Fitness for a Lumbar Hernia: How to Stay Active Safely

Almost everyone who exercises has experienced lower back pain at some point. For some, this pain leads to a doctor's visit, where a herniated disc or intervertebral hernia is diagnosed. Once diagnosed, it's common to be advised to significantly limit physical activity, particularly any exercises that involve axial loading, or even to refrain from certain sports altogether.

But is a herniated disc really so dangerous? And how can you continue enjoying physical activity while managing a lumbar hernia?

Let’s dive into the details.

How Common is a Herniated Disc?
Surprisingly, herniated discs are quite common. According to the American Association of Neurological Surgeons, by the age of 35, about 40% of people have some form of intervertebral hernia. By age 60, nearly 100% do—it's just part of the aging process.

Metabolism decreases as we age—on average by 12% by the time we’re 35, and by 4-5% every seven years after that. The water content in our intervertebral discs also drops. In early life, these discs contain 88-91% water, but by age 70, that number shrinks to 68-70%. This natural dehydration weakens the structure of the spine, making us more prone to injury and herniation.

Understanding the Spine's Structure

The spine isn’t just a stack of bones; it’s a complex system designed to handle tremendous forces. At the core of each intervertebral disc is a soft, gel-like center called the nucleus pulposus, composed of proteins like chondroitin and glucosamine, along with small amounts of collagen and elastin. These proteins bind with water, creating a natural expansion force. The pressure inside these discs can reach up to 25 atmospheres—just for comparison, the average car tire holds only about 2.2-2.4 atmospheres.

Surrounding this nucleus is a tough outer layer called the annulus fibrosus, made up of intertwined collagen and elastin fibers. These fibers, also bound by water, help contain the high internal pressure of the nucleus. Together with the disc’s endplates, ligaments, and muscle-tendon systems, the spine is equipped to handle tremendous axial loads and movements.

What Causes a Hernia?

Herniated discs occur when the internal pressure exceeds the capacity of the surrounding structures. This imbalance is often due to a lack of essential disc proteins, combined with poor circulation that hinders the flow of nutrients and water. The result is a disc that weakens and bulges out, forming a hernia.

In most cases, hernias form because of injuries. These can be acute—caused by sudden trauma—or chronic, resulting from poor posture or movement patterns over time. Repetitive stress, inefficient movement, and improper biomechanics are more common culprits than single traumatic events.

For example, the shoulder joint is a ball-and-socket joint, designed to move in three dimensions. If someone uses their shoulder only for limited movements, such as writing, they effectively “turn off” the muscles and motor pathways that are meant to fully engage the joint. This leads to imbalanced muscle tension, changes in local acidity, poor blood flow, and, eventually, tissue damage—all conditions that contribute to hernias in the spine as well.

Can You Restore Function?

If poor movement patterns are the root cause of hernias, can they be corrected? The short answer is yes, with proper training and awareness.

The key lies in training the stabilizer muscles. These are muscles designed for endurance and low-threshold activity, rather than fast, explosive movements. Stabilizer muscles have short tendons and large muscle bellies, and they rely heavily on oxygen to function properly. For the lower back, these stabilizer muscles are critical to maintaining spinal health.

To strengthen them, you need static or static-dynamic exercises. The goal is to keep the muscle under tension for 40-90 seconds, working at about 30-40% of its full capacity. This sustained effort causes the muscle to burn due to the accumulation of lactic acid, which helps improve the muscle’s oxygen uptake and nutrient delivery. Once the workout is finished, the acidity levels normalize, and the muscle recovers.

This type of stress—known as physiological stress—is healthy and necessary for stabilizing the spine. However, you don’t want to push the muscles to the point of “failure” because that shifts the load onto the discs, ligaments, and joints, which are already compromised due to the hernia.

Strengthening with Static-Dynamic Workouts

To minimize irritation and overloading of the damaged tissues, it's essential to activate the antagonistic muscles, particularly the abdominal muscles. These muscles can be trained in the same static or static-dynamic way. By engaging the abs for 40-90 seconds at moderate intensity, you can effectively strengthen them without overloading the spine.

Aim to perform 2-3 sets with a 2-3 minute rest between each, and you can even train every day. If you do 4-5 sets, space out the workouts to 2-3 times per week. Gradually, you’ll notice a more stable lower back, less discomfort, better mobility, and more confidence in your movements.

Once the abs are strong enough, you can start incorporating exercises that target the back muscles in a similar fashion.

Best Exercises for Lumbar Hernias

Planks

Why they work: Planks are fantastic for strengthening the stabilizers of the spine. Start by holding a plank on your elbows and knees. If this feels too easy, increase the difficulty by moving to your toes and palms. The key is to avoid letting your lower back sag.
Form tip: Engage your core to smooth out the lumbar curve. If you can’t maintain this position, it’s better to skip the exercise to prevent injury.

Hyperextensions

Why they work: This exercise strengthens the lower back without placing too much strain on the spine. Just be mindful not to push the stabilizers to failure.

Modified Exercises

You can also modify exercises on parallel bars, a horizontal bar, or a Swedish wall by adjusting the angle to your comfort level.
When to Avoid Certain Exercises
Axial loads, such as those involving heavy barbells or dumbbells, should be approached with caution. While it’s possible to train with these tools, proper technique, body awareness, and experience are crucial. Always listen to your body.

This approach also applies to yoga and Pilates, which can be beneficial for those with herniated discs—provided the intensity and time under load are controlled.

Final Thoughts

It’s important to note that each herniated disc is unique, and a healthcare professional should evaluate factors like size, shape, and location before beginning any fitness regimen. However, most people with hernias don’t end up requiring surgery. In fact, European statistics show that only about 5% of patients with herniated discs end up on the operating table.

In the acute phase of a herniated disc, treatment usually involves medication, physiotherapy, and rest. But once in the subacute or remission phase, the fitness program described here can be highly effective in preventing further flare-ups.

So don’t be afraid to stay active—just do it smartly and regularly. The secret to maintaining health lies in understanding your body and respecting its needs.