There is an exceedingly high chance that you or someone you know is suffering or has suffered from lower back pain, especially here in New York City. How high is that chance? A full 80%. But did you know that there are some simple exercises that can help you prevent and get rid of low back pain? Exercises that don't require a gym, a lot of space, very little time, are appropriate for any fitness level and are low-risk.
Too many of us just assume that lower back pain is the result of weak back muscles or an untreatable herniated disc and that it's something that we just have to get used to. Fortunately there are ways of alleviating and ridding yourself of low back pain once and for all, but not in the way you may think. In addition to manual therapies such as Active Release and Acupuncture, you can begin to take control of your low back health once and for all using these 5 exercises as a jumping off point.
It is important to note that if you have long-term and/or severe low back pain, you should consider consulting an injury recovery specialist or sports medicine doctor in order to get an accurate diagnosis and guidance on the best treatments, back exercises and stretches for your specific circumstance. As basic and simple as the exercise below are, they still may not be appropriate for certain injuries and during certain phrases of the injury recovery process.
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.
The #1 underrated muscle group in our body is the Gluteal Muscles. The Gluteus Maximus and Gluteus Medius are two of the most important muscles when it comes to low back health. They are directly below our lower back after all and work to stabilize and support hip and back movement, but not so effectively when weak and under-active.
That old and somewhat cliche motto of 'lift with your legs' or 'bend from your knees' when lifting anything moderately heavy touches in part on the importance of these muscles in that if they are weak or not engaged sufficiently, you can more easily injure your lower back when reaching down to pick something up whether heavy or not. Body mechanics, postural alignment and muscle synergy are key to all body movements, especially ones that involve the hip and low back and the Glute muscles are central to spine, hip and knee health.
There is a group of smaller muscles underneath the Glutes know as hip external rotators that also significantly affect the low back if they are tight, weak, injured and afflicted with chronic trigger points and muscle adhesions. These muscles are often overlooked, not fully understood or properly targeted in the prevention and rehabilitation of low back pain.
When the Glutes are weak and/or under-active, the muscles in your low back must work harder to produce and control important movements as well as withstand external forces. So for example, when lifting heavy objects, the low back muscles can get strained and the joints in your low back can sustain both small and significant damage when the Gluteus Maximus in particular, one of the strongest muscles in the body, don't fire produce and control movement.
To be fair, it's not just the glutes that need activation and strength. The pelvic floor and deep abdominal muscles are just as important. But the glutes are a vital piece of the puzzle in any serious attempt to prevent, manage and overcome low back pain and that's what we'll focus on below. But remember, a strong inner core (especially the obliques and the transversus abdominus) is also essential for low back health. Because so many people in New York City and beyond sit at desks for up to 10 hours or more each day, the glutes may become over-stretched, under-active and weak while your hip flexors potentially become short, overactive and perhaps even too strong. Add many more hours of sitting to the equation when you consider sitting during transportation and relaxing on the couch. And for those spin class enthusiasts, even though you're getting your sweat on, intense spin classes just reinforce the negative aspects of a seated lifestyle. I have so many active and well-intentioned clients struggling with low back pain who I have to encourage to find temporary alternatives to spin classes that don't reinforce the root causes of the problem. The simple solution?
Stretch short and overactive muscles. One example in the case of low back pain is to stretch the hip flexor muscles which can cause compression and hyper-extension in the lumbar spine as well as cause the glute muscles to shut down / de-activate. There are 5 primary hip flexor muscles that collectively produce a lot of strength and stability which is great. But when they are overly shortened, they develop trigger points, adhesions and scar tissue that can limit movement and cause dysfunction. When this is the case, it won't matter how much strength and activation you do for the glutes, abdominals and low back unless you stretch short muscles. They are in a sense opposite sides of the coin or seesaw that need to be in balance and harmony for everything to work properly.
Activate over-stretched and under-active muscles.
If a muscle is under-active and very weak, it won't be able to function properly. In the case of the glute muscles, this can be an important factor in chronic low back pain. There's a legitimate reason we constantly hear the words, "bend from your knees" when lifting heavy things. The reason for doing so, in part, is to put the glutes in a position to work better, that is, to contract better and with more strength..
Why? When the Glutes don't contract or "fire" properly, we tend to overuse the low back muscles which are smaller, less powerful and directly attached to delicate and important low back bones, discs and joints.
This easy rule of thumb - to stretch short muscles and activate weak ones - for the muscles in our body is why so many people actually worsen their bodies’ conditions. Stretching is not the cure for all pain, and neither is strengthening. Understanding how to target specific muscles and in what way they are afflicted, is the key to better muscle and joint health.
