A person with spinal stenosis will have pain
in the lower back and legs when they walk. The pain almost disappears when they bend
forward and sit down. But, they start walking again and boom, there is the pain again.
The pain is even worse when they walk downhill, or if they try to walk straight up like this.
So, the person will end up bending forward to alleviate the pain when they walk.
This is the shopping cart sign and it is usually caused by spinal stenosis.
Today, I’ll show you 4 resting positions to alleviate pain from spinal stenosis. Plus, 10
exercises that you can do to improve your pain AND walking tolerance, and 3 activities
modifications to help alleviate your symptoms. Let’s talk about spinal stenosis today
Spinal stenosis is a term that we use when there is a narrowing of the spinal canal, the
canal is the hole inside the spine to protect the spinal cord. Stenosis means narrowing.
So, when there is osteoarthritis of the spine, or slipping one vertebra over the other
one, this causes compression on the nerves that go to both legs and leads to pain.
When you bend forward, the spinal canal is opened and the compression stops. When you walk,
the veins of the spinal cord get full of blood and this occupies the space in
the canal, causing more compression. Before you start this routine that I recommend
in this video, I suggest you get a pedometer, and start a diary of how many steps you can walk
every day, and take note every day for a whole week. Then, take the average for the week.
There are some Apps for your smartphone and they do this for you, or some fancy pedometers
that connect to your watch or your computer. The most important is that you track the
amount of steps you can take every day, for one week, before you start the exercises
I recommend in this video, and then, as you progress, you should be able to walk longer
without having to stop because of the pain. Some people may have a poor circulation
in their legs. They have blockages of the arteries that bring oxygen to the legs, so
they also have pain in the legs when they walk, and they get better when they stop. This is called
vascular claudication. That is why it is important to see a doctor to get a proper diagnosis,
if your problem is coming from the nerves in the spine or from the circulation in the legs.
Spinal stenosis cause neurogenic claudication and claudication is the term that we use to
describe when a person has to stop walking, and poor circulation causes vascular
claudication, so this is spinal stenosis, neurogenic claudication. This is
circulatory problems, circulation problem,s and this is called vascular claudication.
First, I'll show you four relieving positions that you can use when your pain is really aggravating
and they are really good to relieve the pressure on the nerves and the spinal cord, and those four
positions you can try many times you want to, during the day, instead of taking a
painkiller, instead of taking an analgesic, you can try these positions, and
then your pain would be much better. This is the first position to alleviate the
symptoms of spinal stenosis. It's called the zed-lie position, so you lie down on the floor
or on a ma, or on the carpet, put a pillow under your head, get a chair, and a chair, or this can
be your couch, and you put your knees and your legs there, and adjust the position until you can
feel that your knees are above your abdomen level, and the small of your spine, here the lumbar
spine, is relaxed, and once you find this position, you can stay here for a couple of
minutes and adjust, and you can bring closer and adjust, and once you find this position, you
can be here for five minutes, ten, even twenty or thirty minutes to alleviate the pressure, and pain
on your lumbar spine. You may have noticed that i showed this position this z-lie position in my
previous videos for disc problems, degenerative disc disease, facet joint syndrome, lumbar disc
herniation, sciatica, and now for spinal stenosis, so because this is an excellent position to
really relax the pressure on your lumbar spine. This is the second position to
relieve the symptoms. It's called knee to chest. You're going to lie down
a mat with a pillow under your head, and then you're going to start slowly
bringing your knees towards your chest, and here, you see the small of my spine, the
lumbar spine, is flat, and then i'm going to wrap around, you can wrap around your knees,
but if you have knee pain you may do this under your knees, it doesn't matter for the spine,
but just try to avoid knee pain when you do this, so here, you're going to wrap your arms around
your legs and relax, the most important thing is that you breathe, relax, so try not to do this,
okay? Stop, don't hold like this because your blood pressure will go high, so relax your head.
