Fitness Rx For Bum Backs, Hips, Knees, and More

These doctor-designated stretches will relieve joint pain

The Editors of Prevention Health Books for Women November 3, 2011

Exercisers and would-be exercisers need their own serenity prayer: Grant me the courage to work through mild discomfort so in the long run I have less pain; the serenity to baby my joints and muscles when they really need it; and the wisdom to know the difference.

Any active woman occasionally experiences backaches, shoulder strain, knee pain, or other bone, muscle, or joint discomfort. Some women earnestly want to exercise but are hampered by chronic pain.

If discomfort is moderate to severe or lasts longer than 3 to 4 days; if you have any redness, bruising, or swelling; or if the pain is too intense to work through, you need to see a doctor. If you have shooting pain or numbness radiating down your arms or legs, stop exercising at once and consult your doctor. You may be referred to an orthopedist or physiatrist, to prevent nerve damage.

Mild discomfort is usually nothing to worry about, though. Most likely you need to warm up or cool down more effectively. Or it may be time to replace your workout shoes. After the age of 40, men and women alike have less elastin, a specialized protein that keeps skin, muscles, tendons, ligaments, and other connective tissue flexible. As a result, your muscles feel more irritated when stretched, and you are sorer after a hike on the trails, a tennis match, or a day at the pool than you were when you were 25.

If you feel achy after exertion, fight the urge to lunge for the couch, says Dan Hamner, MD, a physiatrist and sports medicine specialist in New York City. Inactivity can worsen mild joint and muscle pain because it prevents blood from flowing to that area. Plus, if you stop working out and begin filling out, added weight will cause more stress to your musculoskeletal system.

Cut back on the intensity of your workouts, but not the frequency, says Willibald Nagler, MD, professor of rehabilitation medicine at New York Weill Cornell Medical Center in New York City. If anything, you want to exercise more regularly, in order to condition all your muscle groups and keep them from getting even stiffer.

"Your muscles and joints are better off with a little conditioning every day rather than heroic efforts once a week," says Dr. Nagler. Daily stretching, for instance, renders muscles more flexible, in effect giving them the same properties they had in younger years, when elastin was more plentiful.

Yet even with serious injuries or physical problems such as a herniated disc or torn ligament, the goal is to return you to a fitness routine after getting the proper treatment from your doctor, Dr. Hamner explains. If you've been sidelined by a serious injury, don't be surprised if your doctor prescribes a well-designed exercise program in addition to ice, heat, and medications. If you're certain that regular exercise will help, not hinder, your achy body, these doctor-designed workouts can help you stay fit not fat at 40-plus. Use these exercises for mild discomfort or if approved by your doctor for more serious problems.

[header = Back-Friendly Fitness]

Back-Friendly Fitness

Based on his experience, almost 9 out of 10 women who complain about having a "bad back" are experiencing discomfort because of a basic musculoskeletal problem, says Dr. Hamner.

Some are simply more prone to muscle spasm. For most, the lumbar muscles supporting the lower back are too tight or too weak, or there is an imbalance and one muscle, like the hip flexor, overcompensates for a weaker one, like the hip extensor, explains Dr. Hamner.

You may also be feeling an imbalance in more than just the muscles of your back. When muscles in the shoulders and neck are too tight, back muscles are forced to overcompensate.

And since tight hamstrings, at the backs of the thighs, pull on your pelvis and tight hip muscles like the piriformis prevent you from rotating properly, you'll also want to keep your lower body limber. Along with strengthening and stretching the back muscles themselves, you need to condition the abdominal muscles to help support your spine.

If you have the classic "bad back," which is usually caused by either tight or weak muscles, check with your doctor to see if you'll benefit from these moves. Your doctor will probably need to rule out a disk problem or another abnormality that needs special therapy before you begin.

Note: All exercises should be done on an exercise mat or soft carpeting.

The Bicycle

Lie on your back, and raise your legs straight in the air. Tuck in your pelvis, and put your hands on your abdomen. "Bicycle pedal" your legs, being sure not to arch your back. Start with 30 seconds, and work up to 1 minute over time.

What makes it back-friendly: Fosters strong thigh muscles while loosening up the back muscles.

The Bridge 

Lie on your back with your knees bent and arms stretched out at your sides. Slowly squeeze your buttocks together while raising your hips and lower back as far as you can while still maintaining floor contact with your upper back, neck, and shoulders. Try to form a straight line between your knees and shoulders. Hold for 2 to 3 seconds, then gently lower yourself to the floor. Repeat 10 times.

What makes it back-friendly: Releases tension in the lower back and hips and strengthens muscles in the upper and lower body that foster good posture.

[header = Knee-Saving Exercises]

Knee-Saving Exercises

The knee is a sensitive joint, and at one time it was feared that vigorous exercise would in time wear out the knee, eventually leading to osteoarthritis. Not so. Actual research—including data on 150 lifetime female exercisers in England—found little association between habitual exercise of any kind and increased risk of developing painful arthritic knees.

