Exercises for low back pain, are effective in the acute period after childbirth, cesarean section. Dr. Bubnovsky, Dikul, Agapkin

Most often, severe back pain recommended complete rest, however, a number of talented doctors and athletes offer to perform in this period are simple, but very effective exercises.

The essence and basic principles of exercise for low back pain

Question of the application of methods of physical therapy in the acute period has always aroused controversy among physicians. Despite the fact that many of the techniques are not only tested, but also underwent successful clinical trials, the point in this dispute has not yet been set.

Exercises for low back pain were originally formulated PF Lesgaft and continued by many Russian scientists. Over the past decade has made an emphasis on the Western methods of treatment, although in principle they It causes a lot of problems, both in terms of cost and special equipment, and in terms of Physiology.

A worthy successor of the traditions established by luminaries of Russian medical science, is SM Bubnovsky. It was he who brought to the common denominator of all existing techniques and combined them into a single unit - kinesitherapy.

Kinesitherapy is a method of treatment using only physical exercises for functional recovery. Its main principle is a systemic movement. Any limitation of physical activity or surgery are exceptional measures.

Indeed, when there is insufficient blood supply to the muscle activity of the bodies is at its lowest level. And it is already insufficient in areas of pathology. Hence, only the deterioration of the patient takes place without any additional movement.

According to the theory of SM Bubnovskaya physiotherapy accelerates metabolic processes throughout the body and in combination with other physiotherapy means paving the way for the restoration of normal functions body.

VI Treatment program Dikulja is deepening and modification techniques Dr. Bubnovskaya and essentially based on the method kinezeterapii. The difference is observed only in the technical methods and slightly different application exercises. There is no doubt that Bubnovsky and Dikul similarity of their individual techniques confirm efficacy of kinezeterapii.

Techniques SN Agapkina developed them on the basis of the teachings of yoga. It should be noted that in this case very methodical approach to the treatment identical to the previous two. A content exercises again confirms the validity of the procedures used for its amazing similarities with exercise and Dikulja Bubnovskogo.

The techniques developed by different researchers, different age, different education and built on centuries of experience of different ethnic and racial groups have led to a common result.

All three techniques mentioned above - not the theoretical developments.

All three authors have gone through serious personal trials, restoring his own health after practice disability. In the future, techniques are clinically tested in Russian clinics and abroad. High efficiency is achieved kinezeterapii consistent and systematic approach.

Its main principles are:

1. Formation of high motivation to recovery for patients.
2. Theoretical training patients in the use of physical therapy.
3. Complex use of physical therapy techniques.
4. Optimal integrated use of special and general physical exercise.
5. System repetition complexes at various time periods.
6. Using elements of meditation.
7. The use of training devices.
8. The use of individual homework.

Results kinezeterapii application techniques are:

1. Improvement of mental and emotional state of patients.
2. Elimination of acute pain syndromes.
   
3. Improved blood circulation and lymph circulation in foci pathologies.
4. Reduction of hyper inflamed muscles.
5. Unloading of the spinal column.
6. Strengthening the back and abdominal muscles.
7. Restoration of spinal mobility and correct posture.
8. Improved coordination of movements.

It should be noted that kinezeterapii techniques are not a dogma and systematically developed. There are many examples of successful application and improvement in clinical practice. For example, a large contribution to this process made by the scientists VM Volyak and NS Egorova.

Indications for use of top exercises for low back pain

Exercises for low back pain are appointed after appropriate examination and clearly defined indications.

In determining the indications for the treatment of pain in the lumbosacral there must be two approaches:

1. Adaptive and preventive.
2. Therapy.

First used in the early stages of disease and minor manifestations of pain, as well as It recommends the inclusion kinezeterapii exercise daily complexes and sports physical exercises training. The second step applies acute pain and accurate diagnosis of the disease, its causes.

As a rule, these are diseases of the musculoskeletal system with a stable functional disorders:

1. Scoliosis and posture disorder.
   
2. Pain in the spine with functional disorders.
3. Post traumatic and postoperative conditions.
4. Paralysis and paresis.
5. Herniation and protrusion.
6. Osteochondrosis of the lumbosacral spine.
7. Instability of the spine segments.

The most common situation is tightening between courses of drug treatment or after surgery, as well as - a rejection of the motor activity in the presence of symptoms. In addition, patients in need of rehabilitation, often simply can not get to the specialized centers and medical institutions.

