Recent media reports indicate that a woman in Xi'an, Shaanxi, has gained followers by imitating animal crawling to treat her lumbar disc herniation. Zhu Zexing, Deputy Chief Physician at the Orthopedics Department of the Rocket Force Medical Center, explains that while crawling exercises can be effective for preventing and treating lumbar disorders and muscle strain, they carry both benefits and drawbacks and are not suitable for all patients with back pain.
Five Primary Causes of Lumbar Disc Herniation
Clinically, lumbar disc herniation refers to a complex condition where degeneration of the intervertebral disc, rupture of the annulus fibrosus, and protrusion of the nucleus pulposus stimulate or compress nerve roots and the cauda equina. It ranks among the most common causes of lower back and leg pain in daily life.This condition predominantly affects individuals engaged in heavy physical labor, as well as those in sedentary occupations such as IT professionals, teachers, civil servants, and drivers. Approximately 75% of cases occur in young adults aged 20-40, with a male-to-female ratio of about 3:1. Both severely obese and excessively thin individuals are susceptible to developing the condition.
Five primary factors contribute to lumbar disc herniation.
First, disc degeneration. Lumbar discs endure immense stress from spinal movement and load-bearing. With aging, discs degenerate as the annulus fibrosus and nucleus pulposus gradually lose water content. The nucleus pulposus loses elasticity, and fissures appear in the annulus fibrosus.Against this degenerative backdrop, cumulative strain and external forces can cause the disc to rupture. The nucleus pulposus then protrudes posteriorly, compressing nerves and triggering symptoms like low back pain.
Second is trauma. Repeated bending, twisting, and similar motions can damage discs, accelerating early degeneration. Acute injury is also a common trigger for disc herniation.
Third, pregnancy. During pregnancy, the entire ligament system becomes relaxed, while the lumbosacral region bears greater stress than usual, increasing the risk of disc herniation.
Fourth, genetic factors. Among adolescent patients under 20 years old, approximately 32% have a family history.
Fifth, developmental abnormalities.Congenital abnormalities in the lumbosacral region, such as lumbarization of the sacrum, sacralization of the lumbar spine, and asymmetrical facet joints, subject the lower lumbar spine to abnormal stress, thereby increasing disc damage. Crawling Exercises: Pros and Cons The vast majority of patients with lumbar disc herniation can achieve clinical symptom relief or resolution through conservative treatment. Only 10%-20% of patients require surgical intervention.Conservative treatment and rehabilitation should incorporate exercise to enhance lumbar muscle tone, correct abnormal spinal alignment, improve ligament elasticity, maintain proper spinal structure, and prevent further degeneration. Zhu Zexing explains that crawling distributes body weight across all limbs, reducing strain on specific areas—particularly the lumbar spine—thus offering therapeutic benefits for preventing and treating lumbar disorders and muscle strain.During crawling, lumbar extension movement shifts the nucleus pulposus forward, preventing its continuous backward impact. This helps reposition the displaced nucleus pulposus toward its normal position and avoids its posterior rupture through the annulus fibrosus into the spinal canal. Typically, crawling exercises refer to ground-based crawling movements, primarily encompassing the following two methods:
Kneeling crawl. This involves placing both hands and knees on the ground, crawling by alternating hands and knees sequentially. Posture: Head extended, fingers spread and touching the ground, arms shoulder-width apart, knees touching the ground shoulder-width apart.
Hand-foot crawl. This involves placing both hands and feet on the ground, crawling by alternating hands and feet sequentially.Posture: Head extended, fingers spread and touching the ground, arms shoulder-width apart, feet touching the ground about one and a half shoulder-widths apart, forefeet touching the ground, knees slightly bent. Currently, the hands-and-feet crawl is the most commonly used method, emphasizing stability over speed.Crawling requires bending the waist and lowering the head. During the movement, blood may pool in the head and heart, potentially triggering cardiovascular incidents in individuals with hypertension or cardiovascular/cerebrovascular diseases. For those with anemia or hypotension, rising from a squatting position may cause dizziness, risking insufficient cerebral blood supply and fainting. Direct contact between palms or knees and the ground during crawling carries a risk of friction injuries.The weight borne by the shoulders and elbows during crawling far exceeds that in an upright position. Abnormal loading on the hips and knees can cause joint wear and damage to surrounding soft tissues. Prolonged high-intensity exercise poses significant potential adverse effects on joints such as the shoulders, elbows, hips, and knees.
Therefore, while crawling exercises offer benefits, their drawbacks should not be overlooked. Within lumbar rehabilitation principles, crawling is not actively recommended. Patients must select appropriate, scientifically sound exercise methods based on their individual physical condition.
Recommended Proper Exercise Methods
Below are several common lumbar and back muscle exercise methods.
Bridge Exercise Lie supine on a bed without a pillow, knees bent. Press elbows and back into the bed, lifting abdomen and buttocks upward to form a "bridge" shape. Support your entire body weight using only your shoulders, elbows, and feet. Hold for 3-5 seconds, then relax the lumbar muscles and lower the hips to rest for 3-5 seconds. This completes one cycle.
Three-Point Support Exercise: Once you've built some core strength from the previous exercise, progress to the three-point support method: Lie on your back with hands clasped behind your head. Lift your hips off the bed, supporting your body with your head and both heels.
Swallow Exercise Lie prone on the bed. Push your chest up forcefully, lift your head, extend both arms straight forward, straighten your knees, and push your legs backward. Raise your head, chest, and limbs as high as possible off the bed, resembling a flying swallow—hence the name "Swallow Exercise." Hold for 3-5 seconds, then relax your muscles and rest for 3-5 seconds. This completes one cycle.The number of repetitions and intensity of the Flying Swallow exercise should be adjusted individually. Generally, perform 20-40 repetitions per session, lasting about 5 minutes.
Cat Pose Exercise This movement mimics a cat's stretching posture, gently extending the spine. The basic position involves supporting the body on hands and knees. Maintain natural breathing. First, arch the lower back downward as much as possible while lifting the head, holding for 10 seconds;Then lower your head, tuck your chin toward your chest, and slowly arch your back upward, holding for 10 seconds. Repeat this sequence at least 10 times, performing 2-3 sets daily. Additionally, breaststroke swimming is an excellent exercise for alleviating lumbar disc herniation. Water's buoyancy reduces gravitational stress on the spine, muscles, and joints during aquatic workouts, thereby aiding in the treatment of conditions affecting the lower back, legs, and joints.
These exercises help enhance lumbar stability, delay the progression of lumbar degeneration, and effectively prevent back pain. It's crucial to remember: seek medical attention if experiencing severe back pain, numbness or pain in both legs, or if pain doesn't significantly improve after consistent exercise.