Still, things can go wrong. The most common forms of sudden injury are tears to the anterior cruciate ligament (ACL), deep inside the knee. Women suffer about three times more ACL injuries than men.

Women also seem to have more than their share of painful kneecap problems, such as bursitis and tendinitis (two types of inflammation) and iliotibial band syndrome (tight tendons that rub the bones and cause irritation) and chondromalacia (softening of cartilage).

But bad knees don't have to stand in the way of your fitness program. Muscle-strengthening exercises can help prevent most kneecap problems."The secret to keeping a knee healthy throughout your life is to condition the long muscles and tendons connected to it," says Dr. Hamner. Your hamstring muscle runs up and down the entire back of your leg, not only supporting the ligaments and tendons surrounding the knee but also stabilizing your ankle. In front, your mighty quadriceps supports your kneecap by connecting it to the entire front of your thigh and the tendons across your hip.

A torn ACL usually calls for surgery. But the more supported your knee is by the connecting muscles and tendons, the better you avoid or recover from injury. And since we lose protective cartilage around our kneecaps as we age, it's all the more important to strengthen our legs to reduce stress to the knees. Maintaining strength and flexibility of your entire leg can also lessen the discomfort of any knee overuse condition, such as bursitis, tendinitis, or arthritis. If you have had a previous knee injury, you are at greater risk for developing osteoarthritis in your knee. Under your doctor's direction, a physical therapist or certified fitness instructor can give you a specialized routine.

Otherwise, Dr. Hamner recommends these knee-safe moves to prevent injury or for rehabilitation. (Before beginning exercises for rehabilitation, check with your doctor).

Wall Squat

Start with your feet shoulder-width apart approximately 18 inches from a wall. Keeping your head and back against the wall, slide down until your knees are at about a 45-degree angle. Hold this position for 60 seconds. Repeat three times. As your knees recover, you can push in to the wall with your back to slide between standing and squatting positions up to 15 times, but never squat so deeply that your hips drop below the level of your knees.

What makes it a knee saver: Conditions quadriceps and hamstrings to stabilize the knee. The wall prevents the tendency to use your back or overflex your knees during squats.

Straight and Rotated Knee Extensions

Start with your back against a wall, with your right leg bent and foot flat on the floor. Extend your left leg straight out in front of you, about 8 inches above the ground. Bring your left leg in and extend it back out to a straight leg with your toes up. Do two sets of 15 repetitions. Do a third set of 15 repetitions, but with your leg and ankle turned out. Repeat on the other side.

 What makes it a knee saver: The first two sets concentrate on building strength in all four quad muscles. The third set gives special attention to your inner quads, which tend to be weaker than the rest.

[header = Hip-Helping Workouts]

Hip-Helping Workouts

Hip pain is commonly caused by strained or pulled muscles anywhere from the lower back to the buttocks and upper legs. As we age, many of us also endure the ache of osteoarthritis in our hips, the wearing down of the cartilage cushion between the ball and socket of the joint.

"A woman with mild to moderate arthritis can benefit tremendously from keeping up with her normal exercise program while taking glucosamine and chondroitin supplements," says Dr. Hamner. Note that if you are taking chondroitin alone or with glucosamine, it may increase the effects of blood-thinning drugs and herbs. "A woman with advanced arthritis will need to work with a therapist or doctor to modify her activities," he says.

See a doctor to evaluate any hip pain and to see what exercises might be right for you. If hip pain radiates down the front of your leg or into your groin or the pain keeps you from bearing weight, the following exercises won't be for you. For mild pain or discomfort, focus on improving flexibility and strength in the entire greater hip area. One safe and comfortable way to achieve this goal is swimming. The following moves will also help put the tilt back in your pelvis.

Gentle Twist

Lie on your back with your legs straight. Bend your left leg, then drop it over your right leg so your left foot is up near your right knee and your left knee points to the right. Using your right hand, gently press your left leg toward the floor. Trying to keep both shoulders on the ground, turn your head to the left so your spine feels like it is rotating and you feel a deep release in your hip and buttocks. Hold for 30 seconds. Repeat three times on each side.

How it helps the hips: A classic hip stretch known to runners, swimmers, dancers, and yoga students worldwide, this stretches all the gluteus muscles as well as the whole back.

Hip Stretch

Starting on your back with both knees bent, cross your right foot over your left knee. Clasp both hands behind your left knee and bring it toward your chest until you feel a deep stretch in your right buttock area. For a deeper stretch, push your raised knee away from you with your right elbow. Breathe slow and deep while you hold the stretch for 30 seconds. Do the stretch four times on each side.

How this helps the hips: Tight gluteal muscles contribute to a feeling of stiffness in the hip; this exercise releases the tension in the buttocks and surrounding area.

Tags: Pain Relief