Lumbar stenosis: exercises to avoid and recommendations

Lumbar stenosis is the most common form of spinal canal stenosis. Basically, it is a narrowing of the canal in the lower area of the spine. If you have this condition, you should avoid high impact exercises. In the following article we tell you what these are and describe some other exercises that you should also avoid if you have lumbar stenosis.

Lumbar spinal stenosis can be a very painful disorder. People with spinal stenosis may feel pain, pressure or numbness in the back, and in the legs. The narrowing of the canal may be the result of a herniated disc or growth of ligaments of the spinal canal.  

Under these circumstances, there are a number of exercises and stretches that could make your condition even worse if you do them. This does not mean that you should eliminate all type of exercise from your life, but that you must stick with appropriate exercises that contribute to your well-being instead of practicing those that could cause you problems.

Exercises to avoid if you have lumbar stenosis

If you're wondering why you should give up certain exercises if you have stenosis but your symptoms are controlled with medication, it's because medication doesn’t make the stenosis go away, it just treats the symptoms. You should get your doctor’s approval before beginning any exercise program. In the following we describe some of the exercises you should avoid if you have lumbar stenosis:  

1. Back stretches: you should avoid stretching forward to try to touch your toes or the floor, because this flexion movement places a lot of pressure on the lumbar discs.  Also, any stretches that involve leaning backwards (extension) should be eliminated, because the backwards leaning motion narrows the spinal canal. 
   
   These types of exercises are often done to increase flexibility, but for those suffering from stenosis, the backward position further collapses the spinal canal, which could increase pain in the area.
     
2. Cobra pose exercise: This position involves the spine moving in a way called extension, so lying on your stomach and pushing your upper body up off the ground is an exercise to be avoided. As we stated in the previous example, this type of movement causes the bony surfaces of the spine to get closer to each other and close the narrow spaces even more.
     
3. Gluteal bridge: this is an ideal exercise for strengthening the buttocks and can be a great exercise for some people with sciatica, but the truth is, that if you suffer from lumbar stenosis, you should avoid it. When you lie on your back and raise your hips off the ground, it extends the spine, which will cause pain in the lower back as the bony spaces close.
    
4. Exercises with free weights: we refer specifically to using dumbbells and barbells on the shoulders, which requires a significant effort and increases the axial load. Just placing a weight bar on your shoulders and doing squats place unnecessary pressure, which will end up compressing the spine. This means that the intervertebral discs can be crushed depending on how much weight you lift, which could cause further compression of the adjacent nerves.
    
5. High impact activities: If you have been diagnosed with lumbar stenosis and cycling is part of your fitness routine, take note, because it’s best to stay away from cycling in the mountains or on rough terrain. Other high impact activities you should avoid include running, jumping, and climbing. When your feet hit repeatedly against a hard surface for a long period of time, it increases the compressive load on the spine.

In addition, if you have lumbar stenosis and walking is one of the ways that you enjoy exercising, you should avoid very long walks. Walking for prolonged periods will cause a compressive load on your spine due to its weight and muscle fatigue. This could lead to increased back pain or feelings of numbness, tingling, and weakness. 

Is walking good for lumbar stenosis?

Exercises you can do with lumbar stenosis 

We don’t want you to give up all exercise, of course, so we are going to list some alternatives to those activities that we’ve said you should avoid. However, be aware that these are general guidelines and you should definitely consult your doctor for approval. Remember that your doctor or physical therapist can give you exercise guidelines to suit your condition: 

1. Floor stretches: you already know that extension stretches should be avoided if you have lumbar stenosis. So instead, try to stretch out while you're lying down. On your back, gently bring one knee bent to the chest and then return the leg to its original position, do the same with the other. Then put both knees together and bring them to your chest, hold them for a few seconds and return to the starting position.
    
2. Weight machines: A weight machine is designed to maintain the balance of the body while exercising a specific muscle group. For example, while lifting weights to strengthen your arms or legs, the machine helps stabilize your back, as long as you're using it correctly. It serves as a substitute for dumbbells and barbells.  However, it is important that you adapt the weight to your condition and always take into account the recommendations of the specialist.
     
3. Swimming: swimming is a non-impact way to exercise that will stimulate your metabolism and greatly benefit your spine. Without a doubt, it is one of the best activities for patients with lumbar stenosis, because it works a wide range of muscles and allows you to stretch and exercise simultaneously, all in a cushioned, weightless, floating environment. 

Safe stretches for lumbar stenosis

Our team of specialists at Instituto Clavel Rehabilitation offers this sequence of stretches that will help alleviate pain and gain mobility in the lumbar spine:

Begin by assuming this protective posture: lie down on a mat, face-up with your back flat on the floor and your feet raised and placed flat against the wall, so that your knees are at a 90º angle with the floor. Place a towel under your head as a pillow to support the neck. This position is ideal for cervical, thoracic, and lumbar pain.

• From this position, next place your hands on your ribcage and stretch one leg up until it is straightened against the wall, while keeping the other knee bent. Hold this posture until you feel your muscles relax, then repeat with the opposite leg.
• While in this position, do the following respiratory exercise to maximize the benefits: inhale through your nose, and when you exhale, use your hands to gently close your ribcage, without any tension in your chest. Now, do the same while flexing the foot of the leg that is extended, so that the toes point towards you. You may feel some discomfort, but should not feel pain.
• After about five minutes, stretch out the other leg so that both legs are extended up against the wall. As you breathe, flex both feet to point your toes towards you. You will notice that it does not feel the same on both legs, and it will be necessary to practice until they behave equally, both as flat and straight as possible. 

After another 5 minutes, bring your right foot down to rest on the front of your left knee, with your right knee held out sideways. Keep your hips straight and your back flat on the floor. With your right hand, gently press the right knee back further towards the wall to increase the work on the joint. Inhale, exhale, and if you want, push the knee back a little more. After a few minutes, try to do that stretch without the help your hand. Then, bend your left knee, bringing both legs a little towards the body, to relax the piriformis muscle. Repeat the exercise using the opposite leg. 

At Instituto Clavel we have a rehabilitation and physical therapy center that offers patients comprehensive treatment to guarantee the best results. Please don’t hesitate to contact us if you would like us to help you design your exercise routine or if you have any questions regarding exercise.

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