EXERCISES FOR SCIATICA
SPINAL STENOSIS
My name is Sammy Margo. I'm a chartered physiotherapist.
Today we're going to look at exercises for spinal stenosis.
The main aim of spinal stenosis exercises
is to strengthen the surrounding area, gap the joints, improve the scaffolding
and just ensure that the area is strong, stable
and we've gapped the joints as much as possible.
The exercises should take place in crook-line, in this position.
You're lying on your back, on the floor or on a plinth
or possibly on the bed if you really can't get yourself into a good position.
You need to keep your knees bent and your low back flat.
Usually with spinal stenosis,
most patients prefer to be in more of a foetal or a crook-line position
as opposed to being in an arched-back position.
They usually, but not in all cases, find that they're more comfortable
when they're more bent forward than when they're arched backwards.
A lot of these exercises are to help mobilise the joint.
Starting off, can you bring your knee up towards your chest?
Put your hands on top of your knee.
Gently, pull it down ten times.
This will be gapping the joint.
You don't need to engage your abdominals at the moment.
We'll move on to that.
Some people with spinal stenosis even like doing this in sitting.
And ten. Let's do the other one.
Gently place your legs down.
Onto the other one, just pulling your knee down towards your chest.
One. Two. Three.
Normally, it takes about ten to help mobilise things.
This is more of a gentle, gapping, mobilising,
rhythmical, bouncing movement.
Great. Bring your leg down.
Now bring both legs up towards your chest. But be careful.
If this is uncomfortable, you don't need to do both legs.
For some of you, you may have a tummy in the way
or you may be a little bit stiff or uncomfortable.
As an advanced movement, you can do what we call stirring,
a gentle rolling movement going all the way around.
This is slightly more advanced.
This is not for those that are experiencing
any pain or discomfort on the other movements.
Then reverse it, the other way around. OK?
Ten in each direction. Then bring your legs down, but gently.
You don't want to put any undue strain on your low back.
We're now going to get you up into sitting to do some further exercises.
Get yourself up.
Over the side, please.
Just, in this position, pull your knee up towards your chest.
Doing that in sitting is quite a...
Just drop it down. Pulling it up again.
And drop it down. And again pull it up again.
Keep it up there and bounce up and down in that position.
OK. Not everybody is going to be able to do that.
That's a good way in sitting to gap the joints.
The main aim is to gap the joints.
OK. Come and lie yourself down again, please.
So, if you do feel any pain or discomfort, you need to stop.
And then another very good exercise for spinal stenosis is again...
If you can feel my hand underneath you.
Push down while you're pulling your tummy muscles in,
as hard as you can.
And relax, but don't go into the arched position.
And again. Push down,
holding it for five, four, three, two, one.
And relax.
You can do those ten times. Obviously, I won't be there.
If you want to have a go at putting your hand under your back yourself...
And just push down.
Holding it, holding it, holding it.
If you feel any pain or discomfort, stop and let it go.
Another very useful exercise for spinal stenosis is knee rolling,
so rolling your knees from side to side.
You might find that it's a bit uncomfortable on one side.
Pulling your tummy muscles in, just roll your knees from side to side.
Side to side.
We've got two things going on at once here.
You're holding your tummy muscles in
at the same time as gapping the joints, side to side.
Good. Just ten of those, rolling from side to side.
OK. Just have a rest.
The last is buttock squeezing. Squeeze your buttocks as hard as you can.
Suck your pelvic floor up and in as if you're stopping yourself from weeing.
And relax.
That's just good old contractions.
Squeeze yourself as hard as you can. Hold it there.
Two, three, four, five.
And relax.
And again. Squeeze your buttocks as hard as you can.
Hold it there.
Two, three, four, five.
Relax.
And one more. Squeeze in.
Two, three, four, five.
And relax.
The main thinking that you have to have behind spinal stenosis
is really about gapping the joints as much as possible, stabilising the area,
so that you'll be strong and you'll be able to take any pressure off the nerve.
IF YOU EXPERIENCE ANY PAIN OR DISCOMFORT
WHILE DOING THESE EXERCISES
PLEASE STOP AND CONSULT YOUR GP
FOR MORE INFORMATION GO TO: www.nhs.uk/sciatica
