Mechanical Low Back Pain Exercises
Exercise and Physiotherapy
Research shows that a graded exercise program is the best management plan for patients with back pain. The initial aim of exercise is to increase the range of movement in the back, which we know the back needs to get better. This will in turn reduce pain and improve your general function. Due to the importance of movement, at the end of the exercises there is a full range of stretches to help increase your flexibility and reduce any stiffness.
When carrying out the exercises there may be a slight increased ache but this is normal. However, the level of pain should not exceed 3-4/10 on a pain score.
As your range of movement increases and the pain reduces we aim to provide stability to the trunk, through core and Pilates based exercises. Our focus then moves onto normal movement patterns, when we introduce general exercises to not only develop muscle strength but also improve your confidence to return to normal, keep active and reduce the risk of flare ups.
Participating in an exercise program carries a certain element of risk for some people. You should consult with your healthcare professional before initiating this program if you have any concerns, to ensure your safety.
If you have any issues please do not hesitate to contact the physiotherapy department. If you feel light headed, dizzy or have issues with your breathing please contact your general practitioner (GP) immediately.
Level one: Range of movement
Lower Back Extensions (The Cobra)
Begin lying on your front then prop yourself up on your elbows, extending from your lower back. Hold this position for 2 - 5 seconds and relax downwards to the starting position. As this becomes more comfortable you can progress to pushing up from your hands with straight arms. Keep your breathing relaxed throughout.
Knee Rolls
In a lying position, on your back, with your knees bent and together. Keep your upper body relaxed and chin gently tucked in. Slowly roll your knees to one side, keeping both shoulders on the floor. Hold for 2 – 5 seconds and go to the opposite side.
Repeat exercise 10 – 15 times and do 3 sets
Pelvic Tilts
Lie with your back on the floor in a neutral position with your legs bent and toes facing forward. Pull your belly button in toward your spine, pushing your pelvis up toward the ceiling. Tighten your bottom muscles as you tilt your pelvis forward. Hold for 2 - 5 seconds and then go as far the opposite way and do the same. If you have a Swiss ball you can progress this exercise to doing it on this.
Repeat exercise 10 – 15 times and do 3 sets
Knee Hugs
In a lying position, on your back, with your knees bent and relaxed. Pull one knee up to your chest and hold for 2 -5 seconds, repeat on the other side. As this gets easier change the starting position to lying with your legs straight. The next progression is to pull both knees up at the same time.
Repeat exercise 10 – 15 times and do 3 sets
Level two: Core activation
Bridge
START POSITION: Lie on your back with your knees bent and your feet flat on the floor, approximately hip distance apart. You should have equal amount of weight through all parts of your feet. Push your back into the floor whilst engaging your core.
ACTION: keeping your torso in one flat piece, press your feet into the floor and squeeze your buttocks as you lift your hips up. Come up to a point that makes a straight line between your shoulders to your knees. Hold this position for 10 seconds and return to the starting position.
Repeat exercise 10 – 15 times and do 3 sets
Heels slides in neutral spine
STARTING POSITION: lying on your back, knees bent and core engaged (Same starting position as exercise 1).
ACTION: Gently draw navel to spine. Maintaining this position and gently slide one heel down until your leg is straight, hold for 5 seconds and return to the start, keeping your pelvis stable and core activated throughout.
Repeat exercise 10 – 15 times and do 3 sets
Table Top
STARTING POSITION: lying on your back, knees bent and core engaged (Same starting position as exercise 1).
ACTION: Raise one leg until the thigh is straight up with your knee over your hip and your knee is bent so your shins are at 90 degrees, with your ankle slightly higher than your knee. Follow with lifting your other leg into the same position. Inhale and exhale while holding the position for 5 seconds. Exhale and lower your legs one at a time back to the floor. As this becomes comfortable to do you can push onto dead bug exercise, which you can see in the video below. The key feature with this is to ensure you keep your lower back pushed into the floor throughout the movement.
Repeat exercise 10 – 15 times and do 3 sets
Four Point Kneeling
Starting Position: Start on your hands and knees, with the heel of the hands under shoulder joints keeping the arms long at the elbows without locking, allowing the wrists to flex. Knees directly under hips and feet relaxed.
Action: lift either one arm or leg off the ground (for core control + limb movement) As this gets more comfortable progress to 4 point kneeling lifting opposite and opposite leg (core control + peripheral limb movement). Remember to keep your back flat throughout. Hold each position for 5 seconds.
Repeat each exercise 10 – 15 times and do 3 sets
Level three: Movement patterns
Squat
With a band around your knees. Perform a squat keeping your knees over your second toes, with your back straight and body weight evenly spread over both feet. As this gets easier try to bend your knees further and add a weight to provide further resistance.
Repeat exercise 15 – 25 and do 3 sets
Lunge
Standing tall, take a large step forwards with either leg and bend that knee until the opposite knee is approximately 5cm above the floor. Then extend through the hip and knee to return to the starting position. Remember to keep your back straight throughout the movement. To progress this you can add a weight for resistance or do it on an unstable surface. Repeat on the other side.
Repeat exercise 15 – 25 and do 3 sets
Deadlift (Romanian – RDL)
Stand with your feet hip-distance apart with a slight bend in your knees, a weight placed in front of you.
Hinge forward at the hips, keeping your spine long and straight as your torso reaches toward the floor. Grip the weight with both hands plugging your shoulders back and down to secure your spine and brace your core. Look down and slightly forward to align your neck with the rest of your back and avoid hyperextension.
Tighten your glutes, hamstrings and core and drive your feet into the ground to stand up straight, lifting the weight to about your upper thighs. Squeeze your glutes and lock out your hips at the top.
Repeat the movement by lowering the weight somewhere between your knees and toes (depending on your flexibility), torso parallel to the ground while maintaining a flat back, slight bend in the knees, and core engaged.
Repeat exercise 15 – 25 and do 3 sets
Lawnmower
Begin with your feet hip width apart and step onto a resistance band with one foot and grab the band with the opposite hand. Bend your knees ad rotate your torso to the side that you have stood on the band. With a firm grip of the band, in a slight squat position, stand up rotating your torso whilst pulling the band diagonally across your body and above your head. Return to starting position.
Repeat exercise 15 – 25 and do 3 sets
Stretches
There are many benefits to regular stretching. Not only can stretching help increase your flexibility, which is an important factor of fitness, but it can also improve your posture, reduce stress and body aches, and is an excellent way to help manage low back pain. Some of these exercises are yoga poses, which we know to be a great form of exercise.
For each exercise hold the position for 30 seconds and do 3 sets.
Quadratus Lumborum in standing
Happy cat/sad cat - Childs Pose
Pidgeon
Hip Flexor
Piriformis
Spinal Rotation
Hamstrings