Lumbar spinal stenosis is a narrowing of the spinal canal or opening in the lumbar region of the spine. The spinal canal houses your spinal cord. When the spinal canal becomes stenotic, it places pressure on surrounding nerves and/or the spinal cord as well. Lumbar spinal stenosis typically causes dull or aching low-back and/or leg pain. Additional symptoms include numbness, tingling, burning, pins and needles or the sensation of a leg going to sleep. Lumbar stenosis causes weakness in the legs and decreased endurance. As a result, walking and balance are difficult. Stretching exercises help stretch tight muscles that contribute to back and leg pain. Tight muscles misalign your posture, pulling you in a direction that increases the stenosis and associated symptoms. Stretching exercises do not correct the lumbar stenosis but are merely part of the treatment plan to increase space in the spinal canal and decrease nerve pressure.
Active stretches use the contraction of the opposing muscle group to perform the stretch or your movement into a stretch position without any external assistance. The hamstrings, gluteals, lumbar spine, hip flexors and calf muscles are frequently tight in many people. The tightness causes postural misalignments and discomfort. To actively stretch the hamstrings, place one leg on a step or sturdy table and bend forward from the hips and spine. If lifting your leg on a step or higher surface isn't safe or comfortable, place the heel of one foot in front of you with the toes up and sit backwards on the opposite leg by bending your hips. Use the Mecca stretch to increase flexibility in your lumbar spine and gluteals. Kneel, sit back on your heels and bring your chest over your thighs. Reach forward with your arms and sit back as far as you can tolerate. The hip flexors are often tight and tend to pull your pelvis forward placing stress on the spine. Stand in a lunge position with the knee of your back leg under or slightly behind your hip. Press your body weight forward with the front leg to actively stretch your hip flexors. Stretch your calf muscles to alleviate tightness and discomfort in your lower back. Place your hands on a wall in front of you and step backwards keeping your knees and feet facing forward. Press your back heel down as far as you can tolerate while pushing into the wall. Hold all stretches 20 to 30 seconds and repeat on the opposite side where appropriate.
Passive stretches entail a partner, your hands or equipment to stretch a muscle. Perform the single-knee-to-chest stretch for your gluteals and lumbar spine. Lie on your back with both knees bent and feet flat on the floor. Place your hands behind one leg and pull it toward your chest as far as you can tolerate. If you can tolerate stretching one side at a time, progress to stretching both sides simultaneously. Stretch your gluteals and lumbar spine using the double-knee-to-chest stretch. Lie on your back with both knees bent and feet flat on the floor. Pull both knees into your chest as far as you can tolerate with both hands. The hamstring muscles require stretching, also. Many people have tight hamstrings that tend to contribute to their lumbar spine discomfort. Lie on your back with one leg straight and the other leg bent at the knee and foot flat on the floor. Lift your straight leg with your hand, towel or stretch strap as far as you can, keeping your knee straight. Tight calf muscles contribute to low back pain and are often tight. To stretch your calf muscles stand on an incline board or rocker with both feet, keeping your knees straight, and press your heels down. Perform this stretch off of a step as well. Place the ball of your foot on the step and press your heel down. Hold all stretches 20 to 30 seconds and repeat on the other side when necessary.
Correct Stretching Technique
Make sure you adequately warm up prior to stretching. Do a minimum of a five- to eight-minute warmup or up to a 12- to 15-minute warmup if you have medical conditions like diabetes or hypertension. When you begin to sweat, then the temperature of your muscles is adequate to begin stretching. Hold stretches 20 to 30 seconds to lengthen the muscles, increase your flexibility and decrease tightness. If you can not tolerate that duration of a stretch, start with a three- to five-second hold and progress to a 20- to 30-second stretch. Stretch only to the point of discomfort and not pain. Repeat each stretch three to five times to improve your flexibility. Repeat on the opposite side when appropriate. Perform stretches three to five times daily to maximize your stretching efforts for long-term gains in flexibility.
Practice Perfect Posture
Practice perfect posture to decrease strain on the lumbar spine. Many people with stenosis tend to bend forward because standing straight is painful. Once canal space, flexibility, endurance and strength improve, standing straight is less painful. Keep your ears over your shoulders; shoulders back, down and in line with your hips; chest up; and hips over your knees. Proper postural alignment places your body in the position of the least amount of stress and strain for your joints and other body structures. Prevent symptom recurrence and worsening by maintaining your flexibility, strength and postural endurance to allow for proper postural alignment.
- "Therapeutic Exercise"; Carolyn Kisner and Lynn Allen Colby; 1996
- "Advance for Physical Therapy and Rehab Medicine"; Developing and Using a Lumbar Stenosis Protocol; Carole Lewis; 1996