Safe and Effective Workouts for Herniated Disc Relief

Lanman Spinal Neurosurgery, led by renowned spinal surgeon Dr. Todd H. Lanman, is at the forefront of spinal health and treatment for herniated discs. With decades of experience and expertise in advanced surgical techniques like artificial disc replacement, Dr. Todd Lanman offers comprehensive care for patients suffering from spinal conditions.

Exercise can strengthen the muscles supporting the spine, improve flexibility, increase blood flow to the affected area, and reduce pressure on the herniated disc. These benefits not only contribute to pain relief but also aid in preventing future injuries and improving overall quality of life. However, it’s important to approach exercise cautiously and under the guidance of a healthcare professional to ensure safety and effectiveness.

In this article, Dr. Lanman presents various exercises that can help alleviate pain and promote recovery for individuals with herniated discs. As always, talk to your spine doctor before starting any herniated disc exercise program.

Understanding Herniated Discs and Exercise

Defining Herniated Discs and Their Impact

A herniated disc, also known as a slipped or ruptured disc, occurs when the soft inner core (nucleus pulposus) of an intervertebral disc protrudes through a tear in the tough outer layer (annulus fibrosus) into the spinal canal. This condition can affect any part of the spine but is most common in the lumbar (lower back) and cervical (neck) regions. When a disc herniates, it may compress or irritate nearby spinal nerves, leading to pain, numbness, tingling, or weakness in the affected area and potentially radiating to the extremities.

The impact of a herniated disc on the spine and surrounding tissues can be significant. The displaced disc material can cause mechanical compression of nerve roots, leading to radiculopathy (nerve root pain) and potential neurological deficits. Additionally, the herniated disc can trigger an inflammatory response in the surrounding tissues, further exacerbating pain and discomfort. In some cases, a large central disc herniation may compress the cauda equina (a bundle of nerve roots at the lower end of the spinal cord), potentially causing serious neurological symptoms and requiring immediate medical attention.

The Role of Exercise

Exercise can help lumbar disc herniation. Evidence suggests that exercise interventions for more than two weeks can reduce disease symptoms. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic lumbar disc herniation. Exercise can alleviate sciatica (pain radiating along the sciatic nerve) caused by a herniated disc by relieving pressure on the affected nerve through specific stretches and movements. Lumbar stabilization exercises, which involve controlling balance through pelvic movements, can improve the mobility and stability of the sacroiliac joint. Specific trunk muscle activation exercises can also benefit patients with acute low back pain. McKenzie exercises and manual therapy have been shown to effectively reduce symptoms in individuals with lumbar disc herniation. Furthermore, lumbar stabilization exercises and manipulation can reduce symptoms by strengthening the muscles supporting the lumbar spine. Lastly, gentle exercises, stretches, and activities, such as neck, back, and hamstring stretches, can improve flexibility and alleviate pain associated with a herniated disc.

What Is a Herniated Disc?

Anatomy of a Herniated Disc

A herniated disc, also known as a slipped or ruptured disc, occurs when the soft, jelly-like center (nucleus pulposus) of a spinal disc protrudes through its outer casing (annulus fibrosus). Disc herniation happens when the nucleus pulposus pushes through a tear or weakened area in the annulus fibrosus. The escaping inner section of the disc can then compress or irritate nearby nerves, leading to various symptoms.

Common Causes of Herniated Discs

Aging: Spinal discs dry out and weaken over time, making them more susceptible to herniation.
Injury: Trauma to the spine from falls or accidents can cause a disc to herniate.
Repetitive Strain: Overuse and repeated movements can gradually wear down the spinal discs.
Other Factors: Genetics, smoking, obesity, and certain occupations may also increase the risk of disc herniation.

Benefits of Exercise for Herniated Discs

Pain Relief and Reduced Inflammation

Gentle exercises can effectively reduce pain associated with a herniated disc. Movement and exercise help to increase blood flow and spinal nerve activity, which may help eliminate inflammatory exudation. Exercise is effective in treating lumbar disc herniation, and exercise intervention for more than 2 weeks reduces disease activity. Moreover, exercise can improve mental health, allowing patients to maintain a positive attitude towards their condition without worsening symptoms.