Relax your arms here around your legs, and stay in this position for a couple of minutes, maybe five
minutes, if you can, until your pain is relieved. This position is the prayer stretch, and
you're going to find a mat, and you're going to kneel down, here with your feet stretched
here, and you're going to start sliding down in front of you with your hands apart, and
you're going to start going down, down, down, tuck your chin inside, and go in front
go, go, go, and stay in this position. Try to relax your lumbar spine, and
try to relax your arms and shoulders, and do this for about five minutes. Stay in this position if you can, and then come back slowly when you finish. Be
careful that you don't get dizzy when you get up. So this is the seating flexion. Sitting
on a chair with your knees apart, you're going to start flexing, bending forward,
and you're going to try to bring your head to your lap, and if possible
touching your hands on the floor, tuck your head in between your knees, and
stay in this position to relax your spine. And try to stay here until you're relaxed, come back slowly not to feel
dizzy when you're coming back. Schedule some time to do activities and
alternate with times to rest in these positions. Now, I’ll show you the 10 exercises that may
help with your pain and walking tolerance. If you do these exercises daily, you may
notice that you can walk for a longer time before you have to stop due to pain. You need to
practice these exercises at least 3 times a week, for 1 month before you notice any improvement.
Don’t expect that doing this routine only once you will see a lot of improvement. If you stick to
this routine for 6 months, your walking tolerance can improve immensely. That is way I
recommend you to take a baseline measure with the pedometer now, before you start.
1. Chair cycle or stationary bike. It is very important to maintain a good conditioning
of the muscles in the thighs and legs. Usually when people have pain when they walk, they tend
to become more sedentary and avoid walking. When you use a stationary bike
like this, or even a chair cycle, you will maintain the muscles in shape,
and good circulation to your legs. Because you can bend forward, it should not
aggravate your pain. If you have been very sedentary, you can start with 5 minutes a day,
and increase to 10 minutes, 20 and 30 minutes. So this is the pelvic tilt on the
on the wall. It's important that you do this for your posture, and to relax
your lumbar spine, and you can find a wall, a door, anywhere you are, or even standing
up in line, you can be doing this exercise, so what you'll be doing is you bend your knees a
little bit, go down, and then you tuck your navel in, you touch all of the bones here, and then
out, so then you'll be doing in, tuck in and out. This is the cat-cow position. So the first
thing you're going to do is: look up and sag your spine down, look up and here, increasing
the curvature of the spine, and alternate this with looking down, and curving your lumbar
spine up, up, up, so like your navel going up, and now the spine goes down, and
you look up, this is the cow, and alternate with the cat.
And you can repeat this 8 times, and increase to 12, and 20 repetitions.
So, the next exercise is the bird-dog. So here again on your four points, on your
hands and your knees, and you're going to raise one arm and one leg at a time, the
opposite one, right arm, left leg, and come back, if you if you're not used to do
this you can just start with the arm without the legs, and just the legs without the arms, and when
you're good with this, you can start alternating, so then the left arm, and right leg,
straight almost like if you want to reach the other wall in front of you, and the other
one stretch, stretch, stretch, hold here, keep your head down, contract your abdominals,
your glutes and then come back, and repeat this eight times for each side, and you can then
increase to 8, to 12, and then 20 as you progress. So now this exercise is the push-up or curls-up.
