Lower Back Pain Exercises Initial Exercise Program

Ankle Pumps

Lie on your back. Move ankles up and down. Repeat 10 times. Repeat 10 times.

Heel Slides

Lie on your back. Slowly bend and straighten knee. Repeat 10 times.

Abdominal Contraction

Lie on your back with knees bent and hands resting below ribs. Tighten abdominal muscles to squeeze ribs down toward back. Be sure not to hold breath. Hold 5 seconds. Relax. Repeat 10 times.

Wall Squats

Stand with back leaning against wall. Walk feet 12 inches in front of body. Keep abdominal muscles tight while slowly bending both knees 45 degrees. Hold 5 seconds. Slowly return to upright position. Repeat 10 times.

Heel Raises

Stand with weight even on both feet. Slowly raise heels up and down. Repeat 10 times.

Straight Leg Raises

Lie on your back with one leg straight and one knee bent. Tighten abdominal muscles to stabilize low back.


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Slowly lift leg straight up about 6 to 12 inches and hold 1 to 5 seconds. Lower leg slowly. Repeat 10 times.

Intermediate Exercise Program

Single Knee to Chest Stretch

Lie on your back with both knees bent. Hold thigh behind knee and bring one knee up to chest. Hold 20 seconds. Relax. Repeat 5 times on each side.

Hamstring Stretch

Lie on your back with legs bent. Hold one thigh behind knee. Slowly straighten knee until a stretch is felt in back of thigh. Hold 20 seconds. Relax. Repeat 5 times on each side.

Lumbar Stabilization Exercises With Swiss Ball

Abdominal muscles must remain contracted during each exercise (see Abdominal Contraction). Perform each exercise for 60 seconds. The farther the ball is from your body, the harder the exercise. Lying on Floor


Sitting on Ball

Lie on your back with knees bent and calves resting on ball. Slowly raise arm over head and lower arm, alternating right and left sides. Slowly straighten one knee and relax, alternating right and left sides. Slowly straighten one knee and raise opposite arm over head. Alternate opposite arms and legs. Slowly "walk" ball forward and backward with legs.

Standing

Sit on ball with hips and knees bent 90and feet resting on floor. Slowly raise arm over head and lower arm, alternating right and left sides. Slowly raise and lower heel, alternating right and left sides. Slowly raise one heel and raise opposite arm over head. Alternate opposite arm and heel. Marching: Slowly raise one foot 2 inches from floor, alternating right and left sides.


Lying on Ball

Stand with ball between your low back and wall. Slowly bend knees 45 to 90 . Hold 5 seconds. Straighten knees. Slowly bend knees 45 to 90 while raising both arms over head.

Lie on your stomach over ball Slowly raise alternate arms over head. Slowly raise alternate legs 2 to 4 inches from floor. Combine 1 and 2, alternating opposite arms and legs. Bend one knee. Slowly lift this leg up, alternating right and left legs.

NOTE: Be careful not to arch your low back!

Advanced Exercise Program

Hip Flexor Stretch

Lie on your back near edge of bed, holding knees to chest. Slowly lower one leg down, keeping knee bent, until a stretch is felt across top of the hip/thigh. Hold 20 seconds. Relax. Repeat 5 times on each side.

Piriformis Stretch

Lie on back with both knees bent. Cross one leg on top of the other. Pull opposite knee to chest until a stretch is felt in the buttock/hip area. Hold 20 seconds. Relax. Repeat 5 times each side.

Lumbar Stabilization Exercise With Swiss Ball

Lie on stomach over ball. " Walk " hands out in front of ball until ball is under legs. Reverse to starting position. " Walk " hands out in front of ball until ball is under legs and slowly raise alternating arms over head. " Walk " hands out in front of ball and slowly perform push-ups.

Back Exercises
Benefits of Back Exercises
Exercise is one of the most effective ways of preventing and treating recurring or chronic back pain. Strengthening muscles that support the spine with exercises can prevent, reduce and in some cases eliminate lower back pain. Stretchingshortened muscles that are pulling the spine out of alignment can also relieve lower back pain. Weak core muscles are often at the root of lower back pain. The muscles of the back, the abdomen, hips and buttocks (the core muscles) work together to support the spine. The core muscles are the spine's main defense against gravity. The core muscles help maintain proper posture and stabilize the spine (keep it firm in its natural alignment during movement - walking, running, lifting, exercising, etc. Improving core stability reduces the risk of injury to the spinal joints, discs, back muscles & ligaments during such activities. Exercises to increase strength, endurance and coordination of the core muscles improve core stability.

Lower Back Stretches Basic Exercises

Rotation in Lying Lie on your back, knees bent, feet flat and together. Gently take both knees from side to side as far as possible painfree (figure 1). Repeat 10 - 20 times.

Figure 1 Rotation in Lying Prone on Elbows Begin lying on your stomach, then gently prop yourself up onto your forearms, keeping your back relaxed (figure 2). Hold for 2 seconds, then slowly lower yourself down flat. Repeat 10 times provided the exercise is pain-free.

Figure 2 Prone on Elbows Knees to Chest Lie on your back, knees bent. Take both knees towards your chest using your hands until you feel a mild to moderate stretch, pain-free (figure 3). Hold for 5 seconds and repeat 10 times.

Figure 3 Knees to Chest Side Flexion in Standing Begin standing tall, back straight, hands by your sides. Gently lean to one side, sliding your hand down the outside of your thigh as far as possible pain-free (figure 4) . Repeat 10 times to each side.

