Lower back problems are probably one of the most common chronic injuries seen today by health care professionals and personal trainers alike. Generally caused by years of overusing an already weak back, these chronic injuries can be as simple as muscles that are too tight and full of scar tissue, or as complex as bulging or herniated discs. Though not all back issues are easily solved most can be avoided or at least managed with proper exercise and knowing ones own limits.

Traditionally the course of action for prevention and rehabilitation of back injures has been to improve range of motion throughout the lower back and abdomen, however several studies have pointed more to muscle endurance rather than flexibility as a better way to provide low back injury prevention and pain relief. With that said flexibility is important for overall range of motion (ROM) and to release the scar tissue that tends to build up in chronically damaged muscle and connective tissues however you need to be sure you are not increasing flexibility and ROM at a faster rate than you are your muscle strength and endurance, both of which are needed to control the extra ROM.

In this lower back stretching and strength routine we have included only one “stretch” exercise for the reason stated above and the rest are all intended to focus on strength and endurance to enhance overall motor control and stability for all other activities. Before you use this routine we must first say that not all of these exercises will be appropriate for everyone and every low back issue. We cannot stress more the need to get your doctors approval before starting this routine as every situation is different and this routine has the potential of causing more injury to certain populations.

We have included below a written transcript of this routine with added explanations of each exercise.

Cat-to-Camel: Though this is a stretch in nature the main focus of this exercise for our purposes should be the motion itself and to a lesser extent the stretch. Start with a limited range of motion contracting the abdominal muscles to arch the back up then relaxing back to a neutral spine before gently contracting the back muscles to let the lower back dip to the floor. Keep alternating back and forth working to get just a bit more range on each repetition and only a very slight stretch feeling. Also be sure to pause for a couple seconds for each position but be sure never to hold your breath; inhaling as you drop your back and exhaling as you arch your back up is the suggested breathing pattern.

Side Plank + Side Raises: We start this exercise with a static hold being sure to keep a neutral spine, keeping the hips and chest perpendicular to the ground. Start with the easier version of coming up on the elbow and knee then progress to elbow and feet as you become stronger and have more endurance, just be sure to keep a straight line through your body not letting your hips dip towards the floor. Next we move into an actual range of motion with hip raises dipping the hips towards the floor then raising them up as high as is comfortable. Start with a very small range of motion then expand this range of motion as you can control it and have the flexibility for it.

Bird Dog: On hands and knees, keeping a neutral spine, lift the left leg and right arm making a straight line from wrist to ankle. Be sure not to try and lift your arm or leg higher than this position as it will cause your lower back to dip putting uneven stress on the discs of the back. Hold this position for no longer than 7 to 8 seconds then switch sides and repeat.

Modified Partial Curl-Up: This modified crunch is intended to work the abdominal muscles while stabilizing the hips and supporting the lower back in a neutral spine position. Start by extending one leg out flat on the ground and bending the other leg with your foot about the level of your knee on the straight leg (having one leg out locked helps to stabilize the hips and keep the back in a neutral position). When laying on your back in a neutral (natural relaxed) spine position there will be a gap under your lower back (or at least an area where the lower back is just lightly touching the ground, as is common with people higher amounts of adipose tissue). This area needs to be supported by the hands or a rolled up towel to keep it from flattening to the ground as you contract your abdominal muscles. Once you have the low back supported then contract the abdominals rolling the shoulders up towards the hips starting with only a light contraction/limited range of motion then building up intensity and range as you become stronger and can tolerate the extra range.