Back and Spinal Fitness at PUSH as Rx leads the field with a laser focus on supporting our youth sports programs. The PUSH-as-Rx System is a sport-specific athletic program designed by a strength-agility coach and physiology doctor with a combined 40 years of experience working with extreme athletes.
The program is the multidisciplinary study of reactive agility, body mechanics, and extreme motion dynamics at its core. A clear quantitative picture of body dynamics emerges through continuous and detailed assessments of the athletes in motion and under directly supervised stress loads.
Exposure to the biomechanical vulnerabilities is presented to our team. Immediately, we adjust our methods for our athletes to optimize performance. This highly adaptive system with continual dynamic adjustments has helped many of our athletes return faster, stronger, and ready post injury while safely minimizing recovery times.
Results demonstrate clear improved agility, speed, decreased reaction time with greatly improved postural-torque mechanics. PUSH-as-Rx offers specialized extreme performance enhancements to our athletes no matter the age.
Can converting a bicycle into a stationary bike be a way for individuals to exercise more while still enjoying cycling?
Bicycle Stationary Conversion
Is your bike collecting dust in the garage? Do you miss riding, but the weather or temperatures keep you indoors? Why not quickly and painlessly turn your bike into a stationary bike? An indoor stationary bike is a great way to maintain physical activity while avoiding inclement weather and outdoor elements. Plus, bicycle stationary conversion in your home, office, or garage is quick and straightforward. A bike trainer or roller is needed to convert a bicycle into a stationary bike. The bike is mounted onto the trainer stand, and its rear axle is replaced with a special axle provided with the trainer kit to secure it and hold the wheel in place while allowing you to pedal, creating resistance for indoor cycling.
Cycling
Bicycle stationary conversion isn’t only for die-hard cyclists. Research shows indoor cycling is a great way to stay healthy and consistent with your workouts. One study showed that indoor cycling improves aerobic capacity, blood pressure, lipid profile, and body composition. (Chavarrias, M. et al., 2019)
Stationary Bikes Types
For those who don’t have the space or know that they won’t regularly use a stationary bike, indoor bike trainers and rollers can provide convenient, economical, and compact options. Whether individuals want to exercise more, maintain a riding schedule, or train for an event, trainers and rollers can be highly effective tools for any cyclist. However, choosing between a bike trainer and rollers varies depending on the pros and cons. Selecting the right equipment depends on several factors, including:
Personal needs
Space – indoor or garage.
Cycling experience
Most cyclists, even hobbyists, prefer indoor cycling bikes over traditional stationary bikes because they are riding a real bicycle, including the positioning and pedaling, compared to upright, air, or recumbent bikes.
Trainer
A bike trainer is a stand that lets an individual ride a regular bicycle while stationary. Cyclists often use it to warm up before races, and it comes in handy when weather conditions or time constraints prevent riding outdoors. Most trainer stands can accommodate bicycles. Trainers are suitable for beginners and professional riders. There are two types of indoor bike trainers.
Direct-drive
Direct-drive trainers attach to the bike’s rear dropouts, replacing the wheel and providing a direct connection to the resistance unit.
These can cost more, but they’re worth the investment because they’re more accurate and deliver the highest resistance levels.
Friction
A small roller is installed against the rear wheel with friction trainers, which use magnetic or fluid resistance.
These are typically lighter and easier to transport than direct-drive trainers but are less accurate and provide less resistance.
Rollers
Rollers are the most basic type of indoor stationary bike but may not be the best option for individuals new to indoor cycling. This is because it requires advanced cycling techniques, such as balancing and keeping the front tire straight while riding. The cycle is on rollers instead of being fixed, allowing the resistance to range from zero to the equivalent of a direct-drive trainer. Rollers help refine pedaling technique and improve cycling form because you balance and stabilize while riding.
