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Exercise in Injury Problems


Exercise is one of the most important parts of a treatment program for people with neck and back pain that lasts more than a few days. In fact, if you have many minor episodes of neck or back pain, exercise usually should be part of your treatment.

For the more lasting problems, exercise is a must. One of the few solid scientific research studies in this area of medicine demonstrated that in people who had low back pain, a regular exercise program was the single most important difference between the people who were feeling better and those who were feeling worse. They studied people who had a low back injury at work, and were treated with various methods of treatment. The people were not all treated by the same doctors or in the same way. This research looked at people who had their injury more than one year before the study. One reason this study is good science is that the doctors studied a very large number of injured people.

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When to start exercise? You must be guided by the individual assessment of your treating practitioner. If you have not broken a bone, ruptured a disc, a tendon, or a blood vessel, or torn a nerve, you should be ready to start some exercise by the sixth week after any injury. The milder the injury, the sooner exercise should start.

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Which Exercises:

The best exercise program is one worked out for you individually. This page is not here to discuss specific exercises, but general principles. These explain the how and why of some types of exercise.

Exercises are not invented for each individual person, but are usually selected from the standard exercises available, and modified for you if needed. The professional skill is in knowing the available exercises, and picking and teaching properly the ones that are right for you.


If your problem is lasting, the muscle knots are often (but not always) part of what is causing the pain. The muscle knots shorten the muscle when they form, and to bring the muscle back closer to normal, stretching is one part of the program. Sometimes the other tissues like ligaments tighten up also, and stretching is needed for this problem too.

Usually stretching exercises are added first to your program. Stretching exercises are normally performed at least once a day. Twice per day is also a common recommendation for stretching.

There are some less common situations when stretching is not included in the program.


This is the most important part of the exercise program. When and how to start is determined individually, usually later than stretching (but not always!). Strengthening exercises are best performed every other day, or three times per week. Sometimes this is done by strengthening one part of the body on the first day, for example Monday, and another part of the body the next day, for example Tuesday.

Exercises on exercise machines, such as Cybex, MedX,and Nautilus are primarily strengthening.

Strengthening helps in the following ways:

1. Support

Stronger muscles provide support for the injured area, which also cushions it against the jars and jolts of ordinary life. This doesn't sound that important, but it turns out to be the single most effective part of a successful exercise treatment program. The day to day result in your life can be huge. This is the most important reason for exercise.

2. Restore

The muscles that have muscle knots are weakened by the process that forms the knots. Strengthening them will restore them to normal functioning, and reduce the strain on the deeper injured areas.

3. Maintain

If you are receiving either massage therapy or chiropractic treatment, stronger muscles and healthier muscles will maintain the improved length of muscles and spinal alignment.

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The Long Term:

The only type of exercise that makes a difference for the long term is called active exercise. Active exercise means that the exercise is work for the person who is doing it. You have to keep on doing the exercise program every day or every other day. That doesn't sound like much fun, but if you have pain every day, you will find after three weeks on the right program you will feel better, and that you can have more improvements for up to two months. Then you have to look in the mirror and ask:

"Do I want to hurt every day or do exercises every day?"

If you have experienced three months or more of pain, the answer is usually clear.

The last word on exercise:


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Last modified: Fri, 17 Jun 2005
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