Strengthening Supporting Muscles

Strengthening the muscles around the spine is crucial for providing support and stability. Lumbar stabilization exercises can improve mobility and stability of the sacroiliac joint. Exercises that target the deep muscles of the trunk, such as the multifidus and transverse abdominis, are particularly beneficial for stabilizing the spine. Furthermore, lumbar stabilization exercises can be used in patients in clinics to retrain the proprioceptive senses (position sense) of the tissues surrounding the joints.

Improved Flexibility and Mobility

Flexibility and mobility exercises are important for alleviating pain and stiffness linked to herniated discs. Hamstring stretches, for example, have been shown to reduce pain and disability in patients with lumbar radiculopathy (nerve root pain) caused by herniated discs. Exercises such as hamstring stretches, and cat-camel stretches can improve spinal flexibility and range of motion.

Best Workouts for Herniated Discs

Low-Impact Aerobic Exercises

Low-impact aerobic exercises are highly recommended for individuals with herniated discs because they increase blood flow to the spine and reduce stiffness without placing undue stress on the back.

Walking: Walking is an accessible and effective exercise that improves cardiovascular fitness and supports the healing process. Studies have shown that walking can reduce pain and improve physical function and quality of life in individuals with chronic low back pain. Starting with short walks and gradually increasing the duration and pace is advisable.
Swimming: Swimming provides buoyancy, which reduces pressure on the spine and joints, making it an excellent option for those with herniated discs. Aquatic exercises, such as swimming and water aerobics, can improve pain and physical function in patients with chronic low back pain, including those with herniated discs. The water’s support allows for muscle strengthening and improved heart health without exacerbating symptoms.
Cycling (Stationary Biking): Cycling is another low-impact aerobic exercise that promotes spinal mobility without excessive strain. Stationary biking is known to improve pain intensity and functional capacity in individuals with low back pain. It strengthens the surrounding muscles and improves endurance.

Core Strengthening Exercises

Here are some safe and effective core exercises that can help stabilize the spine:

Pelvic Tilts: This exercise involves engaging the core muscles to press the lower back into the floor while tilting the pelvis slightly upward. It strengthens the core and supports the lower back.
Bridges: Lie on your back with knees bent and feet flat on the floor. Lift your hips off the ground while squeezing your glutes (muscles in the buttocks), forming a straight line from your shoulders to your knees. This exercise strengthens the glutes and lower back, providing stability to the spine.
Plank Variations: Planks are excellent for building core strength without straining the lower back. Standard planks, side planks, and modified planks (on your knees) can be incorporated.
Bird Dog: Start on your hands and knees, then extend one arm forward and the opposite leg backward while keeping your core engaged and your back straight. Hold for a few seconds, then switch sides. This exercise improves core and back strength, as well as lumbar flexibility.
Dead Bug: Lie on your back with arms extended towards the ceiling and knees bent at 90 degrees. Lower one arm and the opposite leg towards the floor, then return to the starting position. Alternate sides. This exercise strengthens core muscles.
Cat-Cow Stretch: This involves alternating between arching and rounding the back, which enhances spinal flexibility, reduces stiffness, and relieves pressure on the discs.
Waiter’s Bow: Hinge forward from your hips while maintaining a natural curve in your lower back and a slight bend in your knees. This activates muscles in the lower back, hips, and hamstrings without putting undue stress on the herniated disc.

Flexibility and Stretching Exercises

Flexibility and mobility exercises can alleviate pain and stiffness associated with a herniated disc. Stretching can reduce pain and disability in individuals with low back pain and herniated discs. Here are some effective flexibility and stretching exercises:

