Basic Rules for a Healthy Back

  • Exercise regularly. Exercise is critical to muscle strength—and strong back muscles help support your spinal column. Wall squats and leg lifts are good for your back, and many yoga poses help keep your back muscles strong.

  • Keep your back straight. Good posture helps keep your spine healthy by allowing it to maintain its natural shape and keeping blood flowing. Poor posture can stress your spinal column and constrict blood flow.

  • Kneel to bend. Bending at the waist puts pressure on your spinal column—bend your knees and lower your whole body when you need to bend, rather than folding over at the waist.

  • Don’t lift heavy objects. Your back wasn’t designed for lifting heavy objects—use rolling suitcases, hand trucks, or other devices meant to carry the load for you.

  • Spread out loads evenly, and keep them next to your body. Don’t try to carry a heavy load on one side of your body—it puts pressure on your vertebrae – and don’t carry anything at arm’s length. If you must carry a load, keep it centred and close to your body. That goes for kids, too—don’t them carry a heavy backpack slung over one shoulder.

  • When sitting, keep your back straight and support your upper body. Keeping your back straight when sitting keeps it in its proper position and reduces pressure on your vertebrae.

  • Do not stand with straight legs. Keeping your knees “soft,” rather than locked straight, when you stand reduces stress on your spinal column.

  • When lying down, keep your legs bent. Keeping your legs bent when lying down allows your spine to maintain its natural shape. Lying flat (either face up or face down) forces your spine to either flex or extend and puts pressure on your discs.

  • Do sports, particularly swimming, running, or cycling. Many sports provide a good workout without seeming like work. Get your exercise by swimming, running, cycling, or engaging in other sports that get your heart pumping and your muscles moving.

  • Train your spinal muscles every day. Teach your spinal muscles to support your spinal column— exercise to keep them strong.

Side Plank

Lie on your side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm so your elbow is directly under your shoulder. Lift your hips off the floor and balance on your forearm and the outside of your foot. Try to hold this position for 15 seconds, and then slowly lower your hip to the ground. Switch sides and repeat. Work up to holding for 1 minute or longer. This exercise can be made easier by starting with your knees and hips flexed to 45 degree angles.

Quadruped arm/leg raise

Get down on your hands and knees. Tighten your abdominal muscles to stiffen your spine. While keeping your abdominals tight, raise one arm and the opposite leg away from you. Hold this position for 5 seconds. Lower your arm and leg slowly and alternate sides. Do this 10 times on each side.

Extension exercise

Lie face down on the floor for 5 minutes. If this hurts too much, lie face down with a pillow under your stomach. This should relieve your leg or back pain. When you can lie on your stomach for 5 minutes without a pillow, then you can continue with the rest of this exercise.

After lying on your stomach for 5 minutes, prop yourself up on your elbows for another 5 minutes. Lie flat again for 1 minute, then press down on your hands and extend your elbows while keeping your hips flat on the floor. Hold for 1 second and lower yourself to the floor. Repeat 10 times. Do 4 sets. Rest for 2 minutes between sets. You should have no pain in your legs when you do this, but it is normal to feel pain in your lower back. Do this several times a day.

Front Plank

Step 1
Starting Position: Lie on your stomach on an exercise mat or floor with your elbows close to your sides and directly under your shoulders, palms down and fingers facing forward. Engage your abdominal/core muscles. It should feel like you are tightening a corset around your ribs, waist and lower torso. Contract your thigh muscles to straighten your legs strongly and flex your ankles, (tucking your toes towards your shins).

Step 2
Upward Phase. Slowly lift your torso and thighs off the floor or mat. Keep your torso and legs rigid. Do not allow any sagging in your ribcage or low back. Avoid hiking your hips into the air or bending the knees. Keep the shoulders away from the ears (no shrugging). The shoulders should be directly over your elbows with your palms facing down through the entire exercise. Continue to breathe, keeping the abdominals strong while holding this position. Try holding this position for 5 seconds or more.

Step 3
Downward Phase: Keep the torso and legs stiff as you slowly and gently lower your body back towards the mat or floor. If you experience any pain in the low back with this movement, stop the exercise immediately and consult with your doctor.

GLUT BRIDGE

Step 1
Starting Position: Lie on your back on an exercise mat or the floor in a bent-knee position with your feet flat on the floor. Place your feet hip-width apart with the toes facing away from you. Gently contract your abdominal muscles to flatten your low back into the floor. Attempt to maintain this gentle muscle contraction throughout the exercise.

Step 2
Upward Phase: Gently exhale. Keep the abdominals engaged and lift your hips up off the floor. Press your heels into the floor for added stability. Avoid pushing your hips too high, which can cause hyperextension (arching) in your low back. Keeping your abdominals strong helps to prevent excessive arching in the low back.

Step 3
Lowering Phase: Inhale and slowly lower yourself back to your starting position.

Step 4
Progression: Gradually progress this exercise by starting with both feet together and extending one leg while in the raised position.
Avoid arching your low back as you press your hips upward, which normally occurs if you attempt to push your hips as high as possible. This can be achieved by contracting your abdominal muscles prior to lifting, and keeping them engaged throughout the lift.

