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our physio explains the best exercises for lower back pain

Best Physio Exercises For Lower Back Pain

Let me teach you the best physio exercises for lower back pain.

In our previous article, we discussed lower back pain; the causes and treatment options.

We also touched upon how a loss of muscle relaxation and reduced movement around the lower back is a common signature of people with chronic lower back pain or after an acute episode of lower back pain.

If you have not read that, I highly recommended that you do to gain a more meaningful understanding of the exercises below. 

The Best Physio Exercises For Lower Back Pain

In the first part of the article I will be focusing on bending and twisting exercises to help you improve spinal mobility.

In the second part, we’ll look at exercises to help strengthen your back and regain selective control of your spine through its available range of movement.

Part One: Spinal Mobility

Side Bends

side bends the best physio exercises for lower back pain

This stretch is especially useful for people with increased muscle tightness on one side of the back that is associated with their recent lower back pain.

Begin standing in a position of comfort with arms by your side. If you have increased muscle tightness on the left trunk, slowly slide your hand down towards the side of the right knee.

You should feel a gentle stretch on the left trunk.

Hold it for 5 secs. Repeat it for another 5 repetitions.

Avoid stretching the opposite side of the trunk for the time being if you are still in the early stage of your back pain as it might bring on your symptoms

To progress the exercise, you can reach overhead with arms to the opposite side to stretch the trunk.

Knee To Chest

knee to chest best physio exercises for lower back pain

The knee to chest stretch is an effective position to stretch both your hips and lower back. To perform the exercise, lie on your back and bring one of your knees close to your chest.

You should feel a slight stretch in your lower back.

Hold it for 10 seconds. Repeat it for 3 sets.

To progress the stretch, bring both of your knees to your chest instead.

Child’s Pose

childs pose best physio exercises for lower back pain

The Child’s Pose is a progression to the previous stretch and it also helps improve the mobility of your upper trunk.

Spread your knees apart and with your arms overhead, slowly lower yourself to let your belly rest between your thighs and rest your forehead and arms on the ground.

You should feel a gentle stretch of your hips and low back.

Hold this for 10 seconds and repeat this for 5 times.

This particular type of exercises for lower back pain may not be suitable for those with limited mobility. Also any knee and hip pain in end-range flexion.

Prone Press-Up

prone press up best physio exercises for lower back pain

Lay on your stomach & relax your arms at the sides of your body. As you gently lift your upper body off the floor, you should feel a gentle stretch of your abdomen.

Hold the stretch for 5 seconds, slowly lower yourself down and repeat it 5 times.

This particular set of exercises for lower back pain can aggravate certain back conditions. Be cautious with this exercise. Skip this if it irritates your back.

Trunk Rotation

trunk rotation best physio exercises for lower back pain

Begin in a crook-lying position. Position your feet close to your bottom and keep your knees together.

Slowly lower your knees to the side, holding for 5 seconds at the end of range and repeat this in the opposite direction.

Repeat this for 5 reps each side.

Hip Flexor Stretch

hip flexor stretch best physio exercises for lower back pain

Begin in a lunge position, with one leg forward and the other leg back (stretched leg) . Keep your trunk upright and hips level.

Slowly slide your hips forward while maintaining the upright position. Squeeze the glutes of your rear leg.

You should feel a stretch at the front of the thigh. Maintain this stretch for 30 seconds and repeat for 3 times.

Part 2: Selective Control

People with back pain who brace their trunk or clench their glutes habitually may have difficulty relaxing these muscles. Over time this can result in tightness in the muscle, restricted movement and poor control of the hips and spine through its available range of motion.

The pics below show some relevant exercises for lower back pain and developing selective control. It is important to note that the goal of these exercises is to develop control of the movements when transitioning between positions, rather than achieving the end position alone. This is because you can achieve the same looking end position yet employ an inefficient strategy to get there.

The 2 general rules to follow here are:

  1. If you are using a mass contraction strategy AKA squeezing/contracting all the muscles you can to get moving, you need to relax or regress to an easier exercise. 
  2. Use the minimum muscle activation/ force you need to move. Movement should be slow, smooth & graceful


pelvic tilt best physio exercises for lower back pain
  1. Begin in a crook-lying position. 
  2. Position your feet close to your bottom. 
  3. Gradually tuck your tail bone up, feeling for gradual contractions of your abdominal and gluteal muscles. 
  4. Feel your lower back muscles slowly “letting go” and a gradual flattening of the arch of your back. 
  5. Hold this for 3 seconds and relax. Repeat this 10 times.


bridging best physio exercises for lower back pain

Bridging is a progression from pelvic tilt exercise, requiring you to lift the bottom up as you flatten your back by gradually rolling one vertebrae up followed by the other.
Compared to  the pelvic-tilt exercise which is relatively static, bridging requires greater control of your pelvis through range as you lift your hips further up in the air.

The goal of the exercise is not to bring the hips as high up as possible, doing so tends to result in excessive arching of the trunk with mass contractions of the muscles of the back as seen in the figure below.

Instead, what we are trying to achieve selective activation of the gluteal and abdominal muscle just sufficient to lift the bottom up so that the shoulders, hips and knee are aligned in a straight line.


cat cow best physio exercises for lower back pain

Begin on your hands and knees.

  1. Tilt your pelvis back so that your tailbone sticks up.  
  2. Gradually let your belly sink and chest come forward and finally lift your head
  3. Slowly transit to the cat pose by rounding your back and tucking your tailbone
  4. Relax the head towards the floor
  5. Hold the end position for 3 secs and repeat it for 10 times

Swiss Ball Lateral Pelvic Tilts

swiss ball lateral pelvic tilt best physio exercises for lower back pain

Begin sitting on a Swiss ball with your feet flat on the ground shoulder width apart

  1. Keep your head over your shoulders and keep your shoulders level.
  2. Start with sliding your hips to the right so that the ball moves slightly to the right.
  3. You should feel your left trunk letting go and contractions of your right abdominal muscles
  4. Reverse and slide to the left.
  5. Your shoulders should not move.
  6. Hold the end position for 3 seconds and repeat it for 10 times each side

Conclusion on Exercises for Lower Back Pain

To conclude I would like to leave you with 10 facts about lower back pain recently published in British Journal of Sports Medicine

  1. Back pain is rarely dangerous
  2. Aging is not a cause of back pain. 
  3. A negative mindset, fear avoidance behaviour, negative recovery expectations and poor pain coping behaviour are more strongly associated with persistent pain than is tissue damage. 
  4. Scans rarely tell us about the source of back pain
  5. Pain with exercise does not mean you are doing harm
  6. Posture does not predict back pain 
  7. Weak “core” muscles do not cause back pain
  8. Loading and bending of the spine is safe when it is graded
  9. Pain flare-ups are more closely related to poor sleep, stress, changes in activity than structural damage
  10. Injections, surgery and drugs are not effective for persistent back pain in the long-term. Keeping a positive mindset, optimising your physical and mental health by engaging in physical & social activity, maintaining healthy sleep habits and body weight and remaining in employment help improve outcome in people with lower back pain.

I hope this article has left you with a better understanding of your back pain. As with most things in life, it’s best to get some personal advice from the experts.

You can book in for a telehealth or in clinic session with our physiotherapists.

Disclaimer: This article is not medical advice or treatment plan and is intended for general education purpose only. This article should not be used to self-diagnose or self-treat any medical or physical conditions. Consult your healthcare professional before attempting anything contained in this article.

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Posted by PridePlus Health on Wednesday, 15 April 2020

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