Lower back pain is one of the most common orthopedic conditions for which millions of Americans and New Yorkers seek treatment each year. In fact, 80% of Americans experience low back pain at some point in their lives.
There are several causes and treatments for lower back pain, and the more you know about why the pain is happening, the better you can address the issue.
Why is lower back pain so common?
The back supports most of the movements our body makes, but it isn’t alone in this. The back and spine itself are also supported by other structures in the body such as the glutes, hips, abs and shoulders. When we ignore these other muscles, it forces our back to work harder.
Another common reason for lower back pain, is the lack of attention we give to our spine. When we constantly overload our back with too much pressure, it reduces the flexibility and movement of our spine, which in turn can cause injury and pain.
These exercises for lower back pain are safe and easy for most people, and focus on activating, or “waking up” muscles that are often overlooked while increasing the mobility of our joints and strengthening key muscles. With this fundamental balance, you can easily manage low back pain.
If you have severe pain and/or a diagnosed back injury, please consult your doctor or injury specialist for clearance and supervision to perform these exercises.
Mark is a certified personal trainer and massage therapist who is located in NYC, and has seen countless lower back cases. We have created this guide using his insights and expertise.
HERE ARE MY TOP 9 EXERCISES FOR LOW BACK HEALTH
1.) CAT/COW
Benefits: This basic exercise may seem too easy and simple to bother with but it has a lot of value. It enhances joint mobility and lubricates the joints with synovial fluid. Synovial fluid is essentially the car oil for the facet joints in the spine. Proper circulation of synovial fluid requires joint movement. Plus, this exercise gets the muscles around your spine warmed up and active.
Caution: The range of motion for this exercise should be limited in certain conditions. For example, avoid going into full spinal flexion (the ‘cat’ portion) if you have herniated discs and avoid full extension (the ‘cow’ portion) if you have spinal stenosis.
How: Begin on your hands and knees with your back parallel to the floor. Inhale while rounding your lower back and tucking your head in towards your chest. As you exhale, curl your body into a u-shape, bringing your head and tailbone up. Repeat 5-15 times. Take your time and don’t rush through it.
2.) QUADRIPEDS
Benefits: This exercise is one of the most important and fundamental exercises in low back pain prevention and treatment. It is very safe and although it looks simple, it actually requires a lot of stability, flexibility and mobility in the hip, abdominals, spine and shoulder. This is great to do directly after a series of Cat/Cow.
Caution: This is one of the safest low back and abdominal strengthening exercises anyone can do. The only caveat here is that, if it hurts, either modify or stop. It just means you may not be ready for it in general or just on that particular day.
How: Begin on your hands and knees with your back parallel to the floor. Lift one arm out in front of you while lifting the opposite leg behind you. Pay close attention to form, as this exercise is often done incorrectly. Repeat with each side 5-15 times. Go very slow. Concentrating on your form the entire time is key.
Proper Form:
Try not to shift your body weight to one side as you move. Instead, try to keep your pelvis completely still and let the movement occur within your hip and shoulder joints.
Maintain a neutral spine. In other words, try not to let your low back arch or round too much. Letting this happens defeats one of the main purposes of this exercises, namely to use your deep core musculature to stabilize your spine during movement. The lumbar spine has a natural curve which should be maintained throughout the entire exercise. One great way to ensure this is to place a tennis ball or something similar or slightly larger in size on your low back and not let it move or fall onto the floor as you perform the movements.
Move your arm and leg away from one another, outward rather than upward. If you bring your arm and leg too high up, chances are you’ll overarch your low back and/or neck, lose stability in your shoulder or shift your bodyweight to on side. Pointing your toes and fingers as your limbs move can heEL.
3.) PLANKS
Benefits: Planks are one of my favorite exercises for preventing and recovering from lower back pain. When performed correctly, this exercise helps recruit all of the muscles that play a central role in lumbar spine stability: Tranversus Abdominus, Multifiti, Internal Obliques and Pelvic Floor muscles.
Caution: This exercise may not be appropriate when experiencing acute low back pain and for some conditions. Medical consultation and pain should be your guides.
How: Begin on your knees and forearms with your elbows underneath your shoulders. Your hands and elbows should be shoulder-width apart. Straighten one leg and place your toes on the ground. Repeat with the other leg. Hold for as long as possible or for a designated period of time.
Proper Form:
Maintain the natural curve in your lumbar spine. Make sure not to overarch or flatten your spine.
Keep your entire body parallel to the ground, making sure not to hike your hips in the air or round your upper (thoracic) spine.
Maintain stability in both shoulders, making sure not to ‘collapse’ into one or both of them.
When finished, come onto both knees rather than flopping onto the floor with your back arched, which can compress and irritate the facet joints.
Add modifications throughout: You can lift one leg in the air for a few seconds and alternate, rock your body forward and backwards or side to side without hiking your hips and while maintaining a neutral spine.
How long can you plank?
4.) ARM CHOPS/ROTATIONS
Benefits: This is a great exercise progression series meant to activate and strengthen the deep abdominal and spine stabilization muscles.
