157 A Christian Guide to Body Stewardship, Diet and Exercise swimming in warm water (e.g., 30° C / 86° F) and spinal traction (Zatsiorsky & Kraemer, 2006). In terms of treatment, most cases of low back pain resolve on their own within a couple of weeks. With that in mind, seeking invasive treatment options (e.g., corticosteroid injections, surgery) immediately upon the onset of low back pain is likely unnecessary. Only when it is determined, through a formal medical evaluation, that the pain is in the same neural pathway as depicted on the MRI, should individuals consider more invasive treatment options (Cady, 2016). Research has shown walking to be an effective treatment option for low back pain (Cole, 2019). Walking as little as 30 minutes per day can help strengthen and increase the blood flow to the muscles that support the spine. Additionally, daily walks have been shown to help improve lumbar spine mobility by increasing the flexibility and elasticity of spinal ligaments and tendons. However, individuals currently suffering from low back pain may not be able to tolerate 30 minutes of continuous walking. Instead, multiple bouts of shorter walks (e.g., 5-10 minutes) throughout the day may be a better initial strategy until a tolerance for longer walks has been established. A Case Against Sit-Ups For years, sit-ups have been a popular means of training the abdominal muscles. Due to their effectiveness and ease of administration, sit-ups, or some version thereof, have been used in the military and physical education programs throughout the world. However, current research suggests that performing high volumes of spinal flexion (e.g., sit-ups) or rotation (e.g., Russian twists) exercises may actually cause damage to outer layers of the intervertebral discs thereby leading to low back pain (McGill, 2006). In fact, researchers now believe it may be more effective and safer to train the torso isometrically (Boyle, 2019). In other words, although the spine allows for movement in all three planes (i.e., frontal, sagittal, transverse), the muscles attaching to the spine primarily serve as anti-flexors, anti-extensors and anti-rotators. Table 7.3 provides some sample exercises for training the torso. As depicted in the table, the torso is divided into three parts: midline abdominals, oblique abdominals and low back. It is important to train each part of the torso weekly in order to prevent muscle imbalances. One helpful strategy would be to incorporate torso training at the end of each strength training session and alternate between midline abdominals, oblique abdominals and low back exercises. For example, individuals participating in a 3-day per week strength training program could perform planks on Monday, side planks on Wednesday and back hypers on Friday.
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