Exercises for Low Back Pain
So, what are some specific exercises that might help with your low back pain?
Again, please do not perform any of these exercises if they are actively painful (some discomfort is ok).
Some general tips about stretching and mobilisation
Stretching, particularly when done for rehabilitation or healing (as opposed to mere flexibility for e.g. dancing or martial arts), should always be in pain-free range of movement.
Please note that discomfort is unavoidable, especially after injury, it is pain we want to avoid. Go in the direction of the intended stretch, and when you feel the area you are trying to target start to engage, stop. You do not need to go as far as you can, or put on a brave face and ignore too much discomfort.
Pain is a warning signal, and while the body gets a bit over-zealous in its protectiveness at times, it is always worth listening to your pain (don’t ignore it or completely give in to it).
So stretch within your limits.
So on with the exercises…!
Lie on your back.
Bring both knees up towards your chest.
Perform both as a gentle ‘pump’ (30+ times, as a dynamic mobilisation), then as a gentle stretch (hold for 10-30s).
This stretch targets the back of the upper thigh, and gluteal region, rather than the low back itself. Gently draw one leg up to your chest while leaving the other flat on the floor. If necessary, place a small pillow under the extended leg for comfort.
You should feel the stretch in the thigh and buttock region. Try moving the leg from side-to-side slightly – this will target different muscles in the hamstring group. Again, you can perform this as a sustained stretch, or as a more dynamic movement.
If bringing the leg up with a bent knee targets the upper fibres of the hamstrings, and using a straight leg targets the lower (and back of the knee, and top of the calf), then it stands to reason that bringing the leg up partway, and then straightening the knee, can target somewhere in between. As before, try drawing the leg up further out to the same side as the leg (to target the inner muscles) or across your body slightly (to target the outer muscles).
This is a particularly relevant area to much low back pain. Even more so than with the hamstrings, there are a heap of muscles in the buttock area. This means that varying the angle at which you take your knee will have even more of an impact on where you feel the stretch. Try to find the tightest/sorest bit, this is likely where needs it most! A good way of doing this is to take the knee around in a gentle arc, and feel for the bits that feel most restricted and/or uncomfortable. As before, do not overstretch, just take the leg over until you start feeling the tissues engage in the affected area(s).
Cross one ankle over the other knee. Gently bring that knee towards you until you feel a stretch deep in the buttock region.
If you have extremely limited hip and/or knee range of motion you may find this difficult, so may choose to have the other leg flat on the table/bed (as in the top picture in diagram to the [right]. Otherwise, you may start from the lower of the pictures on the [right], or even seated (as below). Try to avoid bending your whole body towards your knees, remember, this is a stretch targeted towards the hip rotators, not your mid/upper back!
Also remember to repeat on both sides.
Lying on your back, cross one (in the diagram, the left) leg over the other, and use it to draw the right thigh and leg across the midline of the body (to the left, in this instance). Try and ‘hook’ the calf over the outside of the thigh, this will engage the thick fibrous band that runs between the hip bone and knee and make the stretch more focused. Again, try to think about where you are targeting – in this instance, the very side of the gluteal/hip/thigh region. Once your back starts to twist round and leave the floor/bed, you are no longer stretching the intended area any more, you are now stretching the lower back. This is not necessarily a bad thing, but try to stay focused. If you want to stretch the low back into rotation, there are more effective (and specific!) ways of doing this.
You obviously need to have a certain range of motion in your shoulders, knees and ankles, as well as hips and low back, for this stretch to be feasible. Do not do any stretch or movement you are unhappy with.
From a kneeling position, sink your weight back onto your heels, while stretching your hands as far forward as possible. This rounds (or flexes) the low back (lumbar spine) while straightening (or extending the upper-mid back (thoracic spine).
6a. Kneel to prayer (variant)
Another variant that can be very useful when one side of the back is tighter/sorer than the other is to grasp on object on the opposite side. This will make the stretch much stronger where needed.
A nice general stretch that can be played around with to target pretty much any part of the mid or low back. Essentially, imagine you are trying to reach down and touch the floor on the outside of your knee and leg. Changing the amounts of rotation, sidebending and flexion (forwards bending) will change exactly where in the back you will feel the stretch. As long you are gentle and do not push anything too far, you are extremely unlikely to injure yourself, so feel free to play around with the components a bit.
Like the muscles on the back of the thigh (the hamstrings), the quadriceps(or ‘four-headed muscle’) on the front of the thigh also can play a big role in maintaining lower back dysfunction. Unfortunately, due to the anatomy of the area, it is difficult to target the whole muscle group. Most stretches will be felt predominantly in the central, superficial muscle (rectus femoris, or ‘straight muscle of the thigh’, if you are interested!). This muscle attaches to the front of the pelvis, so if you stretch it, it will try to tilt the pelvis forward, increasing the arch of the lower back. To prevent this, make sure you ‘tuck your tailbone in’, or slightly tighten your abdominal muscles to help keep the low back nice and neutral.
[i] Weppler CH, Magnusson SP. Increasing muscle extensibility: a matter of increasing length or modifying sensation? Phys Ther. 2010 Mar;90(3):438–49.
All images of exercises in this post are from BioEx Systems' ExercisePro 5