Exercise therapy for low back pain rehabilitation in a runner: Comparison between exercise protocols recommended by the Indonesia Sports Medicine Centre and the McKenzie regimen

Introduction: Low back pain (LBP) is described as pain emanating from the area of the lowest rib to the gluteal fold, regardless of radiating to the legs. The Orthopedic Section of the American Physical Therapy Association recommends exercises that are repeated in a specific direction, and that, determined by the response, improve mobility and reduce symptoms in patients with acute, subacute, or chronic LBP with mobility deficits. Here, we report a case of LBP and compare the exercise protocol recommended by the Indonesia Sports Medicine Centre (ISMC) with that of the McKenzie regimen. Case report: A 39-year-old male running enthusiast visited the ISMC with a complaint of LBP. He was an employee of a private company. His symptoms started 7 weeks earlier after he bumped into a pump machine while running. The patient was diagnosed with leftsided LBP. He underwent exercise therapy for rehabilitation, but participated in the Bali Triathlon 1 month before finishing the program and ran in the Bromo-Tengger-Semeru event 1 week before. Afterward, the patient continued the exercise therapy regimen. He experienced pain when bending downward but not when bending backward or from side to side. In clinical examination, his vital signs were within normal ranges. His general status was normal. Local status of LBP resulted in no swelling, deformity, or discoloration, but tightening of the left erector spinae muscle was noted. The range of motion (ROM) was normal, with an extension of 25° and a lateral flexion of 25°, but flexion was limited at 70° (normal, 10°), with a visual analog scale (VAS) score of 4. The exercise regimen for LBP rehabilitation included cardiorespiratory, flexibility, and strengthening exercises. After 1 week, his symptoms significantly improved, as demonstrated by a lower VAS score of 2 and increased ROM (flexion 80°). Conclusion: The exercise therapy protocol recommended by the ISMC can significantly benefit LBP, while the addition of the McKenzie exercise regimen can improve rehabilitation outcomes.