Amputations affect how you move and use your muscles. Consequently, between 52 to 89 percent of lower limb amputees and 52 percent of upper limb amputees experience lower back pain. That pain interferes with physical and emotional health and the ability to enjoy family and friends. The answer to managing and reducing amputee back pain often lies in a consistent focus on posture and balance. Stretches and exercises that strengthen the core (abdominal) and back muscles while developing balance build the strength to maintain better posture and reduce amputees’ lower back pain.
Amputation Location and Type
The type and location of your amputation affect how and why back pain develops. Lower limb amputations often cause posture asymmetry, with the amputation side of the body becoming stiff and weak with shortened muscles. The tilt of the pelvis can also change, further altering muscle use and spine alignment.
Upper limb amputees are susceptible to low back pain, too. Again, it comes back to posture asymmetry and imbalances between the body’s amputation and non-amputation sides. In both cases, the result is often lower back pain. While we’re focusing on the lower back, strength and posture issues can lead to pain throughout the body—in the non-amputation side’s knees, ankles, hips, and shoulders. Correcting the posture and building strength and balance may alleviate pain in these other areas as well.
Develop Posture with Strength and Balance
Regular strength and balance exercises can help you maintain body symmetry, better posture, and reduce lower back pain. A note—stretching and exercises are an incredibly helpful way to reduce and manage back pain associated with amputations. However, back and other pain could also stem from prosthesis fit issues or another non-related problem. Talk to your prosthetist or doctor to make sure there isn’t another issue contributing to the pain.
Before starting these or any other exercises, make sure the skin on your residual is clean, dry, and moisturized. If you sweat easily, consider using a liquid-to-powder product to make the prosthesis more comfortable to wear. Better comfort will help you focus on correct form, so you get the most out of each exercise.
You’ll need a Theraband or resistance band for this exercise. Sit on a chair, and hold one end of the Theraband in each hand. You may need to adjust the length by wrapping the band around your hands or shortening the distance between your hands to get the right resistance level.
Use one foot to hold the band to the floor in the middle. Hold the hands at hip height, and lift both arms upward at the same time and rate. You should feel the resistance from the band increase the higher you raise your arms. Keep your shoulders, back, and chest open, forcing you to use your back, abs, and thigh muscle to raise the arms. Stop when the hands reach about head height. Then, slowly lower the arms to the starting position and repeat. Do three sets of ten, repeating using the other foot (or prosthesis) as the center point.
Sit on the edge of a chair with the knee(s) and hips at a 90-degree angle. Tighten your ab muscles as you lean back slightly, keeping your knees and hips at a 90-degree angle so that the feet lift off the floor. Hold this position for five seconds. Slowly return to the starting position and repeat. Complete three sets of five or until the muscles begin to fatigue.
Stand facing the wall. Evenly distribute your weight onto both sides of the body. Raise both arms overhead, placing them against the wall. Hold this position while reaching one arm higher overhead. Hold for a count of five seconds, then bring the arm back to the starting position.
Now, reach with the other arm. Keep your hips even, extending only through the abs, shoulders, and arm. You can add resistance by holding a balance ball between the hands or holding one end of a resistance band in the raised hand while stepping on the other end of the band with the same side foot. Do three sets of five to ten reps, depending on your strength level.
Even Weight Bearing While Standing
This is probably the simplest exercise on our list, and you can do it almost anywhere. Whenever you’re standing (brushing your teeth, cooking, or on the phone), focus on evenly distributing your weight across both sides of the body. Don’t lean to one side, especially the non-amputation side. If you tend to sway the lower back, tilt the pelvis forward slightly to maintain a neutral standing position.
Start in a tabletop position on your hands and knees with the wrists directly below your shoulders and the knees directly below your hips. Tighten your ab and back muscles. Slowly extend the right arm forward while extending the left leg straight back. Hold this position to a count of five and return to the tabletop position. Repeat on the other side.
Your amputation location may require a modification of this exercise.
Leg Clock with Arms
Stand on one leg and reach the opposite arm straight toward the ceiling, like the hand of a clock facing 12 o’clock. Next, move the arm to 3 o’clock, and finally, 6 o’clock. Repeat with the other arm. Now, switch legs (make sure to use both the sound and amputated sides) and repeat the exercise. As you get stronger, try using a balance board, balance disc (wobble cushion), or have someone else call out arm positions to keep you guessing.
A Final Note
Incorporate posture and strength exercises into your weekly exercise routine. Consistent, regular attention to how you’re standing and moving prevents muscular imbalances that can limit your activity down the road. Your dedication can reduce (or even eliminate) lower back pain and keep you free to live an active life.