When considering how often you should perform exercises when you have back pain, there are a number of things to consider:
1. Should you even be doing exercises at all?? How much pain are you in?
When evaluating pain, I use a visual analog scale (VAS). For example, on a 1 to 10, with 1 being “not much pain at all, and a 10 being “worst pain I have ever felt”. Exercises are generally appropriate when you are a 6 or lower. Anything above, rest, relaxation, and even massage therapy is acceptable.
2. What kind of exercise program are we talking about?
Exercises based on your unique muscle imbalances are usually targeted at your weaknesses, as in my DVD program “End Your Back Pain Now!”, and rarely involve the actual muscles that hurt, those can be done more frequently. Doing exercises that directly target painful exercises are not a good idea unless you are being supervised by an expert.
3. What intensity level are the exercises being performed at? (Probably the MOST important factor!!)
I see a range of back pain sufferers in my clinic, from average joe and jane, to weekend warriors, to elite athletes. It may surprise you to know that when high level athletes see me for back pain, I give them deadlifts, pullups, and other full body movements to get rid of their pain. Why? They are usually much more coordinated that the average person, and are used to higher levels of physical exertion. Using this approach helps them get better faster.
The more intense the exercises are, the less often they should be performed. For example, if an advanced athlete needs to deadlift, I usually only allow them to do so 1x every 5-6 days. However, if the weight is very light, I have been known to allow 3x per week, but only for a short period of time.
The lower the intensity of the exercise, such as a Swiss ball reverse back extension (a butt exercise), may be done daily, if no significant soreness results from doing it, and pain levels are monitored.
Pretty much the same goes for light pelvic tilting, and other exercises that target postural muscle fibers. However, as mentioned, caution must be taken to ensure that fatiguing the targeted muscle group does not “destabilize” the lower back or sacro-iliac joints, and cause pain.