Side Plank

Step 1
Starting Position: Lie on your right side on an exercise mat with your legs straight and the left leg stacked directly on top of the right. Bend the right elbow and place is directly under your shoulder. Align your head with your spine and keep your hips and right knee in contact with the exercise mat.

Step 2
Upward Phase: Exhale, keep the abdominals engaged to brace your spine. Lift your hips and knees off the mat. The side of your right foot stays in contact with the mat. Keep your head aligned with your spine and your right elbow positioned directly under your shoulder.

Step 3
Lowering Phase: Inhale and gently return to your starting position. After a prescribed number of repetitions, repeat on the other side.

Step 4
Exercise Variation: You can increase the intensity of this exercise by (1) increasing the length of time you are in the raised position, (2) raising the upper leg off the lower leg or (3) raising the lower leg off the floor and maintaining contact with your elbow and the foot of the upper leg only. When raising the upper leg off the lower leg, there is no need to raise it to a level beyond parallel with the floor.

Standing hamstring stretch

Place the heel of your injured leg on a stool about 15 inches high. Keep your knee straight. Lean forward, bending at the hips until you feel a mild stretch in the back of your thigh. Make sure you do not roll your shoulders and bend at the waist when doing this or you will stretch your lower back instead of your leg. Hold the stretch for 15 to 30 seconds. Repeat 3 times.

Cat and camel

Get down on your hands and knees. Let your stomach sag, allowing your back to curve downward. Hold this position for 5 seconds. Then arch your back and hold for 5 seconds. Do 3 sets of 10.

Quadruped arm/leg raise

Get down on your hands and knees. Tighten your abdominal muscles to stiffen your spine. While keeping your abdominals tight, raise one arm and the opposite leg away from you. Hold this position for 5 seconds. Lower your arm and leg slowly and alternate sides. Do this 10 times on each side.

Pelvic tilt

Lie on your back with your knees bent and your feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. Hold this position for 5 seconds, then relax. Do 3 sets of 10.

Partial curl

Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles. Tuck your chin to your chest. With your hands stretched out in front of you, curl your upper body forward until your shoulders clear the floor. Hold this position for 3 seconds. Don’t hold your breath. It helps to breathe out as you lift your shoulders up. Relax. Repeat 10 times. Build to 3 sets of 10. To challenge yourself, clasp your hands behind your head and keep your elbows out to the side.

Gluteal stretch

Lying on your back with both knees bent, rest the ankle of one leg over the knee of your other leg. Grasp the thigh of the bottom leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the top leg. Hold this for 15 to 30 seconds. Repeat 3 times.

Extension exercise

Lie face down on the floor for 5 minutes. If this hurts too much, lie face down with a pillow under your stomach. This should relieve your leg or back pain. When you can lie on your stomach for 5 minutes without a pillow, then you can continue with the rest of this exercise.

After lying on your stomach for 5 minutes, prop yourself up on your elbows for another 5 minutes. Lie flat again for 1 minute, then press down on your hands and extend your elbows while keeping your hips flat on the floor. Hold for 1 second and lower yourself to the floor. Repeat 10 times. Do 4 sets. Rest for 2 minutes between sets. You should have no pain in your legs when you do this, but it is normal to feel pain in your lower back. Do this several times a day.

Side Plank

Lie on your side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm so your elbow is directly under your shoulder. Lift your hips off the floor and balance on your forearm and the outside of your foot. Try to hold this position for 15 seconds, then slowly lower your hip to the ground. Switch sides and repeat. Work up to holding for 1 minute or longer. This exercise can be made easier by starting with your knees and hips flexed to 45 degree angles.

Back extension without arms supporting

  • Lying face down, place the arms by the side of the body.
  • Gently pull in the lower stomach muscles to activate the core muscles and protect the spine.
  • Raise the upper body off the floor. Keep breathing throughout the exercise.
  • If you feel any tension in the lower back return to the start position and rest for a few breaths.
  • This will allow the muscles to relax before you perform a second lift.
  • A slightly more challenging option is to then raise the arms off the floor. This will increase the effort of the extensor muscles of the spine.
  • Hold the position for 10 seconds.
  • Repeat 10 times.

Back extension with arms supporting

  • Lying face down. Bring the arms to a bent arm position so that the forearms rest on the floor as shown in the photo.
  • Gently pull the stomach muscles in to protect the spine.
  • Gently raise the body off the ground whilst gently resting on the forearms.
  • Avoid using your arms to lift you up, instead lightly rest on the forearms and use your back muscles to lift you. Avoid hyper-extending the spine to avoid ‘pinching’ the lower back.
  • Hold the position for 10 seconds and then return to the resting position.
  • Repeat 10 times.

Plank with knees bent to strengthen the core muscles.

  • The plank is a strong exercise.
  • A good way to start is with the knees bent.
  • Bend the arms and place the forearms on the floor. With knees bent, keep the trunk of the body off the ground.
  • Hold for 10 seconds and then rest.
  • Over time increase the time in the position to 20 seconds, 30 seconds and eventually 60 seconds. If you start to shake, take a rest.
  • Repeat 2 or 3 times.