As a result of this situation is increasing the negative effects:

1. Loss of precious timing of early rehabilitation.
2. Psychological trauma.
3. Muscle atrophy and functional imbalance.
4. Decreased mobility and body functions.
5. Restriction of mobility in the spine and hip joints.
6. Increase in pain.
7. Impaired coordination and balance.

Therefore, the use kinezeterapii techniques recommended both as prophylactic effects, and as a treatment of the first days of the disease. complex exercises are widely used in the event of pain in the lumbar spine after cesarean section and pains in the postpartum period.

Exercises are appointed in the first hours after surgery (the day after the normal delivery) to:

1. Prevention of possible complications.
   
2. Improvement of blood circulation and lymph drainage.
3. Restoring full respiratory functions.
4. Improving emotional background.

When you exercise in this case, it should be remembered that they are implemented smoothly, with no apparent effort. In any case they should not be carried out with the aim of rapid correction of the figure: such efforts should be make after -3 months after birth, when all the internal organs will come to its normal state.

Contraindications to the exercises for low back pain

Exercises for low back pain have virtually no contraindications to perform, since the movement is necessary for any diseases already in the early stages of rehabilitation. The amount and type of exercise selected by the attending physician taking into account the patient's condition.

For relative contraindications include:

1. Conditions after spinal surgery.
2. Surgical interventions on other organs (in the early postoperative period).
3. Injury, accompanied by rupture of ligaments and muscles.
4. Decompensated heart disease.
5. Kidney and liver in the first step above.
   
6. Oncological diseases of the spine.

Absolute contraindications exist when:

1. Malignancies.
2. Any hemorrhages.
3. Preinfarction and Pre-stroke conditions.
4. Fractures of the long bones (before splicing).

Useful advice for patients

Those who intend to undergo treatment kinezeterapiey course there are some useful tips:

1. Make sure you have a license for medical activities at the institution, which is expected to appeal.
2. At the time of treatment is not to take any painkillers and NSAIDs to provide objective diagnostics (drugs relieve pain and inflammation without affecting the truth of their cause).
3. Seek help immediately after the onset of pain or injury.
4. Tune in to a long and continuous treatment.
5. When performing exercises to endure the pain and struggle with them.
6. If there is pain in the lumbosacral region is necessary to normalize sleep and food.
7. To normalize bowel function.
   
8. Get rid of the dark and negative thoughts, adjusting itself to a normal life without pain.

The basic set of exercises for low back pain

Exercises for low back pain should be divided into two main sections:

1. Exercises in acute pain.
2. Adaptive exercises.

In acute pain there is a small set of exercises that will allow before the start of the primary treatment to get rid of sharp pain and restore muscle function while driving. Perform this complex should be, ignoring the pain and chilling psychological factor. For confidence to know that none of them has no contraindications.

These exercises include:

Name	execution Policy	notes
curling	Lie down on a mat. Bend your knees Hands concatenated in a castle at the back. Pull your knees to your elbows. Alternate limb movement (first one, then - the other, and both together). Stomach during movements pulled inward toward the spine.	It recommended during execution placed under waist cryo compress of crushed ice to improve microcirculation, removal of edema and inflammation in the area of ​​pain.
Walking on all fours.	The starting position is clear from the title. The movement is made based on the upper right - lower left limb, and vice versa. Smooth motion and medium length (to avoid axial load on the waist). When you move it is recommended to change the reference point of the hands (palms, fingertips, fists) to increase blood microcirculation in the extremities. it is recommended to use any means of protection in the case of patients with knee. The procedure lasts 5 - 10 min.	The alternate movement of opposite extremities provokes outflow of blood from the dead zone in the lumbar region and sends it to the limb, thereby relieving internal swelling. This has a positive influence on the relief of the inflammatory process in deep spinal muscles, reducing the threshold of pain.
Stretching standing.	Perform standing, feet wider than shoulder width. Made slopes to one foot, and then - to the other. Inclinations performed without bending the legs and back to the maximum depth. Movements are smooth, do not lead to severe pain. The result after a few days of classes should be inclined, when the tips of the fingers touch the foot.	Admission is designed for soft stretching and stress relief to the spine. Smoother provides optimum motion in the lumbar spine.
Floor bridge.	From a prone position with a deep exhale, raise the pelvis. Lower and repeat for at least 5-10 times.	At the initial moment may occur pain in the lumbar region. Sometimes there is pain radiating into the thigh and groin.
Raising the knees in vise	The position of Visa bend your knees to a right angle. Capture at the beginning of no more than 1 sec. with a gradual increase in the duration of fixation to 5 seconds.	It is not recommended to perform caesarean section and birth!

