Back Care Exercises

These exercises should only be done on recommendation of a medical practitioner. Not all exercises are suitable for all persons.  What exercises are suitable for you, among the below explained ones, will depend on the condition causing the back pain, consult your doctor.

Williams' Flexion Exercises

These exercises were deviced by Dr. Paul Williams in 1937 for patients with chronic low back pain after finding that majority of these patients had degenerative disk disease.

Williams' Flexion Exercises

1. Pelvic tilt.

• Lie on your back with knees bent, feet flat on floor.
• Flatten the small of your back against the floor, without pushing down with the legs.
• Hold for 5 to 10 seconds.

2. Single Knee to chest.

• Lie on your back with knees bent and feet flat on the floor.
• Slowly pull your right knee toward your shoulder and hold 5 to 10 seconds.
• Lower the knee and repeat with the other knee.

3. Double knee to chest.

• Lie on your back with knees bent, feet flat on floor.
• After pulling right knee to chest, pull left knee to chest and hold both knees for 5 to 10 seconds.
• Slowly lower one leg at a time.

4. Partial sit-up.

• Lie on your back with knees bent, feet flat on floor.
• Flatten the small of your back against the floor, without pushing down with the legs.
• Hold for 5 to 10 seconds.
• while holding this position, slowly curl your head and shoulders off the floor.
• Hold briefly.
• Return slowly to the starting position.

5. Hamstring stretch.

• Start in long sitting with toes directed toward the ceiling and knees fully streched.
• Slowly lower the trunk forward over the legs, keeping knees streched, arms outstretched over the legs, and eyes focus ahead.

6. Hip Flexor stretch.

• Place one foot in front of the other with the left (front) knee bent and the right (back) knee held rigidly straight.
• Flex forward through the trunk until the left knee contacts the axillary fold (arm pit region).
• Repeat with right leg forward and left leg back.

7. Squat.

• Stand with both feet parallel, about shoulder’s width apart.
• Attempting to maintain the trunk as perpendicular as possible to the floor, eyes focused ahead, and feet flat on the floor, slowly lower your body by bending your knees.

Devised by Robin McKenzie in 1981, after noting that some of his patients reported lower back pain relief while in an extended position. This went against the predominant thinking of Williams Flexion biased exercises at this period of time.

McKenzie Back Extension Exercises

1. Prone lying.
   

• Lie on your stomach with arms along your sides and head turned to one side.
  
• Maintain this position for 5 to 10 minutes.
  

2. Prone lying on elbows.

• Lie on your stomach with your weight on your elbows and forearms and your hips touching the floor or mat.
• Relax your lower back. Remain in this position 5 to 10 minutes.

3. Prone press-ups.

• Lie on your stomach with palms near your shoulders, as if to do a standard push-up.
• Slowly push your shoulders up, keeping your hips on the surface and letting your back and stomach sag.
• Slowly lower your shoulders. Repeat 10 times.

4. Progressive extension with pillows.

• Lie on your stomach and place a pillow under your chest.
• After several minutes, add a second pillow.
• If this does not hurt, add a third pillow after a few more minutes.
• Stay in this position up to 10 minutes. Remove pillows one at a time over several minutes.

5. Standing extension.

• While standing, place your hands in the small of your back and lean backward.
• Hold for 20 seconds and repeat.
• Use this exercise after normal activities during the day that place your back in a flexed position: lifting, forward bending, sitting, etc.

Extension exercises may cause further damage in people with spondylolysis, spondylolisthesis and facet joint dysfunction. Flexion exercises should be avoided in persons with acute disc herniation.

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