Figure 4 Side Flexion in Standing

Lower Back Stretches Advanced Exercises

Extension in Lying Begin lying on your stomach with your hands in the press up position as demonstrated (figure 5). Gently straighten your elbows, letting your back fall into an arch. Keep your back relaxed. Straighten your elbows as far as possible pain-free. Repeat 10 times.

Figure 5 Extension in Lying

Core Exercises Basic

Transversus Abdominis Activation Begin this core exercise lying on your back as demonstrated (figure 1). Slowly pull your belly button in, "away from your belt line", and breathe normally. Your rib cage should remain relaxed and should not elevate during this process. You should be able to feel the muscle contracting if you press deeply 2cm in from the bony prominence at the front of your pelvis (figure 1). Practise holding this muscle at one third of a maximal contraction for as long as possible during everyday activities (e.g. when walking etc.) provided it is pain free. Repeat this core exercise 3 times daily.

Figure 1 Transversus Abdominis Activation

Bridging Begin this core exercise lying on your back in the position demonstrated (figure 2). Slowly lift your bottom pushing through your feet, until your knees, hips and shoulders are in a straight line. Tighten your bottom muscles (gluteals) as you do this. Hold for 2 seconds and then return to the starting position. Perform 1 - 3 sets of 10 repetitions provided the exercise is pain free. Maintain activation of your transversus abdominis muscle throughout the exercise.

Figure 2 Bridging Abdominal Crunch Begin this core exercise lying on your back, with your knees bent and your hands on the sides of your head as demonstrated (figure 3). Keeping your neck straight, slowly lift your shoulders and trunk off the ground, tightening your abdominals. Perform 1 - 3 sets of 10 repetitions provided the exercise is pain free. Maintain activation of your transversus abdominis muscle throughout the exercise.

Figure 3 Abdominal Crunch Prone Hold Begin this core exercise propped up on your elbows and toes, in a tall, straight posture as demonstrated (figure 4). Maintain activation of your transversus abdominis muscle during the exercise. Try to keep your spine and pelvis still and breathe normally. Hold this position for as long as possible provided it is pain free and you are maintaining good posture. Repeat 3 times.

Figure 4 Prone Hold Four Point Kneeling Opposite Arm & Leg Raises Begin this core exercise in Four Point Kneeling as demonstrated (figure 5). Maintain good posture and activation of your transversus abdominis muscle throughout the exercise. Slowly raise one arm and the opposite leg and then return to the starting position. Keep your spine and pelvis still throughout the exercise and breathe normally. Perform 1 - 3 sets of 10 repetitions, provided the exercise is pain free, alternating between sides.

Figure 5 Four Point Kneeling Opposite Arm & Leg Raises Side Holds Begin this core exercise propped up on one elbow and foot with your back straight as demonstrated (figure 6). Maintain activation of your transversus abdominis muscle throughout the exercise. Hold the position for as long as possible provided it is pain free and you are maintaining good posture. Repeat 3 times on each side.

Figure 6 Side Holds (left side) Roll Outs Begin this core exercise in kneeling with your hands on a Swiss Ball and in good posture, as demonstrated (figure 7). Maintain activation of your transversus abdominis muscle throughout the exercise. Slowly roll the Swiss Ball forwards, moving at your knees, keeping your back, hips and arms straight, then return to the starting position. Keep your spine and pelvis still throughout the exercise and breathe normally. Perform 1 - 3 sets of 10 repetitions provided the exercise is pain free.

Figure 7 Roll Outs

Beginner Pilates Exercises

The following beginner Pilates exercises should be performed approximately 1 - 3 times per week. As your control improves, the exercises can be progressed by gradually increasing the repetitions, or frequency of the exercises provided they do not cause or increase pain. Heel Slides Begin this Pilates exercise lying on your back with your hands by your side in neutral spine as demonstrated (figure 1). Maintain activation of your transversus abdominis and pelvic floor muscles throughout the exercise. Slowly straighten one knee and then return to the starting position. Keep your spine and pelvis completely still and breathe normally. Perform 10 times alternating between legs.

Figure 1 Heel Slides Leg Openings Begin this Pilates exercise lying on your back with your hands by your side in neutral spine as demonstrated (figure 2). Maintain activation of your transversus abdominis and pelvic floor muscles throughout the exercise. Slowly take one knee to the side and then return to the starting position. Keep your spine and pelvis completely still and breathe normally. Perform 10 times alternating between legs.

Leg Lifts

Figure 2 Leg Openings

Begin this Pilates exercise lying on your back with your hands by your side in neutral spine as demonstrated (figure 3). Maintain activation of your transversus abdominis and pelvic floor muscles throughout the exercise. Slowly lift one leg and then return to the starting position. Keep your spine and pelvis completely still and breathe normally. Perform 10 times alternating between legs.

Figure 3 Leg Lifts

Heel Taps Begin this Pilates exercise lying on your back in neutral spine with your hands by your side and your hips and knees bent to 90 degrees as demonstrated (figure 4). Maintain activation of your transversus abdominis and pelvic floor muscles throughout the exercise. Slowly lower one leg until your heel touches the ground and then return to the starting position. Keep your spine and pelvis completely still and breathe normally. Perform 10 times alternating between legs.

Figure 4 Heel Taps Bridging Begin this Pilates exercise lying on your back in neutral spine as demonstrated (figure 5). Maintain activation of your transversus abdominis and pelvic floor muscles throughout the exercise. Slowly lift your bottom pushing through your feet, until your knees, hips and shoulders are in a straight line and then return to the starting position. Breathe normally. Perform 10 times.

Figure 5 Bridging