Hamstring Stretches: Tight hamstrings are common in individuals with lower back pain. Regular hamstring stretches can significantly reduce pain and disability in patients with lumbar radiculopathy (nerve pain) caused by herniated discs. To perform this stretch, sit on the floor with one leg extended and the other bent. Reach forward toward the extended foot until a gentle stretch is felt, holding for 20-30 seconds and repeat on the other side. Or, try a seated chair stretch by sitting in a chair with one foot on the floor, and the other extended out straight, with the heel on the floor. Straighten the back and lean forward over the extended leg until there is a stretch along the back of the upper thigh. Hold this position for 5-10 seconds. Switch legs and repeat several times.
Cat-Camel Stretches: Also referred to as cat-cow stretches, this exercise improves spinal flexibility and mobility. This stretch will open the intervertebral disc space, helping to relieve pressure on the herniated disc while improving the mobility of the spine. Start on your hands and knees, arch your back upwards like a cat, then lower it down to create a curve like a camel. Repeat slowly, focusing on spinal mobility.
Quadriceps and Hip Flexor Stretches: Tight quadriceps and hip flexors can strain the lower back. Stretching these muscles can reduce pain and disability. Stand with feet hip-width apart, grab one ankle, and pull it toward your buttocks, feeling a stretch in the front of your thigh. Hold for 20-30 seconds and repeat on the other side.
Neck Stretches: Neck stretches may improve flexibility. To relieve pain and pressure from a herniated disk near the neck, people can try the following exercise: Sit upright in a chair and move the chin toward the chest, then back against the headrest, stretching the neck. Move the left ear toward the left shoulder, then the right ear toward the right shoulder. Repeat this pattern several times.
Spinal Decompression: Spinal decompression creates space between your vertebrae and relieves pressure. The way to do this exercise is to find a place you can hang off of a bar. The goal is to try to hang off the bar for 30 seconds at a time for three rounds. Release slowly and continue with other exercises.
Standing Lumbar Extension: Begin this exercise by standing up with good posture. Now take both hands and place them on both sides of your lower back. Now with the help of your hands push your pelvis forward and extend your spine back. Follow the extension with your neck so that you end up facing the ceiling. Start with 10 repetitions and do 2-3 sets.

Water-Based Exercises

Aquatic therapy and water aerobics offer a beneficial, low-impact environment for individuals with herniated discs. The buoyancy of water reduces the weight-bearing forces on the spine, which can significantly decrease muscle spasms caused by disc herniation and provide a feeling of weight loss, making movement easier and less painful. Studies indicate that aquatic exercise can significantly reduce pain and improve physical function in individuals with low back pain. The hydrostatic pressure of water can also help reduce inflammation and swelling, while the warmth of the water promotes muscle relaxation and increases blood circulation. Furthermore, aquatic exercises allow for early active mobilization and strengthening, contributing to improved range of motion and overall quality of life. Therapeutic aquatic exercise has demonstrated greater improvements in pain relief, function, quality of life, sleep quality, and mental state compared to physical therapy modalities.

Here are some specific water exercises recommended for relieving herniated disc pain:

Water Walking: Walking in water uses the water’s natural resistance to work the spine and lower body muscles. Walk from the shallow end towards the deep end until the water reaches your shoulders, then turn around, keeping your spine straight and trunk centered while swinging your arms forward and backward.
Knee-to-Chest: While walking in the water, bring your leg up and try to touch it to your chest with each step. This exercise works your core, which is essential for supporting your spine. Alternatively, stand on one leg, slightly bending the knee for stability (use the side of the pool for support if needed), bend your opposite knee, and raise that leg up towards your chest as far as is comfortable. Hold this position briefly, then slowly lower your leg back to the starting position. Complete five repetitions on one side before switching to the other leg.
Superman Stretch: Hold onto the edge of the pool with your arms a little over two feet apart (just past the shoulders), making sure not to bend your arms. Step backward with your legs out wide so that you’re on top of the water. The water will make you feel nearly weightless, allowing you to stretch out your back muscles and spine.
Pool Planks: While floating in the water, maintain a plank position to engage your core muscles, providing support and stability for your spine.
Leg Lifts: While holding onto the side of the pool, extend one leg outwards, alternating legs to strengthen the lower back.
Medicine ball chops: Stand in deep water holding a medicine ball at one hip, raise the medicine ball to the opposite shoulder and then back to the opposite hip. Switch sides after several repetitions. The water provides constant resistance throughout the motion, building strength in the associated muscles.
Supine planks: Lay supine with floating dumbbells in each hand and under each ankle. Activate the posterior muscle chain (hamstrings, glutes, low back muscles, scapula stabilizers) and bring core into proper position while floating. Hold this position for a period of time then relax.

