摘要：有背痛困扰？动or不动？纽约时报权威指南：科学运动才是“良药”！告别盲目锻炼，解锁安全有效的拉伸、核心强化与低冲击有氧训练，用“正确动”打破疼痛循环。专家干货建议+实操技巧，助你摆脱背痛，重获活力。

有趣灵魂说

有背痛困扰？动or不动？纽约时报权威指南：科学运动才是“良药”！告别盲目锻炼，解锁安全有效的拉伸、核心强化与低冲击有氧训练，用“正确动”打破疼痛循环。专家干货建议+实操技巧，助你摆脱背痛，重获活力。

译文为原创，仅供个人学习使用

The New York Times｜Ask Well

纽约时报｜求知若渴

What Are the Best Exercises for Back Pain?

缓解背痛的最佳锻炼方式是什么？

The condition is hard to treat. But moving can help, if you do it right.

背痛很难治疗。但如果方法得当，运动会有帮助。

By Danielle Friedman

我深受下背痛困扰。我听说过“运动即良药”的说法，但我担心做错了运动类型会让疼痛加剧。对我来说，最有效也最安全的锻炼方式是什么？

Q

当你感到疼痛时，锻炼可能是你最不想做的事情。但越来越多的研究表明，虽然运动不能治愈背痛，但身体活动可能是管理慢性下背痛的有效工具。而且，随着时间的推移，不活动可能会使症状恶化。

“这可能感觉有违直觉，但在大多数情况下，‘对你最好的事情实际上就是继续运动’，”哈佛医学院物理医学与康复系副教授爱德华·菲利普斯博士（Dr. Edward Phillips）说。

锻炼可以通过拉伸和加强支撑背部的肌肉来帮助缓解疼痛。对某些人来说，它还可以改善你对疼痛的感知并减轻慢性压力。

尽管如此，研究表明，背痛患者不锻炼的主要原因之一是他们担心会加剧疼痛。

无论你是想增加运动量，还是已经积极运动但想在背痛的情况下继续锻炼，我们请医生分享了他们关于安全有效锻炼的建议和禁忌。（由于背痛可能有不同的原因，在开始前请咨询你的医疗保健提供者，或者如果你的疼痛加剧了也应咨询。）

进行运动休息

长时间坐着，尤其是保持同一姿势，对背痛会造成三重打击：虚拟骨科护理提供商 Vori Health 的物理医学与康复主任卡罗琳·丘迪博士（Dr. Carolyn Chudy）说，这会给你的椎间盘带来过度压力，削弱你的核心和臀肌力量，并降低腿部的灵活性。而当你站起来时，你的背部肌肉可能会紧张地进行补偿。

丘迪博士说，如果你大部分时间都是久坐不动，那么先从全天进行短暂的运动休息开始。每30分钟，站起来，在家里或办公室走动一下，或者做几个徒手深蹲或坐站练习。

拉伸也会有帮助：丘迪博士说，当你长时间坐着时，你的腿部、臀部和核心肌肉可能会变得紧绷，这会导致它们拉扯你的背部肌肉和脊柱。

专家建议在全天中暂停一下，做做婴儿式（child's pose）和猫牛式（cat-cow）拉伸、针对臀部的4字拉伸（figure-four stretches）以及腘绳肌拉伸。

加强你的核心及其他部位

当你的核心肌肉变弱时，你的脊柱和椎间盘在你运动时被迫承受更大的压力，这可能导致疼痛或受伤。菲利普斯博士说，把你的核心想象成一个由肌肉制成的紧身胸衣。它越强壮、支撑性越好，你的脊柱和椎间盘需要承受的压力就越小。

增强你的股四头肌、臀肌和腘绳肌（这些肌肉有助于支撑你的躯干）的力量也有助于确保你的核心肌肉不会过度劳累。“一切都是相互关联的，”菲利普斯博士说。

菲利普斯博士建议每周进行两到三次平板支撑（planks）、侧平板支撑（side planks）和臀桥（glute bridges）的常规练习。超人练习（Superman exercises）也会有所帮助。（但要避免仰卧起坐，这可能会加重你的背部问题。）

在力量训练期间，专家还建议做一些功能性抗阻练习，因为这些动作可以帮助你以正确的姿势进行日常生活，降低疼痛和受伤的风险。想想下蹲（squatting）或行屈膝礼（curtsying）来捡东西（而不是弯腰），以及定期爬楼梯。

研究表明，瑜伽（yoga）和普拉提（Pilates）也有助于管理背痛，因为它们注重加强和拉伸核心及周围区域。

如果你担心在力量训练中受伤，专家建议找物理治疗师进行评估，他们可以提供个性化的指导。

尝试低冲击有氧运动

纽约特殊外科医院脊柱外科联合主任安德鲁·萨马博士（Dr. Andrew Sama）说，如果你是锻炼新手或有一段时间没有锻炼了，最安全的有氧运动形式是低冲击锻炼，如散步、使用椭圆机、骑自行车和游泳，因为它们对背部的压力比其他形式的有氧活动小。

