Ask the doctor: How can I exercise safely with my back problem?

By | May 19, 2020

Q I haven’t been doing much exercise recently – even before the lockdown I had fallen off the wagon – but I would like to start exercising again as I have put on a lot of weight. I will be doing home workouts. I have previously had lower back problems. Is there anything I should keep in mind or avoid before I start?

A There’s no better day to restart regular exercise, than today. It takes a number of weeks, perhaps months to build up your fitness level and sadly only two to three weeks of doing nothing to fall behind again. On a more positive note, it sounds like you’ve been used to regular exercise in the past and this will stand to you as your ‘muscle memory’ and pre-conditioned good level of cardiovascular exercise will kick back in faster.

A study published in 2016 entitled ‘Blue Zones: Lessons From the World’s Longest Lived’ discussed nine key lifestyle characteristics of the people who lived beyond 100 in five different areas of the world, namely California, Greece, Japan, Italy and Costa Rica. The first of the lifestyle factors (known as the Power 9) was about daily natural movement. There is no need to run marathons, pump iron or be in a gym. But being active in a natural way to sustain flexibility, mobility and strength is vital. Another important factor was ‘the 80pc rule.’ People in these ‘Blue Zones’ do not over-eat as they follow the simple rule of stop eating when 80pc full. The third factor I’d like to point out is their diet is mostly plant-based, on average meat is consumed about five times per month.

There are plenty of free home workouts available on YouTube. Why not start with one of the originals like Jane Fonda – 1982 is when it all began – or Cindy Crawford? Videos range from 20 minutes for beginners right up to advanced 60-minute workouts. You could try search ‘popsugar fitness’ or ‘SELF’ or simply put in ‘HIIT’ (High Intensity Interval Training) and loads of free workouts come up. The key is to find someone you like and continue their programme at least three to four times per week. It should be fun!

You said you’d also like to lose some weight and this is where your diet needs to be assessed for over-reliance on carbohydrates, high glycaemic index foods (eg white rice, bread, bagels, pasta, all sweet treats really) and possibly the hidden calories in alcohol. In order to lose weight you always need to burn more calories than you eat. Counting and cutting calories will work to help achieve weight-loss. So, start counting and remember you won’t have to do this forever, just until you achieve a realistic weight loss. Focus more on high protein and good fat content such as nuts, seeds, avocado, olive oil, eggs, chickpeas, beans, tofu, lentils, quinoa and small portions of lean meat/chicken or fish.

You mentioned that you have suffered with episodes of low back pain, this is even more reason to stay fit and active in order to prevent another episode. The lower back degenerates with age, weight gain, lack of muscle tone in our core muscles, as well as the buttock muscles. Pilates and swimming are excellent ways to build on the core muscle groups. If you remain concerned about low back pain, then you should attend a physiotherapist (when available given current restrictions) for a more targeted examination and professional advice.

⬤ Dr Jennifer Grant is a GP with Beacon HealthCheck

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