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A Healthy Back is a Happy Back



Author     by Karl Knopf, EdD





Back pain affects all of us at some point in our lives. It is second only to headaches as the most common neurological ailment among Americans, according to the National Institute of Neurological Disorders and Stroke. Back pain can be as simple and fleeting as stiffness or as restrictive and disabling as limited mobility.

After age 30, we’re more prone to back injuries because our bones and muscles tend to lose their strength. The good news is back pain is not an inevitable product of aging, and in most cases, can be prevented. Additionally, certain types of back pain such as osteoporosis, fibromyalgia and kyphosis (commonly known as “dowager’s hump”) affect more women than men.

The key to a healthy back? According to the Arthritis Foundation and the American Physical Therapy Association, it helps to maintain good posture, control weight gain and practice regular aerobic exercise, including stretching and strengthening.

Today, many doctors are treating their patients with therapeutic exercise and walking regimens.

Good posture is essential to eliminating back pain and preventing injury. Our backs do not have the same structural advantages as our four-legged friends. Our upright posture causes us to bear the brunt of gravity on our lower backs. Try the following to bring awareness to your posture:

Stand upright with your weight evenly distributed over the balls and heels of your feet and knees slightly bent. Tilt your pelvis slightly so your tailbone is ‘tucked’ under your hips. Increase the distance between your belly button and sternum by letting the chest rise and open, countering the ‘hunched over’ effect. When viewed from the front, your chin, sternum and belly button should be aligned vertically.   From the side, it should look like your earlobes are over your shoulders, which are over your hips.


Imagine a pencil standing upright on a desk, balanced on the eraser. Although you might be able to balance the pencil on its own, wouldn’t it be much more efficient to have guide wires for support? In the human body, the guide wires are the muscles that help keep the back aligned. All of these muscles need strengthening to build a strong support system for your back.  And while many people are aware of the importance of training their abs, they often neglect the buttocks muscles, which are the other side of the guide wires.

The benefits of strength training are numerous.  Strong muscles can help offset some aspects of the aging process; decrease lower back pain; increase bone density; improve mobility, balance, posture and self-image; and combat depression.

But strengthening alone is not the answer.  It is just as important to stretch our muscles to promote joint mobility and range of motion.  A well-balanced exercise routine should include strengthening and stretching activities.  Our ultimate goal is to achieve muscle balance between muscles pairs, i.e. those muscles that are on opposite sides of a joint, such as the biceps and triceps or quadriceps and hamstrings.

Try the following exercises to strengthen and stretch the abs, back and buttocks:

  • Buttocks Strengthener. Lie on your back with your knees bent and your feet flat on the floor. Tighten your gluteal muscles and slowly lift your hips off the floor. Hold this position for a few seconds and relax. Do 10 repetitions.
  • Hamstring Stretch. Lie on your back with your legs extended. Pull your right knee toward your chest and hold for a few seconds. Then gently extend the leg toward the ceiling until you feel a stretch in the hamstrings. Hold, return to start and repeat with the other leg.
  • Mad Cat. Begin on your hands and knees. Arch your back like a cat. Hang your head and neck in a relaxed neutral position. Hold for 10 seconds, then release. (Note: Don’t do this exercise if you have a ruptured disc.)


Also consider other back-strengthening exercises that don’t put extra weight on the spine. The recumbent bike, where the rider sits with the back supported, is an excellent choice for many people. Vertical water exercise also allows you to train all muscle groups while also limiting stress to the spine. Other recommendations include the seated chest press and lat pulldowns to the front for upper body training. Use caution with leg exercises.  If there is injury or pain, performing sit-to-stand is often a preferred activity to strengthen the leg muscles. In this exercise, you sit on the edge of a chair, then stand up and sit down again. It’s a ‘no-load’ version of the squat that works the front of the legs without putting any strain on the spine. If you want to increase resistance and build more strength, you could work up to holding dumbbells in your hands.

Individuals suffering from chronic back pain may want to see a physiatrist, a medical doctor who specializes in physical medicine and rehabilitation. They treat acute and chronic pain as well as musculoskeletal disorders with a focus on restoring function. Physiatrists have no vested interest in doing surgery and are usually very open-minded to medical interventions such as chiropractic and acupuncture.

Taking steps to improve or eliminate chronic back pain will allow you to live a healthy, more active lifestyle.



Dr. Karl Knopf has been involved in health and fitness for over 45 years, working in almost every aspect of the industry – from personal trainer and therapist to consultant. While at Foothill College, he was the Director of the Fitness Therapy Program, a teacher of adaptive PE, and recognized with several awards for teaching excellence. For 15 years, Dr. Knopf served as the President and Founder of Fitness Educators Of Older Adults. He has authored many articles, has written over 20 books, and has been a frequent guest on the Sit and Be Fit television show.


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