Conversion – What Is Needed
The most important equipment needed to convert the cycle is a bike stand, which will be the foundation of the stationary bike setup. (Bike To Work Day, 2025) There are two-piece stands and one-piece stands. (Bike To Work Day, 2025) Tools like an Allen wrench may be needed. Various bike trainer kits contain all the parts needed for this conversion, but extra standard tools may be required to remove the back wheel and replace the axle.
Choose the right trainer: Consider your bike type, desired resistance levels, and budget.
Install the trainer: Follow the manufacturer’s instructions to position and secure the trainer properly.
Mount the bike: Remove the rear wheel quick release, insert the trainer’s axle, and tighten it securely.
Adjust resistance: Most trainers have a knob or lever to control the difficulty level.
If you are uncertain whether your bike stand is set up correctly or having issues with the installation, contact a professional bike mechanic. They can help get the stationary bike up and running properly.
Considerations
Tire wear: Using a dedicated trainer tire for the rear wheel can minimize wear and tear.
Noise level: Some trainers can be noisy, especially wheel-on types.
Stability: Ensure the bike is properly secured on the trainer and your training area is stable.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Body In Balance: Chiropractic, Fitness, and Nutrition
References
Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Pérez-Gómez, J. (2019). Health Benefits of Indoor Cycling: A Systematic Review. Medicina (Kaunas, Lithuania), 55(8), 452. doi.org/10.3390/medicina55080452
For individuals looking to improve sleep, could weight training be the answer to increase healthy sleep?
Weight Resistance Training
Researchers found that resistance weight training improves sleep quality, among other methods like diet and sleep hygiene practices. Resistance training may improve sleep by reducing anxiety and stress, benefiting heart health, and promoting muscle recovery. Researchers examined non-medication methods of improving sleep in younger and middle-aged adults, comparing exercise, diet, and sleep hygiene practices. The findings showed that for adults under 65, resistance training is the best non-pharmacological way to improve sleep quality. (Hirohama, K. et al., 2024) These findings reinforce that sleep and exercise lead to improved restful sleep. Resistance training is highly effective compared to aerobic exercise (running or cycling) in improving sleep quality. The research shows that resistance exercise has more profound benefits than aerobic training alone.
Resistance Training and Improved Sleep
Resistance training, also called strength training or weight training, is intended to build muscle and strength using resistance. This can include:
Your body weight
Resistance bands
Free weights
Weight-lifting machines
The mechanisms by which exercise alters sleep are unknown. However, the researchers point out that weight training may improve sleep by improving mental health issues such as anxiety and depression. (Cunningham J. E. A., & Shapiro C. M. 2018) (Carbone E. A. et al., 2023) Other research on resistance training and sleep found that resistance training helped decrease anxiety and stress. (Alley J. R. et al., 2015) Resistance training can benefit heart health as it increases blood circulation. This means the heart’s vessels don’t have to work as hard during sleep when blood pressure should naturally drop, which is known as nocturnal dipping, which is great for individuals with high blood pressure.
Another reason this training may help with sleep is its impact on the body. Previous research on resistance training and sleep suggests that since weight training stresses muscle tissue, it could signal the brain that sleep is needed to repair the damage (Iowa State University, 2022). The hormone adenosine, which helps promote sleep, is a key factor in why exercise increases adenosine levels and helps the body doze off. (Roig M. et al., 2022)
How Much Resistance Training Is Needed?
Sleep doctors advise patients to perform some form of daily movement or exercise to improve sleep. The amount of resistance training an individual needs depends on their circumstances, such as underlying conditions, injuries, fitness level, physical ability, and time.
The guidelines for physical activity from the Department of Health and Human Services recommend adults do a muscle-strengthening activity at least two days each week in addition to at least 150 to 300 minutes of moderate-intensity aerobic activity.
The meta-analysis research found that a 55-minute resistance training session consisting of three sets of 10 to 12 exercises done three times a week positively affected sleep quality.
They added that higher intensity and frequency of training could have a greater effect on sleep.
