Exercises to Help Reduce and Prevent Low Back Pain

As a PT (Physical Therapist), one of the most common problems people come to see me for is low back pain. This pain has many CAUSES including:

• degeneration (arthritis)
• nerve impairment
• sedentary lifestyle and weakness
• Abnormal posture 

Stretches

There are several ways to treat low back pain and one of those ways is stretching. Stretching of the muscles of the low back will help to relieve tightness causing the pain. The main muscles I will instruct patients to stretch are the lumbar paraspinals, quadratus lumborum, gluts, and hamstrings. 

I know what you are thinking “the hamstrings?” Yes! 

The hamstrings attach on the sit bones of the pelvis and when they become tight, they can pull the pelvis in the wrong direction and reduce the curve the lumbar spine is supposed to have or lordosis.

The last stretch is actually for the sciatic nerve. Nerves don’t stretch like muscles do but they should be able to move or glide through the available space a few millimeters. With nerve entrapment, the nerves get pinched and causing pain in other parts of the body along that specific nerve. With regular stretching the entrapment can be reduced. 

Now the question I get all the time is “how long do I hold the stretch?” Studies have shown that 30 seconds is the most efficient way to get the desired effects of stretching. Stretching 3-5 times for 30 seconds will give the best results. (I have another blog post coming about how long to hold stretches and why.)

Stretches to Perform

LTR: lower trunk rotation. You should be feeling the stretch on the side of your back on the opposite side of the knees being dropped.

SKTC: single knee to chest. For this stretch you should feel the pulling in the butt and maybe the low back.

Child’s pose: sit back into your heels. You should feel the stretch throughout the back and shoulders.

supine/seated hamstring: feel this stretch in the back of your thighs.

seated QL and hamstring: The QL is the quadratus lumborum, a square shaped muscle in your back that helps to side bend your spine. With this stretch you should feel it in the side of your back that you are stretching away from.

Sciatic nerve stretches: the sciatic nerve begins in the low back and goes down to both lower legs. In the gluteal region the nerve is about an inch in diameter. In this stretch, you sit in your chair in a slumped position with your chin to your chest, extend your knee while pumping your ankle up and down. You may feel a stretch from hip to your foot. If you don’t feel anything your nerve is getting adequate space.

Core Strengthening

Another way to help reduce and prevent low back pain is core strengthening. Now the core is not just the abdominal muscles. The core includes the back, hip, and gluteal muscles along with the abdominals. All of these muscles need to be strengthened because if your core is weak it can lead to poor posture, muscle injuries and LOW BACK PAIN!

Bridges: Knees are bent with feet flat on the floor. Lift your hips up making a straight line from your knee to your shoulders. You should feel the muscles in the hamstrings and glutes activating. 

Supine marches:  Start with knees bent and feet flat on the floor. Brace your stomach and back while you lift one leg, put it back on the floor then lift the other leg. You should feel the back and stomach muscles activate.

Dead bugs: While laying on your back, lift arms and legs into the air (picture 1), then straighten opposite arm and leg while holding the other still. (picture 2).

Bird dogs: While on your hands and knees, stabilize your back by pulling your belly button to your back (picture 1). Lift opposite arm and leg (Left leg and Right arm) picture 2.

Stabilization of Core

But it is not enough for you to just perform these strengthening exercises. Proper posture is also crucial. The main position you need to hold and be able to perform at all for that matter is called a pelvic tilt. This is the very first exercise I will show my patients that I see for low back pain. Holding this position is important to stabilize your core while performing exercises and everyday activities. 

Pelvic tilt: While laying on your back with knees bent, flatten your back into the floor. Hold it for 5 seconds about 30 times. This exercise should be utilized when sitting and standing as well.