Exercises to Avoid with a Herniated Disc

When dealing with a lumbar herniated disc (where the soft cushion between the bones in your spine pushes out), it’s important to avoid certain exercises that can aggravate the condition. While exercise can be beneficial, some activities place excessive stress on the spinal discs in the lower back.

High-Impact Activities

High-impact activities, such as running, jogging, and jumping, can cause repetitive loading on the lower back. These jarring movements may worsen herniated disc symptoms. A study of runners with herniated lumbar discs found that all experienced pain during or shortly after running. It is generally recommended to avoid high impact activities while recovering from a herniated disc.

Heavy Lifting and Twisting Movements

Weightlifters are prone to herniated discs due to the strain on their backs. Certain exercises and movements can worsen the symptoms of a herniated disc.

Weightlifting: Weightlifting, especially deadlifting, can cause herniated discs because of the strain on the back. Lifting back muscles instead of leg muscles is a common way to injure the back.
Twisting: Combining lifting with twisting motions increases the likelihood of suffering a herniated lumbar disc. When combined with flexion (bending), torsion (twisting) markedly reduces the nuclear pressure required to form clinically relevant radial tears (tears of the disc wall).

To prevent further aggravation of a herniated disc, it’s important to avoid activities involving repetitive bending, lifting, or jarring motions. Exercises involving twisting and bending at the waist should also be avoided.

Extreme Flexion or Extension Exercises

Certain exercises involving extreme or repetitive spinal flexion (forward bending) or extension (backward bending) can pose risks to the spine.

Flexion Exercises (e.g., Sit-ups):

Spinal Stress: Exercises where the lumbar spine is allowed to flex, round, or flatten can overstress the discs and ligaments. Repetitive flexion movements may lead to posterior displacement of the nucleus pulposus (the soft, gel-like inner part of the intervertebral disc), potentially leading to a herniated disc.
Compression: Sit-ups can produce large shear and compressive forces on the intervertebral discs and across the lumbar spine. Traditional sit-ups can impose significant compression on the spine.
Back and Neck Strain: Sit-ups can cause lower back and neck strain if done incorrectly. Over-engaging the hip flexors during sit-ups can pull on the lumbar spine, potentially leading to discomfort or injury.
Limited Core Engagement: Sit-ups primarily target superficial abdominal muscles, without fully engaging deeper stabilizing muscles.

Extension Exercises (e.g., Backbends):

Joint stress: Spinal extension loads the facet joints (joints in the back of the spine) and compresses the interspinous ligament (a spinal ligament) which can be at risk for injury.
Neural Arch Stress: Repetitive spine flexion/extension cycles can cause bending of the neural arch (the bony ring that encloses the spinal cord), potentially leading to fatigue fractures.
Overexertion and Pain: Excessive back arching for prolonged periods can lead to pain, injury, and muscle loss, and may worsen symptoms of chronic back pain. Excessive arching can also stress the spinal discs and joints.
Spinal Overstretch: Extreme backbends can cause spinal overstretch and transient dislocation, especially in children.

When to Seek Professional Guidance

Seek professional guidance before starting a new workout routine, especially if you’re over 40 or have pre-existing health conditions. Consulting with healthcare professionals, such as a physical therapist, can help ensure exercise is both safe and effective.

Importance of Consulting with a Specialist

Consulting with a specialist, such as a physical therapist, is crucial for several reasons:

Personalized assessment: Physical therapists conduct thorough examinations to understand an individual’s movement, flexibility, and overall physical condition. This includes reviewing health history to identify potential risk factors.
Customized plan: Based on the assessment, a physical therapist can develop a tailored exercise plan with specific short- and long-term goals. These programs consider any existing impairments or conditions.
Expertise and guidance: Physical therapists are trained to provide appropriate exercise interventions and self-management strategies. They offer guidance on proper techniques and can modify exercises to avoid pain or discomfort.
Address chronic conditions: For individuals with pre-existing chronic diseases, exercise professionals with advanced training can coordinate pre-participation exercise screening and use the results to guide exercise prescription. They can also communicate with the individual’s physician to ensure alignment with their overall clinical status.
Promote healthy lifestyles: Physical therapists play a role in promoting physical activity and overall wellness. They can provide counseling on the need to participate in physical activity and help individuals find meaningful forms of exercise to maintain motivation.