In other research on exercise and sleep, study participants were grouped into resistance training, aerobic, and combination workouts – both resistance and aerobic exercise. Each group engaged in 60-minute training sessions three times a week, with the combination group doing 30 minutes of resistance training and 30 minutes of aerobic exercise each session. (Iowa State University, 2022) Resistance training increased sleep by an average of 40 minutes compared to about 23 minutes for those who did an hour of aerobic exercise. A combination of aerobic and resistance increased sleep by about 17 minutes. (American Heart Association, 2022)
Previous research on resistance training and sleep found that exercise at any time can improve sleep quality compared with no strength training. However, evening sessions tend to help individuals sleep a little better. (Alley J. R. et al., 2015) Resistance exercise may offer benefits regarding the ability to fall asleep and stay asleep for those with osteoporosis, sarcopenia, anxiety, or depression.
Strength Workouts
Resistance training that targets all the major muscle groups is the goal. The Iowa State University research had participants use 12 resistance machines to perform exercises, including:
Leg presses
Chest presses
Lat pulldowns
Bicep curls
Abdominal crunches
Participants performed three sets of eight to 12 reps at 50% to 80% of their one-rep max. (Iowa State University, 2022)
One of the studies had participants work out for 30 minutes using nine different resistance machines, completing three sets of 10 reps. (Alley J. R. et al., 2015)
However, individuals can also use dumbbells such as bicep curls or chest presses, barbells for deadlifts or back squats, resistance bands for lateral shoulder raises or leg extensions, or their body weight for movements such as chin-ups or push-ups.
Other Ways to Improve Sleep Without Meds
Other non-drug methods to improve sleep include a healthy diet, proper hydration, dietary changes, and stress management like meditation. Aerobic exercise is known to improve both sleep quantity and quality. (Kovacevic A. et al., 2018) Lifestyle behaviors outside exercise are also important for sleep. Sleep hygiene refers to having healthy sleep habits and behaviors at night. This includes optimizing pre-bedtime routines to prepare the mind and body for sleep and improving bedroom environments to ensure sleep support, meaning it is cool, dark, quiet, and free from distractions like phones. Another important method of improving sleep is listening to your body and not forcing yourself to stay up late when exhausted. Pushing the brain and body to stay up later leads to chronic sleep debt. Eating sugary and high-fat foods before bed can hinder sleep patterns. Drinking caffeine after dinner or close to bedtime can disrupt the sleep cycle, as well as alcohol consumption before bed can hurt sleep quality.
Injury Medical Chiropractic and Functional Medicine Clinic
Individuals need rest time to adjust to working out, so consult a doctor on the balance of rest and training. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Weight Loss Techniques
References
Hirohama, K., Imura, T., Hori, T., Deguchi, N., Mitsutake, T., & Tanaka, R. (2024). The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials. PloS one, 19(6), e0301616. doi.org/10.1371/journal.pone.0301616
Cunningham, J. E. A., & Shapiro, C. M. (2018). Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review. Journal of psychosomatic research, 106, 1–12. doi.org/10.1016/j.jpsychores.2017.12.012
Carbone, E. A., Menculini, G., de Filippis, R., D’Angelo, M., De Fazio, P., Tortorella, A., & Steardo, L., Jr (2023). Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. International journal of environmental research and public health, 20(5), 4431. doi.org/10.3390/ijerph20054431
Alley, J. R., Mazzochi, J. W., Smith, C. J., Morris, D. M., & Collier, S. R. (2015). Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure. Journal of strength and conditioning research, 29(5), 1378–1385. doi.org/10.1519/JSC.0000000000000750
Roig, M., Cristini, J., Parwanta, Z., Ayotte, B., Rodrigues, L., de Las Heras, B., Nepveu, J. F., Huber, R., Carrier, J., Steib, S., Youngstedt, S. D., & Wright, D. L. (2022). Exercising the Sleepy-ing Brain: Exercise, Sleep, and Sleep Loss on Memory. Exercise and Sport Sciences Reviews, 50(1), 38–48. doi.org/10.1249/JES.0000000000000273
Kovacevic, A., Mavros, Y., Heisz, J. J., & Fiatarone Singh, M. A. (2018). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep medicine reviews, 39, 52–68. doi.org/10.1016/j.smrv.2017.07.002
Should individuals wanting to engage in the exercise start with a warm-up and end with a cooldown to prepare the muscles for optimal performance and post-workout recovery?
