Physical Activity for Health) are:

Adults should accumulate a minimum of 150 minutes of moderate-intensity aerobic physical activity (such as brisk walking, cycling) OR 75 minutes of vigorous-intensity aerobic physical activity (jogging, running) OR an equivalent combination of moderate and vigorous-intensity aerobic exercise - spread throughout the week in bouts of 10 minutes or more. Increasing this amount provides even more benefits. (See How to Measure Intensity on next page). Adults should also do muscle-strengthening activities involving the major muscle groups (the legs, hips, back, abdomen, chest, shoulders, and arms) on 2 or more days a week.

Basically, 2 minutes of moderate-intensity aerobics is equivalent to 1 minute of vigorous-intensity.

People who have been inactive should not start with vigorous-intensity aerobics. Start with moderate-intensity aerobics (or less) and with less than the 150 minutes per week goal to avoid injury. Increase the amount and intensity of any exercise gradually.

There are many ways to reach the 150 minutes of moderate-intensity aerobic activity per week. You can go for a brisk walk for 30 minutes per day 5 days per week - this can be broken down into shorter sessions that total 30 minutes, as long as each session lasts at least 10 minutes (the minimum time needed in one stretch to increase aerobic endurance).

Aerobic Interval training is switching back and forth between moderate and high-intensity aerobic activity. Alternating running and walking is great for people who do not have any joint problems.

For people who cannot tolerate high-impact exercise such as running, there are ways to increase intensity without increasing impact. An elliptical machine is ideal for interval training as you can increase the intensity by speeding up the pace or increasing the resistance of the machine, without increasing impact to the joints.

Break it down into short sessions you are limited for time you have physical limitations. People with arthritis or those who are extremely deconditioned may be limited in how long they can walk or even stand. If walking for too long at one time causes back pain (or sore hips, knees, or feet), walking can be divided into ten minutes sessions, two or three times per day.

Ten minutes is the about the minimum amount of time of continuous aerobic activity needed to increase cardiovascular fitness. However, don't worry about reaching the minimum 10 minute per session minimum right away if you have been inactive. The time spent walking in one go can gradually be increased as fitness increases.

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Safety Tips:

Avoid Overtraining. Aerobic activity should be increased gradually (amount and intensity), especially if you have been inactive, to avoid musculoskeletal injuries and overtraining (caused by not fully recuperating before you exercise again). Overtraining can cause symptoms of depression such as fatigue, difficulty sleeping and low mood. Overtraining also suppresses the immune system.

Muscles, tendons and ligaments gradually adapt to increased demands of exercise  a sudden big increase in exercise can cause injury. The heart and lungs also become more efficient as they adapt to small, progressive increases in aerobic exercise. Minor muscles aches for a couple of days after increasing exercises are nothing to be concerned about.

Overtraining is harmful to your health. It suppresses your immune system and can make you too exhausted to function physically and mentally.

Warm upfor at least 5 minutes with of walking or performing the same activity you are about to do, but at a slower pace. This slowly increases your heart rate, breath rate and body temperature to allow your body to adjust to the higher demands of aerobic exercise. Cooling off in the same way for another 5 minutes allows your body to adjust to its resting state and prevents blood from pooling in your legs.

Stay Hydrated. Drink plenty of water before, during and after aerobic activity to replace water lost by perspiration. Drink a couple of cups shortly before and after your workout, and sip water during your workout to avoid dehydration.

Increase your carbs if you do vigorous-intensity exercise.

Cross-training (varying your activities) reduces the risk of overuse injury (caused by repeating the same motion excessively), especially if you do any high-impact activities such as running or jogging. For example, alternate between walking, cycling, swimming, elliptical trainer - either on different days or spread throughout the day or even in the same exercise session.

Wear proper footwear. Well-fitting shoes help prevent blisters and calluses and shoes with adequate support and cushioning help absorb impact to prevent sore feet, knees and lower back pain. For more information see Footwear and Lower Back Pain.

Avoid Boredom
Watching TV or listening to music while using a stationary cycle or elliptical trainer or treadmill can help avoid boredom. Choose a variety of exercises; alternate indoor and outdoor activities. Finding exercises you enjoy helps you want to keep exercising.

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Aerobic Exercise continued...