Do intra-abdominal pressure exercises for you with prolapse.

Last updated 27/12/2023 by The pain clinics - Interdisciplinary Health

Folding knife abdominal exercise on therapy ball

Do intra-abdominal pressure exercises for you with prolapse.

High abdominal pressure, also known as intra-abdominal pressure, can cause or aggravate prolapse and disc disorders. Sit-ups or crunch abdominal exercises with full spinal flexion are exercises that put such high pressure on the midbrain discs of the lower back. Repetitive flexion exercises can put a progressive pressure on your discs, which over time can cause injury.

What? Can sit-ups really hurt your back?

Yes, and there are several reasons for this. The forces that push the lumbar discs when performing sit-ups or crunches have been measured to 3350 N (McGill 2006, 2007). Other exercises have even higher pressures, among other things the exercise 'parachuting' which has been measured to a full 4000 N. This is relevant, then the 'safe limit' runs at 3000 N, and pressure over it is considered potentially harmful to the lumbar discs.
Other exercises that can give too high abdominal pressure are leg press (especially if you pull your legs too far) and sitting crunch apparatus (outdated device which unfortunately still exists in many gyms).

When performing sit-ups, you also tilt the pelvis backwards (posterior tilt), as again leads to increased disc pressure (Hickey et al., 1980). Sit-ups are otherwise an exercise like many performs on the mornings - and time of day when the slices have not been compressed even after a long night in bedand thus, they are more receptive for damage (Adams et al., 1995).

Exercises adapted to those with disc disorders or with history of prolapse.

A fresh prolapse is difficult to train. In most cases, you have to wait a short while before you begin specific training. In the meantime, general movement and walking on rough terrain is recommended. Consult your therapist (chiropractor, physiotherapist, or physician) if they think it is time for you to begin specific exercises.

Exercise 1: Back lift

Backbone or extension of therapy ball is one of the few exercises that has proven effect on causing hypertrophy (greater muscle mass) in the lumbar multifids. The multifids have become more and more recognized as some of the most important, injury-preventing back muscles we have. They are also called deep, paraspinal muscles, which reflects that they sit at the bottom of the spine - and thus in many ways considered our first defense against acute back problems. You can think of them as a kind of control center, a control room that provides essential information to the brain about the condition around the spine.

Back lift on therapy ball

reps: 5 reps x 3 sets, 10 reps x 3 sets or 20 reps x 3 sets (see how many you manage and then select one of the sets).

Exercises 2 and 3: 'Stir in the pot' (also known as 'stir the pot') and 'the saw'

Exercises 2 and 3 are also performed on therapy balls from the same starting position as seen in the image below. Start with your knees in the ground, after 4-6 weeks you will be able to do the exercises from the starting position below.

Case (Exercise 2):

- Enter the starting position (use your knees on the ground if it is too heavy).

- Let the forearms go back and forth on the ball.

- Make sure that you perform the exercises in a controlled and good method.

Pipe in boiler (Exercise 3):
- Enter the starting position (use your knees on the ground if it is too heavy).

- Let the forearms go in circles on the ball.

- Make sure that you perform the exercises in a controlled and good method.

- 'Stir in the pot' (aka stir the pot) has a clinically proven effect on training lumbar rotation and stabilization (Reynolds et al 2009).

Training on therapy ball

Rehearsals: A 5 reps x 3 sets, B 10 reps x 3 sets, C 20 reps x 3 sets (choose the layout - between A and C - that suits you best).

Exercise 4: Folding knife (also known as jack-knife)

Folding knife on therapy ball

This is an exercise that can be considered one progression exercise - ie an exercise you can start with when you are well used to the other exercises.

How do I set up the workout?

Start calmly and have a gradual progression. Do not push yourself too hard at first - Perseverance is the key to lasting progress. In the first few weeks the body and muscles will protest, this can sometimes cause some pain, but after you have been through your first 3 weeks with this form of exercise you will have noticed a marked progress.

The training can be combined with therapeutic laser treatment (mtp increased repair process) and / or needle treatment. Traction Bench may also, in some cases, be beneficial.

If you are not sure how to do the exercises or need tips, we would love to hear from you in the comments or on our facebook page. All questions are usually answered within 24 hours.

Recommended Exercise Equipment (click the link to learn more):
- Therapy ball from Gaiam (65 cm - with pump and DVD)(also known as Swiss ball)

What can I do even for muscle and joint pain?

1. General exercise, specific exercise, stretching and activity are recommended, but stay within the pain limit. Two walks a day of 20-40 minutes make good for the whole body and sore muscles.

2. Trigger point / massage balls we strongly recommend - they come in different sizes so you can hit well even on all parts of the body. There is no better self help than this! We recommend the following (click the image below) - which is a complete set of 5 trigger point / massage balls in different sizes:

3. Training: Specific training with training tricks of various opponents (such as this complete set of 6 knits of different resistance) can help you train strength and function. Knit training often involves more specific training, which in turn can lead to more effective injury prevention and pain reduction.

4. Pain Relief - Cooling: Biofreeze is a natural product that can relieve pain by cooling the area gently. Cooling is especially recommended when the pain is very severe. When they have calmed down then heat treatment is recommended - it is therefore advisable to have both cooling and heating available.

5. Pain Relief - Heating: Warming up tight muscles can increase blood circulation and reduce pain. We recommend the following reusable hot / cold gasket (click here to read more about it) - which can be used both for cooling (can be frozen) and for heating (can be heated in the microwave).

Recommended products for pain relief for muscle and joint pain

Biofreeze (Cold / cryotherapy)

Sources:

Adams, MA, Dolan, P. 1995. Recent advances in lumbar spine mechanics and their clinical significance, Clin Biomech 10: 3-19.

Hickey DS, Hukins DWL 1980. Relationship between the structure of the annulus fibrosis and the function and failure of the intervertebral disc. Spine 5: 106-116.

McGill SM 2007. Lumbar Spine Stability: Mechanism of Injury and Restabilization in the Rehabilitation of the Spine: A Practitioner's Manual, Liebenson C (ed). Lippincott / Williams and Wilkins, Philadelphia.

Recommended Literature:

- 'Low Back Disorders, Second Edition'- by Stuart McGill

- 'Ultimate Back Fitness and Performance'- by Stuart McGill