Warming Up, Cooling Down
Warming up 5 to 10 minutes before exercise is beneficial for pumping blood to the muscles and preparing them for a run. Dynamic or active stretching and light aerobic activity are a few ways to warm up. This could be active stretching, such as walking lunges, brisk walking, or riding a stationary bike for a few minutes before running. However, individuals should avoid static stretches before running, as they can increase the risk of injury. The minimum length of time for an effective cooldown session is five minutes. Depending on the intensity of the workout, individuals may choose to extend that to 10 minutes.
Steps for a Running Warmup
Do five to 10 minutes of light aerobic exercise to loosen up muscles.
Walk briskly, march, jog slowly, or cycle on a stationary bike.
Don’t rush.
Perform dynamic stretches and movements during the warmup, including walking lunges, jumping jacks, or toe touches.
Begin the run with a slow jog and gradually increase speed.
Slow down if you run out of breath.
This is part of knowing how fast you should run; starting too fast is a common mistake.
Pay attention to posture and form.
Ensure you are using the best technique before speeding up.
Warm Up Benefits
When warming up, the blood vessels dilate. The increased blood flow primes the muscles with oxygen and prepares them to perform at their best. Blood flow also increases the temperature in the muscles for enhanced flexibility. Allowing the heart rate to increase gradually is beneficial, instead of going full max heart output by jumping full speed into the running. (The American Heart Association, 2024)
Properly Cooling Down
At the end of the run:
Cool down by walking or slowly jogging for five to 10 minutes.
Breathing and heart rate should gradually return to normal.
Drink water or an electrolyte-infused drink to rehydrate the body.
Benefits of a Cooldown
The cool-down keeps blood flowing throughout the body at a consistent level. Stopping immediately can cause light-headedness because heart rate and blood pressure can drop rapidly. Winding down slowly allows heart rate and blood pressure to fall gradually. The cooldown is also a good mental transition from the intensity and accomplishing the workout.
Before or After Stretching
Stretching evidence shows it doesn’t have the benefits once thought. Static stretching before, during, or after exercise has not been shown to prevent injury or delayed onset muscle soreness. (Herbert R. D., de Noronha M., & Kamper S. J. 2011) Stretching cold muscles is not recommended. However, there is some evidence that dynamic or active stretching after a warmup can benefit performance. Active stretching is done with exercises that take the muscles through their full range of motion and mimic the actions that will be done during the workout. (Van Hooren B., & Peake J. M. 2018)
Stretching After Running
Standard stretching includes the hamstring stretch, quad stretch, calf stretch, low lunge stretch, IT band stretch, butterfly stretch, hip and backstretch, arms and abs stretch, and triceps stretch. Tips for proper stretching:
Don’t Bounce
Avoid bouncing, as this mimics pulling a rubber band back and forth. You want the muscle to stay stretched.
Hold the stretch for 15 to 30 seconds.
Don’t Stretch Through Pain
Don’t stretch beyond the point where tightness is felt in the muscle.
Do not push through muscle resistance.
Never stretch to the point of pain.
Stretch Whole Body
Don’t just stretch the areas with tightness and/or soreness.
Stretch the whole body equally to prevent injury.
Don’t Hold Your Breath
Take deep breaths during the stretch.
Stay relaxed and breathe in and out slowly.
