Strategies for a Healthy Lumbar Spine

Interview with Adam Wolf, PT on Strategies for a Healthy Lumbar Spine

WebExercises: What are the most important factors for lumbar spine health?

Adam: Efficient hip and thoracic motion, tissue health and awareness of position during activity. The lumbar spine is a region effected by the hip and thoracic spine, and not enough motion in one of those places means too much motion in the lumbar spine.  If tissue isn’t healthy it means there won’t be as much tissue glide and the potential for neurogenic inflammation is increased, and tissue tends to get irritated when in a position for too long (or positioned improperly during movement). Therefore, being aware of how the body is positioned statically and during motion, and that joints are stacked and properly aligned is important. 

WebExercises: Why is exercise so important to stay free from back? 

Adam: Motion is lotion, and if you don’t move it you lose it.

WebExercises: What are your go-to prevention exercises and why?

Adam: It’s hard to speak generally because it depends on WHY someone has back pain, however I find that movements focusing on thoracic and hip mobility that dynamically engages the core is important.

Here some of my favorite exercises for that:

Click here to download 6 Strategies for Dealing with Low Back Pain

WebExercises: Do you prescribe home exercise programs and what’s your strategy to keep your patients compliant to them? 

Adam: Yes, I do prescribe home exercise programs to my patients. It is a critical component of my practice since I have a limited amount of time with patients. It depends on the patient and the intention behind the exercise. On average, I treat a patient 1-2 times per week depending on their needs and schedules. To be honest, the time a patient dedicates to receiving in-person treatment is not enough. Ideally, patients should work on their prescribed exercises at least once a day to truly reap the benefits of physical therapy. I’ve found that patients who adhere to their home exercise programs get better faster, and see lasting results and those that don’t, don’t.

WebExercises: How do you keep patients compliant to their programs?

Adam: One strategy to increase patient adherence to a home exercise program: Keep it simple! Use pictures and videos instead of handouts with only exercise names on them.

WebExercises: What is your focus when treating new patients?

Adam: During initial sessions, I focus on:

  • Bringing awareness to some of the asymmetries that likely exist, or the way in which the patient performs a specific task (such as breathing or lifting). Often times patients aren’t aware of their dysfunction.  It’s a subconscious dysfunction. They don’t know they don’t know. The only way to get them to have conscious function, or to know that they know, is to first make them know they don’t know.  Bringing awareness to a behavior that influences dysfunction creates an opportunity to change the behavior, which initially needs to be conscious in order to eventually integrate it into the system.
  • Analyzing capacities of the individual including gait, lifting, squatting, carrying or whatever the specific capacity is relative to the individual. Anchoring to capacities gets away from treating the specific anatomy only.
  • The one or two things I want the patient to do at home, typically geared towards creating the behavior change and improving the capacity of a specific body part or for a particular task, i.e, controlling the pelvis at mid-stance, breathing more efficiently from the diaphragm or lifting with proper technique. Often home exercises prescribed can be completed with a resistance band or household objects such as a chair and door frame.
  • Educating the patient about the process of pain and also how our interventions are geared towards improving their overall specific capacities while reducing pain.

The WebExercises Story:
WebExercises was created by clinicians who wanted to find a better way to help patients succeed with their exercise rehabilitation programs. As clinicians we are limited with time therefore WebExercises was developed to efficiently design home exercise programs. We offer an engaging patient experiencethat can be monitored virtually by the clinician keeping your patients motivated outside of your office.  Since 2005 we have delivered over 20 million exercises saving clinicians time and improving patient adherence. To find out more how WebExercises can improve your practice call us 866-411-4825 or visit

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Adam Wolf, PT

Author Adam Wolf, PT

Adam’s professional credentials include Licensure in Physical Therapy (IL) and Massage Therapy (IL) and Fellow of Applied Functional Science (Gray Institute)(’09). Some of his certifications include Enhance Running Technician, Functional Range Conditioning (FRC), Dry Needling Certified, Neurokinetic Therapy level 3(NKT), Functional-Neuro-Orthopedic Rehab (FNOR) provider, and he has his certificate of competency in vestibular rehabilitation. As a Physical Therapist of over 15 years in Chicago, he is the owner of REAL Physical Therapy and founder of The Movement Guild. He is the author of two books, including the most recently published Foundations of Movement: A Brain Based Musculoskeletal Approach. Adam is a Master Instructor on the Rocktape Education Team for the past seven years, and also teaches his own material.

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