下腰痛，锻炼指南

关于下腰痛的临床实践治疗指南发表在2012年4月美国JOSPT杂志上（骨科和运动物理治疗杂志）。该指南介绍了基于最佳循证的治疗腰背部疼痛的方法。

Early treatment seems to be key todecreasing your pain and getting back to full activity. Treatments that focuson exercise and staying active limit the amount of time your back pain lastsand reduce the chance that it will reoccur.

早期治疗的关键是减少患者的疼痛和重返完全的活动。治疗的重点是运动和保持有限的活动，减少疼痛复发的机会。

训练时机的选择

Based on your examination, the besttreatment for acute low back pain may be manual therapy (mobilization /manipulation) or exercises that restore motion anddecrease pain in the leg thatis linked to your low back pain. Exercises that improve coordination, strength,and endurance are best added to treatment once the pain lessens. However, ifyour pain becomes chronic, moderate- to high-intensity exercises andprogressive exercises that focus on finess and endurance are helpful in painmanagement.

· 急性下腰痛最佳治疗可能是手法治疗，或恢复性运动训练和减少腿部疼痛。

· 一旦疼痛减轻，最好加入协调，力量和耐力训练。

· 如果疼痛变成慢性的，中~高强度的训练（体适能和耐力）有助于疼痛管理。

训练方案

Back Stretches For Lower Back Pain

§ Standing hamstring stretch 腘绳肌牵伸（站立）

Do 10 to 25 repetitions, then relax. Donot attempt this exercise if the pain is too severe. This exercise buildsstrength in the lower back area.

10~25次，如果太疼痛，不要尝试这个练习

§ Quadruped arm/leg raise 四点跪位（伸上肢/腿）

Keeping your knees bent, squeeze thebuttocks and hold for a second or two,then relax. Do 10 repetitions. This isanother strength-buildingexercise.

保持1~2秒，重复10次

Pull one knee toward your chest and holda second. Extend the otherleg out atthe same time. Stretch the back muscle onone side, then repeat withthe otherleg. Repeat 10 times. Discontinue theexercise if pain is overbearing.

§ Gluteal stretch臀肌牵伸

Pull one knee toward your chest and holda second. Extend the other leg out at the same time. Stretch the back muscle onone side, then repeat with the other leg. Repeat 10 times. Discontinue theexercise if pain is overbearing.

将一侧膝关节拉向胸前，保持1s，重复10次。如果痛苦持续，停止运动。

§ Cat and camel

A helpful starting exercise iscontrolled,gentle spine movement with the Cat & Camel. First arch your backup towardthe ceiling, like an angry cat. Increase the movement with a deepinhale. Thenexhale, tighten (or brace) your abdominals, drop your chest towardthe floorand lift your head slightly as shown. Repeat this exercise 10 times.

首先向上弓起你的背，就像一个愤怒的猫。运动时加强深吸气，然后呼气，收紧腹部，放平躯干，抬起头，如图所示。重复动作10次。调整脊柱运动协调。

§ Pelvic tilt骨盆前倾

Staying in the same position, bring bothknees up together and holdthatposition for a second or two. Drop your feet tothe floor and repeat again.Do this 10 times.

每次1~2秒， 重复动作10次。

§ Partial curl 躯干旋转

Hold the position for 5 to 7seconds,release and relax for 2~3 seconds before repeating.

保持5~7秒，之间休息2~3秒，重复10次

§ Extension exerise 躯干伸展训练

Hold the position for 5 to 7seconds,release and relax for 2~3 seconds before repeating.

保持5~7秒，之间休息2~3秒，重复10次

§ Side Plank 侧向支撑

Hold the position for 5 to 7seconds,release and relax for 2~3 seconds before repeating.

保持5~7秒，之间休息2~3秒，重复5次

核心力量训练