If starting a new fitness routine, consult your healthcare provider to determine the optimal running warmups and stretching exercises.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Herbert, R. D., de Noronha, M., & Kamper, S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane database of systematic reviews, (7), CD004577. doi.org/10.1002/14651858.CD004577.pub3
Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. doi.org/10.1007/s40279-018-0916-2
For individuals who are looking to lower blood pressure, can walking help?
Walking To Lower Blood Pressure
A walking regimen is an accessible workout that can be done almost anywhere at no cost, effectively lowering blood pressure and improving overall health. Studies show that individuals who use walking as a workout for three months have improved systolic blood pressure, which is the top number that measures the pressure in the arteries as the heart beats. (McMullan S., Nguyen C., & Smith D. K. 2022)
How It Works
Walking is an excellent way to get active. It can be done almost anywhere, including on a treadmill, outdoors, or around the house. Exercising lowers blood pressure by strengthening the heart, leading to the heart pumping blood more effectively when it is stronger. This causes less resistance to the blood vessels, which lowers overall blood pressure. (Hegde S. M., & Solomon S. D. 2015) The benefits of walking include: (American Heart Association, 2024)
Weight loss and management
Lowers stress
Improves mental health by reducing anxiety.
Improves sleep quality
Improves cognition
Strengthens the heart
Promotes bone health and reduces the risk of osteoporosis.
Knowing When to Take A Blood Pressure Reading
Various factors can affect blood pressure readings and can include:
Nervousness
Eating a meal
Drinking caffeine
Exercise can affect blood pressure readings.
Knowing how and when to take a blood pressure reading after walking can help prevent false elevated numbers. According to the CDC, individuals should wait at least 30 minutes after exercise before taking a reading (Centers for Disease Control and Prevention, 2024). Exercise and walking have been shown to cause an immediate reduction in systolic blood pressure. This is known as post-exercise hypotension and is normal. The reduction lasts around 24 hours after exercising and is more noticeable in those with high blood pressure. Consistent exercise and walking will cause a longer, more sustained blood pressure reduction. (Hegde S. M., & Solomon S. D. 2015)
It is recommended not to talk while the blood pressure is being taken.
Apply the blood pressure cuff snugly around the arm.
Place your arm on a table, level with your heart.
Sit in a chair, keep your feet flat on the floor, and do not cross your legs or lean back on the chair.
It is recommended not to eat or drink 30 minutes before and to have an empty bladder.
Pace and Intensity
A study found that walking three to five times weekly for 20 to 40 minutes at a moderate pace for three months can lower systolic blood pressure. However, various groups determined BP rates differently by measuring heart rate, VO2 max/the maximum volume of oxygen you can use simultaneously, and walking speed. (McMullan S., Nguyen C., & Smith D. K. 2022)
Increasing Workout Intensity
Individuals with hypertension who walk may want to increase workout intensity to challenge themselves for added fitness. This can include:
Walk faster
Use intervals – walk as fast as you can for a minute or two at a time.
Add inclines
Use ankle or wrist weights or a weighted vest.
Walking with someone to challenge each other to push a little harder.
Try other places to walk.
Always talk to a healthcare provider if you are starting a walking workout for the first time, want to increase walking intensity, and take medications prescribed by a healthcare provider.
Hypertensive Crisis
A hypertensive crisis is when a person’s blood pressure is extremely high, can cause life-threatening conditions like stroke, and is a medical emergency. It is a blood pressure of 180/120 mm Hg or higher. (American Heart Association, 2024) If you get a blood pressure reading of 180/120 mm Hg or higher at home, wait five minutes and take another reading. If the blood pressure is still high, immediately contact a healthcare provider. (American Heart Association, 2024) If the individual is experiencing the below symptoms, call 911 (American Heart Association, 2024)
Chest pain
Shortness of breath
Vision changes
Difficulty speaking
Weakness
Numbness
Back pain
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Hypertension Explained
References
McMullan, S., Nguyen, C., & Smith, D. K. (2022). Can Walking Lower Blood Pressure in Patients With Hypertension?. American family physician, 105(1), 22–23.
