Updated: Mar 19, 2019
This specific sequence of exercises combined with your treatment will greatly help rehabilitate your lower back and prevent recurrences of low back pain (LBP). This is achieved by improving your spinal disc and joint flexibility and not core muscle strength. Why flexibility? Recent studies suggest that core muscle strengthening alone will not prevent LBP. This is likely due to the fact that LBP most often arises from daily cumulative compressive forces on your discs and joints and not weak muscles. As a result, like cereal settling in the box, your lumbar discs slowly compact and lose flexibility. Eventually, your low back partially or completely seizes causing an injury. Strong core muscles do not prevent compaction.
Sitting or bending increases disc compressive forces by 50% to 80% compared to standing. They are now considered the leading cumulative postural reason for causing LBP. Typically, these daily cumulative compressive forces build up over a 3 to 5 week period. Then without warning your disc or facet joints suddenly seize while performing some simple movement. Ouch! Depending on the severity of injury, swelling (inflammation) is produced. In sufficient amount, swelling will cause spasm. Spasm is your body’s natural splinting mechanism to protect you from further injury.
The following sequence of core flexibility poses will boost your healing. There are four phases of injury healing: acute, sub-acute, repair and re-modeling. During the acute and sub-acute phases, perform exercises 1 – 4. Add exercises 5 & 6 during the repair phase (when you begin to experience stiffness and no pain. If a particular exercise hurts, avoid it and do the others. Combined, these exercises will garner a stronger repair of your joints and discs which reduces your risk of future relapses. Core strengthening exercises are next (not shown).
Perform them on a firm bed or carpeted floor and if needed, use a pillow for your neck and head.
- Perform them in the order as listed.
- Breathe naturally and do not hold your breath.
- Key: When exhaling, pull further in the direction of the pose.
- Hold each pose for 30 to 60 seconds.
- Stop if you experience sharp or severe pain and notify Dr. Arthur.
1. Hip flex and knee flex
Grasp one knee and pull it towards your chest as far as it will initially go. The opposite leg should remain straight. Count slowly to 30. Repeat with your opposite knee.
2. Low back/hip rotational flex # 1
Bend both knees and place your feet flat on the floor. Then, place your right ankle on the outside of your left knee. Now use palm of your right hand to press your right knee towards the right. Keep your left arm, elbow and shoulder on the floor. Breathe naturally and press your right leg further and further towards the floor every 5 to 8 seconds as you exhale until you have counted to 30.
Repeat using your left ankle on the outside of your right knee. Press your left knee towards the floor.
3. Low back/hip rotational flex # 2
Bend and point one knee towards the ceiling. With your opposite hand grasp the outside of your bent knee and slowly begin to pull your knee towards the floor. Count slowly to 30. Repeat using your opposite knee.
4. Full spine flex
Pull both knees to your chest. At the same time tuck your chin to your chest as hard as you can. Pull your knees closer to your chest as hard as you can and count to 30.
5. Full spine and hip flex
Sit up and straighten one leg in front of you. Bend your opposite leg placing your foot against your inner thigh. Flex forward as far as you comfortably can and grasp your ankle or foot and pull your head over your knee. Count to 30. Repeat this on the opposite side.
6. Full spine extension
Lastly, turn onto your stomach. Place your palms on the floor next to your shoulders. Slowly press your upper body but not your hips off the floor. Lift your head backwards by looking upwards. Press your upper body as high as you comfortably can. Count to 30.
These 6 flexibility exercises are excellent for rehabilitating your lumbar spine as well as preventing lower back problems when practiced routinely. More importantly, keeping your spine flexible will slow down disc degeneration.*
About the Author:
*Jeng C, Cheng T, Kung C, Hsu H. Yoga and disc degenerative disease in cervical and
lumbar spine: an MR imaging-based case control study. Eur Spine J (2011) 20:408–413.