Bridge Curl

  • Lie on your back with knees bent and feet hip width apart.
  • Slowly and gently lift the spine off the floor one vertebrae at a time.
  • Slowly lower the spine back to the floor, again one vertebrae at a time.
  • If the core muscles are weak, the movement can feel ‘jerky’. Over time, the movement will become smoother.
  • Repeat the movement 5 times.

Table Top

  • Start in the ‘table top’ position.
  • Gently draw in your lower stomach muscles to activate your core muscles.
  • It is good to imagine that you are keeping a tray on your back with glass of water that you wish to balance.
  • Gently lift one arm whilst maintaining your balance. If that feels easy, then repeat this with eyes closed.
  • Alternate arm lifts.
  • Check that your lower stomach muscle contraction is maintained.
  • Repeat 10 times.

Do these exercises only if you do not have pain or numbness running down your arm or into your hand. The first 6 exercises are meant to help your neck remain flexible. Do not do any exercises that make your neck pain worse.

Active neck rotation

Sit in a chair, keeping your neck, shoulders, and trunk straight. First, turn your head slowly to the right. Move it gently to the point of pain. Move it back to the forward position. Relax. Then move it to the left. Repeat 10 times.

Active neck side bend

Sit in a chair, keeping your neck, shoulders, and trunk straight. Tilt your head so that your right ear moves toward your right shoulder. Move it to the point of pain. Then tilt your head so your left ear moves toward your left shoulder. Make sure you do not rotate your head while tilting or raise your shoulder toward your head. Repeat this exercise 10 times in each direction.

Neck flexion

Sit in a chair, keeping your neck, shoulders, and trunk straight. Bend your head forward, reaching your chin toward your chest. Hold for 5 seconds. Repeat 10 times.

Neck extension

Sit in a chair, keeping your neck, shoulders, and trunk straight. Bring your head back so that your chin is pointing toward the ceiling. Repeat 10 times.

Chin tuck

Place your fingertips on your chin and gently push your head straight back as if you are trying to make a double chin. Keep looking forward as your head moves back. Hold 5 seconds and repeat 5 times.

Neck rotation with flexion:

Right: Turn your head to the right and clasp your hands behind your head. Let the weight of your arms pull your chin to the right side of your chest. Relax. Hold for a count of 15. Do this

3 times.

Left: Turn your head to the left and clasp your hands behind your head. Let the weight of your arms pull your chin to the left side of your chest. Relax. Hold for a count of 15. Do this 3 times

Neck rotation stretch

Right side: Rotate your neck by looking over your right shoulder. Lift your right hand and place your palm on the left side of your chin. Push your chin with your palm toward your right shoulder. Hold for a count of 10. Do this 3 times.

Left side: Rotate your neck by looking over your left shoulder. Lift your left hand and place your palm on the right side of your chin. Push your chin with your palm toward your left shoulder. Hold for a count of 10. Do this 3 times.

Scalene stretch

This stretches the neck muscles that attach to your ribs. Sitting in an upright position, clasp both hands behind your back, lower your left shoulder, and tilt your

head toward the right. Hold this position for 15 to 30 seconds and then come back to the starting position. Lower your right shoulder and tilt your head toward the left until you feel a stretch. Hold for 15 to 30 seconds. Repeat 3 times on each side.

Isometric neck flexion

Sit tall, eyes straight ahead, and chin level. Place your palm against your forehead and gently push your forehead into your palm. Hold for 5 seconds and release. Do 3 sets of 5.

Isometric neck extension

Sit tall, eyes straight ahead, and chin level. Clasp your hands together and place them behind your head. Press the back of your head into your palms. Hold 5 seconds and release. Do 3 sets of 5.

Isometric neck side bend

Sit tall, eyes straight ahead, and chin level. Place the palm of your hand at the side of your temple and press your temple into the palm of your hand. Hold 5 seconds and release. Do 3 sets of 5 on each side.

Head lift: Neck curl

Lie on your back with your knees bent and your feet flat on the floor. Tuck your chin and lift your head toward your chest, keeping your shoulders on the floor. Hold for 5 seconds. Repeat 10 times.

Head lift: Neck side bend

Lie on your right side with your right arm lying straight out. Rest your head on your arm, then lift your head slowly toward your left shoulder. Hold for 5 seconds. Repeat 10 times. Switch to your left side and repeat the exercise, lifting your head toward your right shoulder.

Neck extension on hands and knees

Get on your hands and knees and look down at the floor.
Arch your back, relax the muscles in your neck and gently let your head drop.
Reverse the pose, flatten your back and raise your head to look up at the ceiling.
Hold this position for 5 seconds. Repeat 10 times.

Scapular squeeze

While sitting or standing with your arms by your sides, squeeze your shoulder blades together and hold for 5 seconds. Do 3 sets of 10.

Thoracic extension

While sitting in a chair, clasp both arms behind your head. Gently arch backward and look up toward the ceiling. Repeat 10 times. Do this several times per day.