You don't need to go all the way up, you can just by the fact that you're raising your head,
and your trunk, from the mat that's enough, so what you're going to do is lying down a mat
with your knees bent, you're going to go up, and again if you can't go all the way up, you can just
go here, and come back, this is really important because this is the strengthening of your
abdominal muscles, and you can start this is the easiest way when you have your arms
stretch in front of you, This is the hardest. Here, for you to go up, and when you are starting to do this, easier then
you can go this way here, which is even harder, so then you can just hold here, and stay, do
this eight repetitions, come back, relax, two, Three, but this, if this is too hard, you can
put your arms in front of you, and you will have, will be easier for you, so this is easy, medium,
harder, do 8, 12, and then 20 repetitions, This exercise is the dead bug. So, you're
going to lie on a mat or on the floor, and you're going to raise your arms and
your legs like this, and the goal of the dead bug is for you to flatten your lumbar
spine, here, the small of your spine, okay and you're going to straighten one leg at a
time, don't touch the floor, and come back, and then the other one and when you're doing
this, always try to remember to keep all of the bones of your small here touching the
floor, and then you can start alternating with your arms, so left arm, right leg, and
right arm, left leg, don't touch the floor, just come back and do this eight
repetitions, and then you can increase to 12, and then increase to 20. I usually do one minute,
I time one minute of dead bugs. I really like this exercise, there's a lot of for my back pain,
and in one minute i can do 40 45 dead bugs. And this is the bridge exercise. You're going
to lie down on your mat, or on the floor, with your hands on the side of your body, you
bend your knees, put your feet flat on the ground, and you're going to raise your pelvis, and
the important thing is that you are like a straight line here, and you'll be engaging your
abdominal muscles, your new gluteus muscles, and you can stay here, count to 10 seconds,
and then you can increase to 20, 30 seconds, and you repeat this a couple of times. I
like to do repetitions, eight repetitions, and each repetition i hold here, and i hold,
hold, hold, and i engage my abdominals, and gluteus muscles, contract them,
try not to shake and then come back. This is the pelvic tilt exercise. You're going
to lie down with a pillow under your head, your knees bent, your feet apart from each
other, and what you're going to do is, you're going to lie flat, you're
going to move your pelvis up and down, so lie flat your pelvis, will do this movement,
and all the bones here, will touch the floor, or the mat, and then you move your pelvis,
this way, and then this way ,so backwards and forward, this is pelvic tilt to
increase the mobility of your lumbar spine, and do this eight repetitions, five, six, seven,
eight, and then you may repeat this many times, and you can then increase
to 12, or 20 repetitions, you may leave your arms when you're doing this
exercise here, or on the side of your body. So this is the hip clam exercise. Put a pillow
under your head, and lie down on the mat, your knees bend, and your feet together, and what
you're going to do is, you're going to open your knees like a clam opening, and you have to do
this for both sides, so you do eight repetitions for the left side, and then turn on the other
side and do eight for the right side. Keep your feet together, in line with your ankles, should
be aligned with your spine, and you will be doing this this, will be strengthening of the
gluteus medius muscles, the piriformis muscles, which are very important to keep the stability of
your hips and lumbar spine, when you are walking. So, this next exercise is the side-lying
leg-lifts. Put a pillow under your head for comfort, and the lower leg, you're going
to bend the knee, the upper leg here going to keep straight, and you're going to raise, keep
the knees straight, and the toes pointing down, and you're going to do this, then you start with
eight repetitions, and then you can increase to 12, and 20 repetitions, this is really important
to strengthen the muscles that do the abduction of our hip. Try to keep your body straight, and
do this for the left side, and then you're going to turn, and do the same thing for the right
side, and once you have done eight repetitions, if this becomes easy for you, you can
start increasing to 12, and 20 repetitions. Now, the third part of this video is to show you
the activities that you need to avoid because they worsen the symptoms. Because the pain is usually
better when the person bends their trunk forward, we advise the person to avoid anything
that leads to bending backwards. If needed, you may get a walker, or
use a shopping cart to support your body when you go grocery shopping.
When watching TV for prolonged hours, use a recliner, instead of
sitting with a straight-back chair, but try to use a back support to maintain
the curvature in the small of your spine. Sleeping positions for people with spinal
stenosis. When sleeping on your back, you may need to use one or two pillows under your legs,
to alleviate some pressure and bend your trunk. If you sleep on your side, put
one pillow between the knees. Avoid any back braces or lumbar supports that
limit the movements of your spine. At first, these things may seem very helpful
because your pain might be less. However, if you use them for prolonged periods,
the muscles will get deconditioned and weak. Don’t forget that myofascial pain can also
aggravate a mechanical low-back pain such as spinal stenosis. In most cases of chronic
low-back pain, I find that muscle pain is a very important factor that perpetuates the
pain. We call this myofascial pain syndrome and I have a video of exercises
for myofascial low back pain. There are many stretches and strengthening
exercises that you can do in that video. Share this video with anyone that you
know that has lumbar spinal stenosis. In the comments box below write down if you have
lumbar spinal stenosis and which positions and exercises from this video worked best for you.
Also, in the description of this video below you may find a summary of these
positions and exercises that you can download and print to do at home.
Also, there is a link to all products that I mentioned in this video
if you want to purchase them. Please, don’t forget that this video is
for educational purpose only. If you have a condition that needs medical advice, please talk
to your doctor. And if there is an emergency, go to the nearest emergency department.
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Good bye.