Hegde, S. M., & Solomon, S. D. (2015). Influence of Physical Activity on Hypertension and Cardiac Structure and Function. Current hypertension reports, 17(10), 77. doi.org/10.1007/s11906-015-0588-3
For older individuals looking for a workout that can help improve overall fitness, can kettlebell training help achieve health goals?
Kettlebell Training At Any Age
Previous research found that training with a kettlebell can improve aerobic capacity, balance, and core strength. New research suggests that kettlebell training is beneficial at any age (American Physiological Society, 2024). Compared to dumbbells or barbells, the kettlebell’s specific shape—a sphere on the bottom and a handle that can be grabbed by one or both hands—better emulates how the body moves through daily tasks and activities. When isolating a muscle, like a bicep, only that muscle is getting worked out. But in everyday life, a lot of what the body does is lifting and moving things. A kettlebell allows those muscle groups to connect in a stronger and more efficient movement.
Benefits At Any Age
A research study examined how using kettlebells impacted the health of individuals from different backgrounds without prior exposure to resistance training between the ages of 60 and 80. The participants enrolled in a twice-a-week exercise program using kettlebells to improve fitness. At the end of six months, the researchers found the participants had increased muscle mass and grip strength. At the end of the year, the participants had lower inflammation markers in their blood and had met other fitness goals, including climbing stairs faster and making multiple chair stands/standing from a seated position. The researchers say the findings show how effective kettlebells can be for all ages and demonstrate that the kettlebell training program leads to benefits even in older individuals just starting. (American Physiological Society, 2024) The kettlebell’s unique shape allows for an offset center of gravity from the handle, encouraging increased engagement of stabilizing muscles. This combination of strength and functional movement patterns helps to improve the following:
Balance
Coordination
Core stability
This makes it a versatile tool for older adults.
Getting Started
For individuals just starting kettlebell training, it is recommended that they work with a certified instructor or find a beginner’s class. Guided training ensures proper technique and form and reduces the risk of injury. To avoid common kettlebell mistakes when lifting weights for the first time, start with lighter kettlebells to master form and focus on slow, controlled movements. When lifting weight from the ground to the chest, don’t pull with the shoulder muscles. Instead, start in the legs and let the energy move up through the body, known as the kinetic chain. When exercising, spend only 20 to 30 seconds on a rep before resting for 30 seconds, and don’t spend more than five minutes on a single exercise. (American Council on Exercise, 2015)
Injury Medical Chiropractic and Functional Medicine Clinic
Individuals who want to start an exercise routine should consider kettlebell training. Following basic tips and training slowly, kettlebells can be an option for anyone looking to improve their fitness and overall health. Consider working with a personal trainer to ensure safety and get the most out of workouts. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Can Pilates exercise movements be performed in bed for individuals recovering from illness or injury?
Bed Pilates
Pilates exercises can be practiced in bed. Joseph Pilates’ exercises and equipment, such as his patented V-shape bed, were designed to help rehabilitate injured individuals who had to stay on or near a bed. After a healthy night’s sleep, Pilates exercises dynamically stimulate circulation and the nervous system. They can also be used to calm the mind and body before going to bed.
Those with health concerns should check with their healthcare provider before starting any exercise program to ensure safety.
Beginners are recommended to learn the Pilates principles and movement fundamentals.
Here are a few Pilates mat exercises adapted for individuals who need or prefer to exercise in bed. A firm mattress is recommended, as a soft mattress will mess up the correct form, making the exercise ineffective.
Spine Twist
This exercise helps improve the flexibility of the spine and core, making it easier to move around, and supports healthy posture. (Geremia J. M. et al., 2015) Pilates exercises like the spine twist have been found to reduce low back pain and disability. (Notarnicola A. et al., 2014) To perform:
Sit up in bed, torso straight, abs engaged, and inhale.
