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Warning: Do NOT attempt to do any of these exercises
without first discussing them with your doctor!!!!

|||| Level One Exercises |||| Level Two Exercises |||| Doug's Core Program |||| Instructions ||||

ALWAYS START YOU WORK-OUT WITH THIS STRETCH. Simply get in the above position and GENTLY pull your knee to your chest and hold for a count of 20 to 30 seconds. Slowly lower the leg and repeat the other side. Do each leg 1 to 3 times. Do NOT force it or cause yourself any significant lower back pain. You may not be able to flex your hip as far as me; its ok, just go as far as you can without causing pain in your lower back.
Tight Butt muscles, especially the external rotators (piriformis & company), can irritate the already irritated sciatic nerve. This stretch will stretch the powerful gluteal musculature and the piriformis muscle: Simply pull the knee toward the chest and then toward the opposite shoulder. Flop your ankle on the outside part of your non-stretching knee (as above). Hold for a count of 20 to 30 seconds then lower. Repeat other side. Do each leg 1 to 3 times.

Since disc patients lose their ability to 'Reflex-Contract' their core spinal-stabilizers, learning how to 'manually' accomplish this is a must! Here's how: Simply suck/contract/pull your belly-button downward toward the floor. This is NOT done by inhaling deeply!. Also, tighten your buttock muscles; your anus muscles, as in trying desperately to hold in a threatening fart; and urethra opening (pea hole). Do all of the above SIMULTANEOUSLY and HOLD for 8 to 20 seconds, and relax. Repeat 1 to 3 sets. IF you're really in pain (acute) do NOT do the Butt, Pea-hoe, and Anus contractions.  

This exercise starts with your left arm by your side, and your right arm straight over head. Now, tighten your tummy slightly (green arrow) (and butt too if your not too sore) to lock your spine in place and simultaneously lift each arm upward, over the head, and back to the floor (right arm from 3 O'clock to 9 O'clock, left arm from 9 O'clock to 3 O'clock). Note, the left arm will move clockwise and the right arm will move counter clockwise. 1 to 3 Sets of 5 to 20 repetitions with each leg is enough. Also note that the knees are always bent to keep pressure off the sciatic nerve; we may call this the 'starting position'. Always use this position of the all the supine (face up) exercises.

Get in the 'Start position' (both knees bent fig.#4). Also put both of your arms straight up in the air as I'm doing above. Tighten your tummy and SLOWLY raise your knee toward your chest. Keep that tummy tight as you raise it and then lower it back down to the ground. Repeat with the other limb.
To make this more difficult, lift your head off the ground as well and hold it up as you do the leg-ups. 1 to 3 Sets of 5 to 20 repetitions with each leg is enough. You can also use ankle weights if you are tolerating these well.
For our final level 1 stomach exercise, let's combine the previous two exercises. Start in the usual position (both knees bent to 90 degrees) and both arm straight over-head and on the floor. Tighten the tummy and SLOWLY (like a Kung Fu master) lift the left arm and right leg SIMULTANEOUSLY. Bring them to the mid-way point (12 O'clock). Hold for 2 to 5 seconds, and slowly return them to their original positions. Repeat with the other side. 1 to 3 Sets of 5 to 20 repetitions with each leg is enough.
It's now time to work the all-important spinal extensor muscles (multifidi). Simply mount the Gym Ball as shown above. Note that both knees touch the ground, if they don't, your gym ball it too big. Next Slowly raise and extend your right arm and HOLD it at the top for 5 to 20 seconds. Slowly lower it and repeat with the other arm. Only raise your arm to a comfortable height. You don't have to go very high for this to be effective. 1 to 3 Sets of 5 to 20 repetitions with each arm is enough.   This one is a little tricky but very important. First your going to have to roll forward on the ball to position it more under your pelvis; the back should be about parallel with the ground. Note my hands are in a 'half-push-up' position. Also note that my knees will both be off the ground; use your toes to balance yourself. Now, Slowly lift your left leg backwards and then upwards, almost like a mule-kick. Hold at the top for 5 to 20 seconds. Slowly lower it back to the starting position and repeat with the other leg. 1 to 3 sets of 6 to 16 repetitions with each leg will do the trick.
While keeping your low back in the neutral position, simply sit for 5 to 20 minutes while watching TV or reading. You may bounce gently, and slightly roll from side to side. Just 'play', but make sure you keep that neutral spine. Also, make sure there is nothing to hit your head on, like the corner of a coffee table, in case you fall off!   I finish my work-out with a five minute easy ride on the life cycle. I don't even turn it on and just use the natural zero resistance of the off mode. I'm hoping to increase this 5 minutes to 20 or even more in the near future. I'm currently (6-21-04) increasing my bike time by one minute every session.
Final Notes about the Program:

I do the above program at least three times per week (barring Flare-ups) and try and do it every other day. It takes me about one hour to complete, sometimes less if I'm pressed for time. On the days I'm not doing this program, I walk over flat ground for 20 to 40 minutes. I'm currently a little over 4 months status-post microdiscectomy and this is all the exercise I'm able to handle for now.

  I've also found that many of my Chronic Disc patients can't tolerate much more than the above as well. However, hey do quite well with these exercise, and for many of them these exercises are their 'life lines'. They seem to be even more effective when combined with our conservative flexion/distraction treatment, myofascial release, massage, and PT. (06/21/04)


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