Personal Trainer's Guide: Exercising After a Herniated Disc

The average full-time personal trainer works with 15 to 25 clients and delivers 30 to 50 training sessions each week. Of those 15 to 25 clients, it's estimated that 80 percent of them will have back problems at some point! After all, back pain is the most common orthopedic condition and the single leading cause of disability in adults worldwide (1).

The back is a complex region of the body made up of bones, joints, muscles, and ligaments. All of which can be injured, stressed, or irritated to cause back pain. The literal backbone of the back is the spinal column. This surprisingly strong skeletal structure is protective, but also flexible to allow mobility and stability for the human body. It also serves to protect the spinal cord and the spinal nerves that control body movement and functions.

One condition a personal trainer is bound to see in clients is spinal disc degeneration. This gradual age-related wear on the vertebral discs can lead to a more severe condition: a herniated disc. Also called a slipped disc or a bulging disc, a herniated disc happens when a part of the vertebral disc nucleus is pushed into the spinal canal through a tear or rupture in the protective structure called the annulus fibrosus that connects one vertebra to another adjacent vertebra.

Some people will see a physical therapist to manage the symptoms and pain caused by a disc herniation. A physical therapist can help to alleviate a spinal disc injury with exercises to strengthen the back—specifically the muscles that support the spinal column. However, not every herniated disc requires medical attention. A personal trainer or corrective exercise specialist is also armed with the knowledge to strengthen and stretch the back to help minimize pain.

Symptoms of a Herniated Disc

A disc herniation can compress the spinal nerves in the process. This can cause shooting pain in the arm or leg with movement or even a sneeze. The location along the spine will affect where pain may be felt. If the slipped disc is in the cervical spine (cervical herniated disc), pain will likely be in the shoulder or arm. If the herniation is in the lumbar spine (lumbar herniated disc), typically pain will occur in the glutes, thigh, and possibly the calf and often affects the sciatic nerve.

Numbness and tingling can also occur. Again, the location of the herniation along the spine will affect which extremities feel the sensation. In some cases, muscle weakness can happen due to nerve compression from a herniated disc.

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Training a Client with a Herniated Disc

While some people may think they need to stop exercising if they have a disc herniation, this is not the case! Exercise is recommended for people with a disc injury with the main goal of strengthening the muscles of the back to support the spine. It is true that strenuousactivity should be avoided, but light resistance training in physical therapy or with a trainer can help reduce mild herniated disc pain.

Top Exercises for a Personal Training Client with a Herniated Disc

The focus of exercise for someone with a slipped disc or sciatic nerve pain is to strengthen the muscles of the back. Here are the top 5 exercises to do just that as well as build overall core strength to support the spine.

1. Plank

A prone plank from the elbows is a great way to build overall core strength and specifically focus on the muscles that support and stabilize the spine.

Start lying face down on a mat. Place the elbows directly under the shoulders with the hands pointing forward. Tuck the toes and lift the body until the body is in one straight line from head to heels. Hold for 15 to 30 seconds before relaxing.

Modification: Can be performed from the knees instead of the toes until proper strength is built.

2. Cobra pose

This yoga posture builds strength in the shoulders, triceps, glutes, hamstrings, and erector spinae to improve posterior chain strength.

Start lying face down on a mat with the feet relaxed. Bring the hands directly underneath the shoulders. Press through the hands and lift the chest while keeping the hips and thighs on the mat. Relax the shoulders away from the ears. Hold for 15 to 30 seconds before relaxing.

Modification: Come to the elbows instead of the hands.

3. Seated row

Remaining in a seated position (as opposed to a standing bent over position) will protect the spine as you build strength in the latissimus dorsi and spinal stabilizer musculature.

From a seated position with a soft bend in the knees, grab the handles of the row machine. Sit up tall with the core engaged and arms long. Shoulders stay down away from the ears through the whole range of motion. Gently retract (pull back) the shoulder blades, flex the elbows, and pull the handles in towards the body (just above the belly button). Hold for a count of 2 before extending the elbows and lengthening the arms back to the starting position. Repeat 1 to 15 repetitions before resting.

4. Posterior pelvic tilt

This small movement of the hips forward can help to strengthen the lumbar spine and supporting muscles including the glutes.

Start in a standing position with a soft bend in the knees and a neutral spine. Gently squeeze the glutes and tuck the hips under the body (forward) to extend the lumbar spine without moving the upper body. Hold for 3 to 5 seconds before relaxing back to a neutral spine. Repeat 10 to 15 repetitions.

5. Birddog

This core strengthening exercise can help with the muscles that extend the spine, the glutes, and the muscles of the upper back.

Start kneeling on all fours. Ensure the hands are directly underneath the shoulders. Extend the left arm forward from the shoulder as you extend the right leg behind. Try to keep the back flat and the hips level. Hold for a count of 2 before returning to all fours. 5 to 10 repetitions can be completed on one side before switching or you can alternate sides for a total of 5 to 10 reps on each.

Relieving spinal disc pain is more than just strengthening the back! Learn about effective glute exercises that can help alleviate back pain in this informative ISSA blog: Great Glute Exercises for Low Back Pain.

Exercises Your Personal Training Client Should Avoid with a Herniated Disc

Several exercises should be avoided for a client who has a herniated disc. First, heavy resistance training is not advised since it can place excessive pressure on the spine and make the pain (or the herniation) worse. Clients with a bulging disc in their lumbar spinal region should also avoid loaded movement patterns like the deadlift, back squat, or front squat. These heavy compound movements may irritate the sciatic nerve, jar the spine, and cause additional pain.

Other exercises to avoid include:

• Sit-ups or crunches - any core movement pattern that involves pulling on the neck can make pain worse.

• Superman - for many people, the superman core exercise places too much pressure on the spine. Substitute the birddog instead!

• Athletic activities - unfortunately, most sports have abrupt movements that can really jar the spine and make spinal pain worse.

• High-impact exercise - any activity like running, high-impact aerobics, or jumping can place a lot of force on the spine and intervertebral discs.

If you have a passion for fitness and want to learn more about common posture and movement dysfunctions, become an ISSA Corrective Exercise Specialist today!