去年发表的一项研究发现，散步对于预防背痛复发尤其有益。

但如果你能承受，根据你的健康水平，高冲击有氧运动也可能有帮助。最近一项小型研究发现，参加为期12周的跑走计划（run-walk program）的背痛患者，与未参加该计划的对照组相比，疼痛强度和残疾程度有所减轻。

萨马博士说，如果你确实选择跑步或进行高冲击锻炼，请务必穿有支撑力的鞋子，并选择平坦的地形以帮助避免受伤。之后，拉伸和冰敷背部有助于防止疼痛。

一般来说，判断一项锻炼对你是否安全的一个很好的试金石是问自己：这会让我的背痛在期间或之后加剧吗？萨马博士说，如果答案是否定的，你就可以继续你一直在进行的运动方式，而无需担心。◾

Q: I struggle with lower back pain. I’ve heard that “motion is lotion,” but I’m worried that the wrong type of exercise could make the pain worse. What is the most effective — and safest — way for me to work out?

When you’re in pain, exercising may feel like the last thing you want to do. But a growing body of research suggests that, while it’s not a cure, physical activity may be a useful toolfor managing chronic low back pain. And, over time, inactivity may makesymptoms worse.

It may feel counterintuitive, but “the best thing for you to do is actually to keep on moving,” in most cases, said Dr. Edward Phillips, an associate professor of physical medicine and rehabilitation at Harvard Medical School.

Exercise can help to relieve pain by stretching and strengthening the muscles that support the back. For some, it can also improve your perception of the pain and reduce chronic stress

Still, studiessuggest that one of the main reasons people with back pain don’t exercise is because they fear they will make their pain worse.

Whether you’re looking to move more, or you’re already active and want to keep working out despite your back pain, we asked doctors to share their dos and don’ts for exercising safely and effectively. (Because back pain can have different causes, check with your health care provider before getting started, or if your pain worsens.)

Take movement breaks.

Prolonged sitting, particularly in the same position, presents a triple whammy for back pain: It puts excessive pressure on your discs, weakens your core and glute musclesand decreases the flexibility of your legs, said Dr. Carolyn Chudy, the director of physical medicine and rehabilitation at the virtual orthopedic care provider Vori Health. And when you stand up, your back muscles may strain to compensate.

If you spend most of your time sedentary, start by taking short movement breaks throughout the day, Dr. Chudy said. Every 30 minutes, stand up, walk around your home or office, or do a few air squats or sit-to-stands

Stretching can also help: When you sit for long periods, your leg, hip and core muscles can become tight, which can lead them to tug on your back muscles and spine, Dr. Chudy said.

Experts suggest pausing throughout your day to do child’s poseand cat-cowstretches, figure-fourstretches for your hips, and hamstring stretches

Strengthen your core — and beyond.

When your core muscles become weak, your spine and discs are forced to absorb more pressure when you move, which can lead to pain or injury. Think of your core like a corset made of muscle, Dr. Phillips said. The stronger and more supportive it is, the less your spine and discs will have to endure.

Building strength in your quads, glutes and hamstrings — which help support your trunk — can also help ensure that your core muscles don’t become strained. “Everything is connected,” Dr. Phillips said.

Dr. Phillips recommends doing a routine of planks, side planksand glute bridgestwo to three times per week. Superman exercisescan help, too. (But avoid crunches and sit-ups, which can aggravate your back.)

During your strength-training sessions, experts also recommend doing a few functional resistance exercises, since these movements can help you to move through daily life in proper form, lowering your risk of pain and injury. Think squattingor curtsying to pick things up (as opposed to bowing), and regularly taking the stairs.

Research suggests that yogaand Pilatescan also help to manage back pain, thanks to their focus on strengthening and stretching the core and surrounding areas

If you’re concerned about hurting yourself while strength training, the experts recommended getting an evaluation from a physical therapist, who can offer personalized guidance.

Try low-impact cardio.

If you’re new to exercise or haven’t worked out in a while, the safest forms of aerobic exercise are low-impact workouts such as walking, using an elliptical machine, cycling and swimming, since they put less pressure on your back than other forms of aerobic activity, said Dr. Andrew Sama, the co-chief of spine surgery at the Hospital for Special Surgery in New York City.

One studypublished last year found that walking can be especially beneficial for preventing a recurrence of back pain.

But if you can tolerate it, higher-impact cardio workouts can be helpful, too, depending on your fitness level. One recent, small study foundthat people with back pain who did a 12-week run-walkprogram experienced less intense pain and disability compared with a control group who did not participate in the program.

If you do choose to run or do higher-impact workouts, be sure to wear supportive shoes and opt for even terrain to help avoid injury, Dr. Sama said. Afterward, stretching and icing your back can help to keep pain at bay.

Generally, a good litmus for determining whether a workout is safe for you is asking yourself: Does this make my back pain worse, either during or afterward? If the answer is no, Dr. Sama said, you can keep moving the way you’ve been moving without fear.

来源：左右图史