Exhale as you turn your head and shoulders to the right.
Keep your torso straight, and imagine growing taller through the turn.
Inhale as you return to the starting position.
Exhale and turn to the other side.
Repeat five times on each side.
Tendon Stretch
The tendon stretch helps by improving flexibility in the hamstrings and calves. (Chinnavan E., Gopaladhas S., & Kaikondan P. 2015) To perform:
Sit up straight, legs straight out.
Bring heels together and use a towel to pull your feet towards you while pushing your heels away.
Hold for three seconds.
Next, without the towel, point your toes away.
Hold for another three seconds.
Do ten reps.
Double-Leg Stretch
The double-leg stretch is an intermediate exercise that works the abdominals and the core. If this move feels difficult, start with one leg at a time. Another option is to keep the knees slightly bent instead of extending the legs fully. To perform:
Bring both knees to your chest and, with your hands, press down on the ankles to stretch the lower back.
Pull in the abdomen.
Exhale and extend the arms up and the leg or legs as far out in front as possible.
Hold the position for ten seconds and then release.
Do ten reps.
Pelvic Curl
The pelvic curl builds strength in the lower back and core. To perform:
Bend knees and place feet on the bed hip-distance apart.
Curl your pelvis, squeeze the glutes, and lift your body.
A hip-opening exercise, or frog, can be done while lying down or sitting in bed. Hip openers help keep the spine and hips flexible and in alignment. To perform:
Bring the soles of your feet together and as close to the torso as possible.
Let the knees open up as far as possible, and that feels comfortable.
While in the stretch, breathe in and out as deep as possible.
If sitting, place hands on ankles and use forearms to push down on the knees for added stretch.
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Home Exercises for Pain Relief
References
Geremia, J. M., Iskiewicz, M. M., Marschner, R. A., Lehnen, T. E., & Lehnen, A. M. (2015). Effect of a physical training program using the Pilates method on flexibility in elderly subjects. Age (Dordrecht, Netherlands), 37(6), 119. doi.org/10.1007/s11357-015-9856-z
Notarnicola, A., Fischetti, F., Maccagnano, G., Comes, R., Tafuri, S., & Moretti, B. (2014). Daily pilates exercise or inactivity for patients with low back pain: a clinical prospective observational study. European journal of physical and rehabilitation medicine, 50(1), 59–66.
Chinnavan, E., Gopaladhas, S., & Kaikondan, P. (2015). Effectiveness of pilates training in improving hamstring flexibility of football players. Bangladesh Journal of Medical Science, 14(3), 265–269. doi.org/10.3329/bjms.v14i3.16322
Can performing the hip hinge exercise movement help individuals with lower back pain?
Hip Hinge Exercise
A hip hinge is a controlled movement that involves bending forward from the hips while keeping the spine neutral. The thoracic, lumbar, and pelvis stay neutral while bending forward. The movement comes from the hips, preventing the thoracic and lumbar spine from flexing or rounding. It is a fundamental movement that helps prevent back injuries and strengthens the glutes. It’s used in everyday activities, like picking up objects and sitting down.
The hip hinge exercise targets the posterior chain or back muscles, including the lower back, the glutes, and the hamstrings. It also strengthens the core or abdominal muscles to assist in the movement. When the body hinges at the hips, the bend occurs at the hips, and the spine stays neutral. When the lower back hinges or bends, this causes pain and reduces the range of motion.
Performing the Movement
A wooden dowel, broom handle, or PVC pipe can be used as a guide to help achieve the proper positioning and learn the correct form. Place the dowel or pipe vertically on your back, anchoring it to the head, shoulder blades, and tailbone.