These exercises should be continued and, after removing obvious pain. After the relief of acute pain for them, connect the main complex, used in therapeutic and prophylactic purposes.

At the heart of the complex, as a rule, are exercises designed and generalized Bubnovsky, Dikul and Agapkin. Under different names, they borrowed all the medical and training methods.

The best and most versatile in diseases of the lumbosacral spine is a complex of the following exercises:

1. Cat. Get up on all fours, her back straighten and relax. Take a deep breath and exhale arch your back up as much as possible, fix the position, not breathing. Simultaneously with the breath, return to the starting position. As you exhale, bend back down to fix. The number of repetitions pairs movements - 10-0.
2. Walking on the buttocks. Sitting on the floor, hands folded on his chest, with the help of movements buttocks take about a meter back and forth. Such passages make from 10 to 15 units.
3. Bicycle. Lie on your back, hands - along the body, legs bent. Raise your thighs perpendicular to the floor. Perform movements similar to the rotation of the bicycle pedals. Performed to the feeling of fatigue in the legs.
4. Raising pelvis. Lying on the mat, legs bent at the knees so that the feet are close to the buttocks. Holding on to the ankle hands, lift the pelvis with simultaneous deflection of the back. In the case where it is impossible to pull up the foot to the buttocks, put his hands along the body, palms down, and to make these deflections. The amount of exercise no more than 10 per set.
5. Raising hands deflection. Lie on your stomach, stretch your arms forward, palms down. His head rests on her left cheek. Raise the floor chest and right arm. When you return to the starting position of the head to put on the right cheek. The same be done with the left hand. Perform up to 10 times on each side.
6. The rise of the deflection arms. Technique is the same as the previous exercise, only made the simultaneous rise of both hands at once.
7. Side bends. In the bar, feet shoulder width apart, one hand at the top, the second - at the bottom. Bend in the opposite direction his raised hand, using his hands as a traction propeller. Change hands in places, and to make the slope in the opposite direction. Repeat 10-15 times on each side.
8. Lean forward. Standing, hands over his head. Make a smooth slope forward, trying to get his hands fingertips. In the final stage of maximum inclination relax back. Repeat 10 - 15 times.
9. Backward bend and twist. Standing with your feet shoulder width apart, arms at sides. Gently bend your back backwards while turning to the right and try to get his right hand left heel. Repeat to the other side.
10. Cyclists with twists. Lying on his back, his hands - at the back. Try to get a knee to the opposite elbow with simultaneous counter movement of the shoulder and elbow. Repeat a couple of other receiving limb. Perform 10-15 times.

All the above complexes exercises performed slowly and smoothly, avoiding jerks and abrupt movements. If the exercise does not work, you should do it unfinished version: with increasing fitness, it will start to receive.

Those exercises that gets good and require respiratory support component (performed inspiratory or expiratory) should be carried out using the method of "paradoxical" respiration (if recommended to perform on the breath, then exhale and perform vice versa). Such an approach would gently, imperceptibly, but very substantially increase the effectiveness of the exercises.

Securing result

kinezeterapii techniques combine well with all types of physical therapy, massage and water treatments. At the same time, a great role in the treatment belongs to the patient.

For successful completion of the course of treatment requires the following components:

1. Strict compliance with work and rest (organization vnutrismennyh breaks and production gymnastics, respect for the night's rest).
2. Observance sparing diet to reduce weight.
3. Failure (at least - for the period of treatment) of alcohol.
4. Complete elimination of tobacco smoke.

When to expect the effect of exercise for low back pain

One of the most common questions from patients, it is - how soon to expect improvement. The unequivocal answer to the question no doctor not able to give. However, statistics show that in acute low back pain, performing a special set of exercises allows you to get results from the first day of treatment.

First - this is short-term relief, enabling the patient to relax a bit and improve their morale. From the third day of classes occur over long periods of pain reduction. A week later, most often, there comes a period of relatively stable remission.

Deluded as rapid effect is not worth it, because in the initial stages of treatment only one awkward movements or heavy lifting disproportionate to the current state, in order to return to the sharp period. Further treatment to a state of stable remission and complete restoration of spinal function takes 2 - 3 months.

Effective exercises kinezeterapii complexes are used in treatment of pathologies of the spine, in particular, for low back pain. In most cases, these exercises allow patients to return to normal life.

Registration of the article: Lozinski Oleg

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