back injury exercisesBack pain exercises play an important role in the management of most back pain episodes.
For acute episodes of low back pain, “return to normal activity”, which includes normal levels of exercise such as walking or some other recreational activity, is the prescription of choice.  Stretching and strengthening exercises for back pain are also prescribed in the subacute and chronic stages of back pain as well.
But what about individuals who are overweight and have back pain?  Do back pain exercises and return to normal activity have the same benefits as they do to leaner patients?  
Although it stands to reason that exercise should have the same benefit to both the overweight and people of normal weight, some researchers argue that exercises may increase the risk of injury in the overweight population.  Conditions such as knee pain, plantar fasciitis, and increased lower back pain may increase in heavier patients once an exercise program is introduced.
At this point in time, no medical research has investigated the issue of exercise prescription for overweight people with back pain.  However, a recent study from the University of Pittsburgh and published in the International Journal of Behavioral Nutrition and Physical Activity (2010) looked at the effects of exercise on overweight people in general.  Specifically, the authors looked at whether overweight men and women who were prescribed exercise as part of their weight loss program were at greater risk of injury.
For this study, 397 overweight people were placed into one of 2 groups.  Individuals assigned to group 1 were prescribed various intensities of exercise, while individuals assigned to group 2 participated in an educational intervention.  Both groups were studied over an 18-month period.
The results of the study demonstrated that only 7% of the injuries reported were attributed to exercise alone.  The most common injuries (21%) included lower extremity injuries (hip, knee, foot/ankle) and back pain (10%).  
Extrapolating from the results of this study, health care practitioners can safely advise their overweight and sedentary patients to initiate strengthening and stretching exercises for back pain as well as other health promotion efforts.

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