Grasp one end with your right hand in the natural curve of your neck and the other with your left hand in the small of your back. Ensure the dowel touches the back of your head, upper back, and the area where the lower back meets the sacrum. To perform the hip hinge:
Stand with your feet shoulder-width apart
Shift your weight to your heels and
Push your hips back while hinging your torso forward
Keep your chest open and back flat
Slightly bend your knees
Visualize sticking the butt out
The dowel should not lose contact with the three points as you hinge. If it does, the movement is incorrect.
Lower your torso until it’s midway between vertical and parallel to the floor.
Pause when your torso is about 45 degrees
Keep a slight bend in your knees during the downward and upward phases.
Reverse the movement by contracting your glutes and pushing your hips forward and upward to return to the starting position.
Repeat
Benefits
The hip hinge is a fundamental movement pattern that helps the body perform essential tasks such as bending over and picking things up without worry of pain or injury. It’s also required in strength training exercises like the deadlift, kettlebell swing, power clean, and more. The exercise can help strengthen the core, reduce back pain, improve balance, and improve flexion, extension, and trunk rotation. (Michaud F. et al., 2021) Stronger core muscles can increase fitness and athletic performance. (Clark D. R. et al., 2018)
Variations
It is a challenging movement that requires plenty of practice. Individuals who can’t perform it correctly after a few tries may need to modify the movement.
Wall Variation
Using a wall as a guide is an easy way to make the movement easier.
To do this, stand with your back to a wall, about three inches away.
Start hinging at the hips by sticking your butt out touching the wall.
Keep a neutral spine and a flat back.
Once you can do this several times, try stepping out another inch or two and perform the same modified motion. Stick with this until you are away from the wall and can do a full hinge without the wall.
With A Kettlebell
Once you master the basic hinge, you can elevate it using a kettlebell to make this move more difficult.
Start with the kettlebell swing exercise and progress to more challenging moves with the kettlebell.
Common Mistakes
Be aware of common mistakes to keep the move effective and reduce the risk of injury.
Treating the Move Like a Squat
The hip hinge is not the same as a squat.
This is a common misconception. When squatting, the knee joint determines the movement pattern.
But when hip hinging, the movement starts at the hips.
Not Engaging the Core Muscles
This exercise requires core engagement throughout the entire movement.
If these muscles relax, there is an increased risk of dipping the hips during the hinge, which can cause the lower back to dip and cause pain.
Using the Lower Back
Bending or hinging with the lower back rather than letting the hips generate the movement.
Using the wall as a guide can help reduce and eliminate excessive bending at the waist.
Lost Dowel Contact
If the dowel loses contact with one or more set-up positions on the back, the hinge is not being executed correctly.
If your head loses contact with the dowel, the neck is flexing too far forward.
If you lose contact with the sacrum or lower back area, the spine is flexing too much.
If you lose contact with the mid-back, the knees are bending rather than the hips.
Safety
Stop and check your form if you feel back pain during any part of the movement. The movement may need to be modified further or decrease how far the hinge is at the hips. If the pain continues, discontinue the exercise and talk with a doctor or a physical therapist before reattempting the exercise. The dowel is a great tool to help maintain a neutral spine. If you cannot perform the hip hinge while keeping the dowel in contact with the body, you might benefit from working with a personal trainer or physical therapist who can walk you through the steps with the correct form.
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Chiropractic: The Secret to Unlocking Mobility
References
Michaud, F., Pérez Soto, M., Lugrís, U., & Cuadrado, J. (2021). Lower Back Injury Prevention and Sensitization of Hip Hinge with Neutral Spine Using Wearable Sensors during Lifting Exercises. Sensors (Basel, Switzerland), 21(16), 5487. doi.org/10.3390/s21165487
Clark, D. R., Lambert, M. I., & Hunter, A. M. (2018). Contemporary perspectives of core stability training for dynamic athletic performance: a survey of athletes, coaches, sports science and sports medicine practitioners. Sports medicine – open, 4(1), 32. doi.org/10.1186/s40798-018-0150-3
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