What to Do in Group Fitness Classes (When You Have Chronic Back Pain)

Don’t let back pain keep you out of the gym or studio—virtual or otherwise. Here’s our top tips to for group fitness classes when your back always hurts.

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If you struggle with low back pain you might be skeptical about group fitness classes involving core exercises. Will the instructor have the skills and the patience to make accommodations for me? In a virtual class, will I be able to talk to the instructor about my concerns? I know I should strengthen my core, but what if the exercises make my pain worse? All of these questions are legitimate. And even though they should, not every fitness instructor will offer modifications.

group fitness back painYou can participate in group fitness classes despite your back pain. We'll show you how.

But that doesn’t mean you need to completely avoid group fitness. A little knowledge can empower you to approach novel moves safely, and ultimately help you get fitter and stronger—without exacerbating your low back pain.

We talked to Theresa Marko, DPT, board-certified clinical specialist in orthopedics in New York City and SpineUniverse Editorial Board member, to find out why  those with low back pain should prioritize core strength—and how to do so safely in a group format.

Why Core Strength Matters

“The core is basically a box,” explains Dr. Marko. “It has a top, a bottom, and then it has sides.” Far from being flimsy cardboard, this box is made of muscle. It helps support your entire body and even helps you breathe.

  • Top: The diaphragm muscle
  • Bottom: Pelvic floor
  • Sides: Internal and external obliques and the transverse abdominus (TVA), a key muscle that’s weak in many people, way down deep around your sides
  • Front: Rectus abdominus, the six-pack muscle
  • Back: Paraspinals, quadratus lumborum, and the little-known but very important multifidi, the deep muscles that attach the vertebrae to one another

According to Dr. Marko, whether you’re performing activities of daily living (ADL’s) or planks, all areas need to be strong. “You couldn't ship a package if you were missing one side of that box.”

When your core is too weak to give your bones adequate stability, the core muscles may not contract as they should. Instead, they go into “panic mode” and in an attempt to protect your spine, tighten too severely—leaving you with a painful muscle spasm.

Exercises

To develop strength and avoid pain in a fitness class, you may need to proceed with caution or avoid some exercises altogether. To help you prepare, we’ve categorized some common core exercises into three groups: Green (safe), Yellow (be careful), and Red (avoid). As always, consult your physical therapist or other medical provider before attempting any exercise program.

Green

While you should be able to complete these exercises without problems, always listen to your body and stop if you feel pain.

Bird dog        

To perform:

  1. Get on hands and knees.
  2.  Extend one leg back, extending at the hip and the knee. Focus more on extending your leg behind you than upward, engaging your glutes.
  3.  Repeat with the other leg, alternating legs.
  4.  When you feel comfortable kicking back with your legs, add arms; while extending one leg back, extend the opposite arm forward, straightening at your elbow, avoiding arching your back.

Group fitness bird dogBird dogs are safe, effective exercises for people with back pain.

This exercise targets your back extensors, a muscle group that’s often neglected. Marko recommends doing this exercise in front of a mirror to be sure you’re not arching your back.

Dead bug

To perform:

  1. Lie on your back.
  2.  Extend your arms toward the ceiling and bend your hips and knees to 90 degrees. While extending one arm down to the floor above your head with your palm up, bring the opposite leg down so your heel is on the floor. Avoid arching your back.
  3.  Bring your arm and leg back to the original position and repeat with the opposite arm and leg.

While this move focuses on your abdominal flexor muscles, like with bird dog, it’s key to avoid arching your back.

Yellow

Approach these exercises slowly and cautiously.         

Abdominal crunch

To perform:

  1. Lie on your back with your knees bent and feet on the floor.
  2. With your palms against your neck for support and hands clasped, flex your abdominals to elevate your shoulder blades off the floor.

A common mistake, says Dr. Marko, is attempting to overdo this one. Because your rectus abdominus only has 45 degrees of flexion available, there’s no benefit in attempting to bring your chest any closer to your knees. (Full-sit ups, she says, are best avoided by people with low back pain and “a waste of your time” for everyone else.) While doing a crunch, Dr. Marko suggests imagining your stomach as an elevator, pulling you up to the ceiling.

While many people with low back pain can perform crunches safely, Dr. Marko says to avoid them if you have a herniated disc, or trouble with trunk flexion or extension.

If you can’t safely do a crunch, try heel taps instead.

To perform:

  1.  Lie on your back with your legs up, your hips and knees at a 90 degree angle.
  2. With your back flat and your core engaged, slowly bring one leg down so that your heel touches the floor.
  3. Bring your leg back to the starting position and perform with the other leg, continuing to alternate sides.

Plank

To perform:

With your chest facing the floor, rest your weight on your forearms and your toes and hold this position for an isometric exercise. Start with 20 seconds at a time and make sure you breathe.

Group fitness planksBe careful with planks if you have spine trouble.

No matter how you approach the plank, it’s important to avoid arching your back; by putting your lumbar spine into extension, this engages your hip flexors and rather than your core.

If you can’t maintain good form with a traditional plank, here are a few modifications:

  • Instead of resting your weight on your forearms, straighten your elbows and press your weight into your palms. (This stance is great for building shoulder girdle stability.)
  • Instead of resting your weight on your toes, support yourself on bent knees.
  • Rather than pressing your upper body into the floor, use a higher surface such as a sofa or a bed.

Red

You’re better off completely avoiding these exercises.

Hip-up (a.k.a. side bend)

To perform:

  1. From a side-lying position, rest your weight on the outside of one foot and your same-side elbow.
  2. Using your obliques, lower your hip down to the ground and then raise it back up.

According to Dr. Marko, due to the stability plus the contraction it requires, the hip-up is an advanced move to steer clear of if you have low back pain.

Modifications to try:

  • Hold a side plank, maintaining the “top” position of the hip-up move for up to 30 seconds.
  • Hold a side plank with your weight resting on the outside of your knee rather than your foot.

Mountain climbers

To perform:

  1. Assume the top of a push-up position, with your weight in your palms and toes.
  2. While supporting your upper body with your hands resting on the ground, bend one leg forward, flexing at the hip and knee so your knee is directly under your chest in a forward lunge. Then bring it back to the starting position while bringing your opposite leg forward, alternating legs.

To do this move with correct form, you must hold your pelvis stable and avoid arching your low back. In other words, you need a tremendous amount of core stability in two different planes of movement (up and down and side to side). Compared to a traditional plank, it’s like jogging versus walking, says Dr. Marko.

If the class goes into mountain climbers, stick with a plank or a modified plank.

Don’t let uncertainty and fear keep you from trying that group fitness class you’ve been curious about. A little preparation will go a long way in keeping you safe and pain-free during your next workout.

Updated on: 10/16/20
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Theresa Marko, DPT
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