In an interview with the Health Channel, Noel Gressner, Physical Therapist at Miami Orthopedics and Sports Medicine Institute, talks about how to strengthen your back through exercise and manual physical therapy when you have stress fractures. Stress fractures are tiny cracks in a bone, usually from overuse such as excessive running or jumping. 

Noel says that the best exercises for people with back pain due to stress fractures should strengthen spinal and core stabilization. You want to do exercises that keep your back in a neutral position so that way you do not cause pain from flexing or hyper extending your back. You want to avoid extreme motions that could stress your joints, so exercising while your back is in the neutral position will give you strength as well as keep you from being in pain. 

Noel Grassner specializes in manual physical therapy, a type of therapy that uses joint and soft tissue mobilization to treat the spine through hands-on methods. Manual physical therapy is not just about the treatment, the physical examination is just as important. During the examination, Noel says he looks for bony landmarks, such as where your pelvis and sacrum sit in relation to your back. As part of the manual assessment Noel says he checks, “if your pelvis has rotated, the heights of your iliac crest, your posterior superior iliac spine and if you’re rotated forward, if certain bony landmarks on your sacrum are turned one particular way.” Noel says he then uses manual techniques, that include muscle activation and joint mobilization, to de-tone the muscles. There are different types of treatment depending upon what is necessary for the patient but in a nutshell manual physical therapy consists of the rigorous diagnosis followed by the hands-on treatment.

Watch the full segment of Noel Grassner talking about how he suggests for his patients to strengthen their backs, here: https://youtu.be/jWPfGxkOZ1Q