Caution: While this is generally a safe exercise, it does create some rotational torque on the spine and thus may not be appropriate for certain back conditions, especially in the acute phase of an injury. Proper technique is vital to both safety and effectiveness. Consult your doctor and injury recovery therapist for approval and proper technique.
How: The most important cues to focus on when performing any of these exercise are the following: Try not to dip your shoulder much if at all, do not hunch over or overarch your low back, keep your arms straight at all times, exhale as you pull down/across and inhale as the weight/band moves away from your body, rotate your hips as little as possible, keep your belly button lightly drawn in towards your spine, bend your knees only slightly and stop if your low back tightens up or becomes painful.
5.) EXERCISE BALL ROTATIONS
Benefits: This exercise is a great way to strengthen many of your low and middle back muscles, posterior shoulder complex and certain abdominals. It is one of my favorite exercises.
Caution: If you have a herniated disc or spinal stenosis, you should consult your physician and injury therapist for approval and proper technique.
How: Lay over an exercise ball on your stomach. Your pecs and/or breasts should be just in front of the ball. Exhale as you rotate up and inhale as you come down. Keep your arm straight and follow your hand with your eyes. Keep your belly button drawn in towards your spine, relax your shoulders and as you rotate up with your right side, push off the floor with your left arm.
6.) OVERHEAD EXERCISE BALL RAISES
Benefits: This exercise focuses on the spinal stabilization musculature from your low to upper back. By performing this exercise while on your knees, the lower body is removed from the picture and thus targets the back and shoulder muscles.
How: With straight arms, raise the exercise ball overhead, hold at the top for 1-2 seconds and slowly lower. Be sure not to overarch the lumbar spine or shift your head forward while raising the ball. Engage your glute muscles and keep your belly button drawn in towards your spine. Be careful not to shrug your shoulders or tense the neck.
7.) BAND-ASSISTED DEADLIFTS
Benefits: Deadlifts can either be extremely beneficial for low back health or very risky. When done correctly, deadlifts engage the Gluteus Maximus as the prime mover while the abdominals, multifi and pelvic floor muscles stabilize the spine.
Caution: Deadlifts of any kind should not be performed when there is back pain. Before attempting any type of deadlifts, consult with your doctor and injury rehabilitation therapist and make sure to get thorough instruction on proper form. I strongly recommend never doing straight leg deadlifts because the benefits are minute compared to the risks.
If you have a history of low back pain, do not perform any type of deadlift without medical clearance and expert supervision.
I prefer the Band-Assisted Deadlifts because it forces the glute muscles, especially the gluteus maximus and medius to work hard to resist the backwards pull of the band. You can add kettlebells and weighted straight bars to increase difficulty.
8.) SHOULDER EXTENSION (W/ ARMS STRAIGHT)
Benefits: This is a great exercise to help activate and strengthen many of the muscle groups that stabilize and move the lumbar and thoracic spine as well as the posterior shoulder muscles. In essence, as you pull the resistance cable (or exercise band) down to your sides, the following muscles are recruited: Transverse Abdominus (the deepest abdominal muscle which is important for lumbar spine stability), the lumbar and thoracic erector spinae group, middle and lower traps, latissiumus dorsi and posterior deltoid as well as the glute max which acts as a fixator.
Caution: This is a very safe exercise as long as you remember not to over-arch your low back. As with any exercise, if your low back tightens up or becomes painful, then stop.
How: Anchor a cable pull or exercise band somewhere between eye level and two feet above your head. Keep your palms facing the ground and arms straight at all times. Exhale and bring your hands down to line up with your body. Keep your arms straight, shoulders relaxed, shoulder blades squeezed together gently, maintain the natural curve in your low back (don’t flatten or over-arch), bend your knees slightly and gently squeeze your butt muscles (gluteus maximus in particular). Maintain these postures while slowly letting your arms raise back up.
9.) SQUAT/ROW
Benefits: This is a fantastic full-body exercise that combines the traditional squat with a standing row. It works on many levels in that it targets the lower body, upper body and torso equally and when done correctly is very effective at getting the glutes, abdominals and many postural mid and upper back muscles to work synergistically.
Caution: While this is generally a very safe exercise it does involve a lot of different muscle groups and joint movements. Be sure to perfect your standing and seated row technique as well as squat technique before moving on to this integrated movement.
How: As with many exercises that involve squatting, deadlifting and rowing movements, there are some basic guidelines to consider
Guidelines For All Exercises:
If it hurts, don’t do it. Whether it is the exercises below or yoga poses, an exercise in physical therapy or something your friend shows you, pain is always your guide. If it hurts, stop. There are a lot of other options out there, especially here in New York City.
What is your diagnosis? Whether you have experienced chronic and repetitive low back pain over a long period or whether it is a new but very painful injury, your next step (if you haven’t already) is to see a medical physician. This is especially the case if you have already tried some conservative treatments such as sports massage and Active Release.
These exercises along with clinical massage will go a long way in effectively treating and preventing back pain. Residents of New York are especially notorious for raking up issues and pain in their back due to active lifestyles and careers that require long periods of inaction. Of course, no two people are alike, so be sure to get specialized attention to really treat problem areas get rid of nagging back pain.