The Best Exercises When You Have DDD of L3 and L4

If you've been diagnosed with degenerative disc disease, or DDD, you're not alone. In fact, DDD in the lumbar spine is the most common cause of low-back pain, according to a 2015 study in the Journal of Clinical & Diagnostic Research. Degenerative disc disease exercises can help support your spine and improve weakness that can occur with this condition.

Your spine is made up of small stacked bones called vertebrae. Between the bones are cushions called intervertebral discs. Degenerative disc disease causes these discs to flatten out and dehydrate. DDD is part of the aging process; however, not everyone has symptoms.

There are five vertebrae in the lumbar spine. DDD between the third and fourth vertebrae — L3 and L4 — can lead to bone spurs and arthritis. It can also put pressure on nerves that exit your spine to provide sensation to the skin of your lower body and power your leg muscles.

DDD between L3 and L4 can cause pressure on the L3 spinal nerve root, which supplies sensation to the skin on the inside of your knees and front of your thigh, and powers the muscles that flex your hip and straighten your knee. This condition is called lumbar radiculopathy.

As a result, DDD can cause pain, tingling and/or numbness in these areas, as well as weakness in your hip and knee.

According to a 2018 article published by StatPearls, most people with DDD improve with at least six weeks of physical therapy without the need for surgery. Early intervention includes degenerative disc treatment exercises, focusing on stretching and core strengthening.

Stretch the muscles that attach to your lumbar spine to improve flexibility and reduce pain from DDD between L3 and L4. Stretch your thigh muscles as well. Tendons from these muscles attach to your pelvis, which in turn attaches to your spine. Tightness in these muscles can contribute to DDD symptoms.

Hold stretches for 20 to 30 seconds each, and repeat three times on each side. Do not stretch to the point of pain.

The quads and hip flexors attach to the front of your pelvis. Tightness in these muscles can cause overarching in your lumbar spine, stretching out your degenerating disc. Target both of these muscle groups with one stretch.

‌HOW TO DO IT:‌ To target the hip flexors, stagger your feet and kneel down on your back knee. Keeping your chest up, shift your weight forward through the front leg. Stop when you feel a pull through the front of your back hip.

Add a quad stretch by reaching behind you and grabbing your back foot. Slowly pull it up toward your buttock until you feel additional stretching along the front of your thigh.

The hamstrings are a large group of muscles that attach to the back of your pelvis. Tightness in these muscles can flatten your lumbar spine, placing increased pressure on your degenerating discs.

‌HOW TO DO IT:‌ Stand up straight and prop up one heel on an elevated surface. Keeping your knee straight and chest up, slowly lean forward at your hips until you feel a stretch along the back of your leg.

Start with a low surface such as a step. Progress up to waist height as flexibility improves.

The cat-camel yoga stretch targets muscles along your back that support your spine.

‌HOW TO DO IT:‌ Begin on your hands and knees with your back flat. Breathe in slowly through your nose, drop your chin to your chest and arch your back.

As you slowly exhale, allow your low back to arch. Drop your belly down toward the floor and lift your chin toward the ceiling. Repeat for five breaths.

Your core includes your abs, pelvic floor and deep spinal muscles. Core strength and stability exercises build the muscles that support your spine. While this won't stop your discs from degenerating, it can decrease the amount of pressure on these structures.

Begin strengthening exercises by correctly contracting your core. You will need to perform this movement — sometimes called a pelvic tilt or abdominal draw in — at the beginning of each core-strengthening exercise as you progress.

‌HOW TO DO IT:‌ Lie on a firm surface with your knees bent and feet on the floor. Place your hands on your hips with your fingertips resting in front of your hip bones.

Tighten your abs and press your lower back into the floor. You should feel the muscles under your fingertips tighten. Hold for a few second; then relax. Repeat 10 times.

Once you have mastered the pelvic tilt, make this exercise harder by adding some arm and leg movement. Maintain a contracted core throughout these movements to prevent excess pressure on your discs. Perform each movement 10 times on each side, working up to three sets in a row:

• March in place.
• Bring one knee to your chest and lower back down.
• Bring both knees to your chest and lower them down together.

Progress these exercises by performing them in a bridge position — core tight and hips lifted up off the floor.

Perform degenerative disc disease exercises in quadruped, or hands and knees position. Begin by lifting one arm out straight, keeping your core tight. Repeat this with each arm and each leg individually. When this becomes easy, lift the opposite arm and leg at the same time. Hold each position for several seconds.

Spinal disc problems specific to L3 and L4 can cause weakness in hip flexion and knee extension. Strengthen the muscles that perform these movements with ankle cuff weights. Start with 10 repetitions on the affected leg and work up to three sets in a row.

‌HOW TO DO IT:‌ Sit on a firm chair. Lift one knee up as far as possible, hold for one or two seconds; then lower back down to target hip flexion. For knee extension, straighten your knee all the way, hold for a couple of seconds and then lower back down.