Recognizing Warning Signs

Certain warning signs may indicate exercise is aggravating your condition:

Pain: Any exercise that causes pain or substantial discomfort should be avoided or modified.
Numbness or tingling: Numbness or tingling, especially in the extremities, can be a sign of nerve impingement and should be evaluated.
Other symptoms: Other symptoms that warrant stopping exercise and seeking medical help include chest pain, extreme breathlessness, or a rapid or irregular heartbeat.

Dr. Todd Lanman’s Approach to Exercise and Rehabilitation

Lanman Spinal Neurosurgery, under the direction of Dr. Todd H. Lanman, takes a comprehensive approach to spine health, integrating personalized exercise and rehabilitation programs to improve patient outcomes and overall quality of life. Dr. Lanman’s approach, known as 4D Health™, considers various factors, including nutrition, hormone status, exercise routines, and spine and joint health, to optimize well-being. This holistic method aims not only to treat spinal conditions but also to enhance the overall quality of life, ensuring patients maintain active and healthy lives as they age.

With the right exercises and expert guidance, many patients experience significant relief from pain and improved function. A well-structured conditioning program can aid in returning to daily activities, sports, and recreational activities, as well as preventing further injury.

For sophisticated and innovative care aimed at restoring motion, relieving pain, and elevating your overall quality of life, schedule a consultation with Dr. Lanman at Lanman Spinal Neurosurgery today.

FAQs: Workouts for Herniated Disc

What are the best exercises for a herniated disc?

The best exercises for a herniated disc focus on strengthening core muscles, improving flexibility, and promoting proper spinal alignment. These exercises typically include lumbar stabilization, McKenzie method extensions, and gentle aerobic activities.

Can exercise make a herniated disc worse?

Yes, exercise can potentially exacerbate a herniated disc if performed incorrectly or with excessive intensity. Avoid high-impact activities, strenuous exercises, and movements that involve significant bending, twisting, or lifting, as these can increase radicular pain and radiculopathy (sensation of numbness, tingling, and weakness). Instead, low-impact exercises and physical therapy, under professional guidance, are recommended for safe and effective management of herniated disc conditions.

How often should I exercise with a herniated disc?

Patients with lumbar disc herniation should exercise at least 2-3 times per week for a minimum of 2 weeks to see significant improvements in pain reduction and physical performance. However, it’s important to start with gentle activities and gradually increase intensity under the guidance of a healthcare professional. The optimal frequency may vary depending on individual factors, but maintaining a consistent exercise routine of at least twice weekly has shown positive outcomes in reducing symptoms and improving lumbar strength.

Are yoga and Pilates safe for a herniated disc?

Yes, yoga can be safe for individuals with a herniated disc when practiced with proper guidance and modifications, but caution is advised. Some studies suggest that yoga may be beneficial for managing chronic low back pain and improving function in patients with herniated discs.8 However, it is important to consult with a healthcare professional before starting any yoga program, as certain poses may exacerbate symptoms or pose risks for those with spinal injuries. A tailored approach under the supervision of a qualified yoga therapist or instructor experienced in working with back conditions is recommended to ensure safety and effectiveness. Hyper-twisting, flexing, extending and rotating of the spine needs to be proceeded with caution. Pilates is safer in this regard as a more stabilized exercise.

When should I stop exercising due to herniated disc pain?

You should stop exercising if you experience persistent or worsening pain, especially if it radiates into your legs or buttocks. Additionally, if you notice any loss of bowel or bladder control, this could indicate a severe disc issue requiring immediate medical attention. Listen to your body and avoid pushing through pain, because continuing to exercise with these symptoms may exacerbate the herniation and lead to further complications.

Can exercise help a herniated disc heal faster?

Yes, exercise can indeed help a herniated disc heal faster. Multiple studies have shown that targeted exercise interventions, such as lumbar stabilization exercises and motor control exercises, can effectively reduce pain, improve function, and potentially accelerate the healing process in patients with lumbar disc herniation. These exercises work by strengthening the core muscles, improving spinal stability, and enhancing blood flow to the affected area, which may promote tissue repair and reduce inflammation.