Return Appendix 
Spine  Resource  Clinic                                                  
This is the first of two aspects of conditioning.  Each aspect is like a broken link in a chain protecting your back.  Without fixing both links, you have no protection.   Conditioning is similar to what baseball players have to go through each season to comfortably tolerate daily activity.  If conditioning is uncomfortable - your spine is telling you how little protection you now have and how badly it is needed.   These activities are no more dangerous for your back than sitting on the side of the bed before rising in the morning. 
First, Conditioning Recommendations: 
The muscles play a very important role in protection of your spine.  Becoming generally tired can reduce the coordination and reactions of these muscles.  Therefore, we recommend the first phase of conditioning with exercises less stressful on your back than sitting on the bed before you rise in the morning. 
Scientific studies on exercise and back problems have indicated that building your endurance, by achieving a higher fitness level, averts lingering back problems. 
To begin your exercise program... 
1.        Choose an exercise which requires stamina using large leg muscle groups in continuous rhythmic movements. 
Exercise Options (that do not over stress the back) 
       a) Young active patients might jog for 15-20 minutes (do not be concerned about your heart rate not reaching the needed level while jogging) 
       b)  Brisk walking, stationary bicycling at the proper heart rate* 
       *     Keep your heart rate about  ______ beats per minute.   
You can determine your heart rate by taking your pulse for 6 seconds and multiplying by 10:  for example, if you count 12-13 beats in 6 seconds and multiply by 10 you will have a heart rate of 120-130. 
Duration: You should exercise for 30 minutes continuously at your target heart rate unless you choose to jog for 20 minutes. 
Frequency: Exercise at least 5 times per week for 6 weeks; it is often best to start out alternating morning, then evening, skip a day, then morning again and so on.  After 6 weeks of 5 sessions per week, you only need 2-3 sessions per week.  It is like an airplane - takes more energy to get up to altitude than keep it there - 2-3 sessions per week then becomes enough.  After 4 weeks of 5 days per week we can usually start specific back muscle conditioning. 
Important: Conditioning exercises are best tolerated on an empty stomach. (e.g., before breakfast or before supper). 
© If reproduced, no alterations without the written permission of Stanley J. Bigos, MD 
SRC Spinemate - only used or reproduced with written permission from