While glute stretches such as pulling your leg to your chest or the pigeon stretch in yoga may feel very good, in reality they may not need to be stretched a lot because they are already stretched enough, "turned off" and in essence sleeping on the job because they aren't being used. I had a client recently to whom I described her glute muscles as suffering from a massive hangover and needed to be kicked out of bed and splashed with a bucket of cold water.
To that point, here are 5 Glute exercise: 1. Clam Shells Benefit: This is a great exercise to activate the Gluteus Medius and to a lesser extent the gluteus maximus muscles as well as a few others. Before strengthening muscles, activation is essential to avoid further damage. In many cases, this exercise is included in the early stages of low back rehab. And while it is a pretty simple exercise in theory, there are several ways to get it wrong or to not get the most out of it. So as with any exercise, especially ones for injury rehabilitation, form and technique are key.
How: Lay on your side with your knees bent to 90 degrees and your hips bent to about 45 degrees. With a band around both legs just above the knees, lift the top knee up while keeping the feet stacked. Move slowly and hold at the top for 1-2 seconds. Activation exercises should be done slowly and in high repetition.
Caution: While performing this exercise, be sure not to allow your entire body to move and rock backwards when the leg lifts. When this happens, the targeted muscles may not be engaging sufficiently. Also be sure not to overuse the low back muscles by collapsing forward either. If you feel any tension or pain in your low back, take a break and try to modify. You can use a resistance band or even just your hand to provide enough resistance. 2. Side Leg Lifts Benefit: This exercise isolates the Gluteus Medius muscle, an important hip stabilizer which, when weak and underactive, can contribute to altered biomechanics affecting the lower back. It can be done with no resistance or with ankle weights or a resistance band. This exercise should be much harder than it looks when done right.
How: The most important thing to remember, as the video above shows, is to keep your leg in line with your torso. You should not be able to see your foot when your leg is on the ground nor should your leg be in front of your body when in the air. You can use a resistance band, ankle weight, your hand or even just let gravity on its own provide enough resistance. You might be surprised with how easily the side of your upper leg gets tired!
Caution: While performing this exercise, be sure not to allow your entire body to move and rock backwards or to rotate forward when the leg lifts. When this happens, the targeted muscles may not be engaging sufficiently and the low back muscles could dominate the movement, reinforcing the problem you're trying to fix and creating tension and even more pain. If you feel any tension or pain in your low back, take a break and try to modify. 3. Side Walks with Band Benefits: Side Walks are an excellent way to increase stability and biomechanics throughout the entire lower extremity and Lumbo-Pelvic- Hip- Complex. It can be used as an activation exercise for the gluteus medius muscle, a very important hip stabilizer that is often underactive and weak in many people who have low back pain and leg injuries.
How: When stepping to the left, push off from your right hip instead of leading with the left. The side of the right upper leg is where you should feel it when stepping to the left and vice versa when stepping to the right. Keep your shoulders level at all times, meaning don’t lean to the side as you move. Keep your knees bent slightly and always keep your feet a little apart even as they get pulled together throughout the movement.
Alternatively, unlike in the video, it it totally fine to emphasize the leg you are leading with. In most cases this will happen when the band is around the ankles as opposed to above the knee.
Caution: If you geel any spasm, tension or pain in your lower back, take a break. You might need to go back to the side leg lifts for a while to build up some strength and neurological activity. While you can do this exercise fast or slow depending on your goal, when beginning or adding to a lower back treatment program, take it slow at first. 4. Bridges Benefits: Bridges are great for activation the gluteus maximus muscle primarily and both the low back and hamstring musculature secondarily. If while doing a bridge you feel any tightness or pain in your low back, you should either try just the basic exercise or stop entirely. Full range of motion is not necessary to achieve the desired result of glute activation.
How: Lay on your back with knees up, and feet planted firmly on the floor, shoulder width apart. Slowly raise your hips and glutes, then return. The most important thing is to squeeze your glutes and gently engage your deep abdominal muscles by ‘drawing your belly button towards your spine’. Your hamstrings and low back muscles will inevitably be contracting as well but the goal should be to minimize their involvement.
As the video above shows, there are several modifications including one-leg bridges and physio-ball bridges. 5. Monster Walks with Band Benefits: Monster walks, both backward and forwards, are an excellent way to activate many of the glute muscles and hip rotators.
How (Forward): Lean forward slightly, push off with one leg straightened while stepping forward with the other. The leg from which you push off is the focal point in which the glute should be fully engaged to propel you forward. Move slowly and methodically, focusing more on muscle activation and contraction than on the movement itself. How (Backwards): It’s even more important to move slowly when going backwards so not to cause the low back muscles to take over and tense up. Remember, this is primarily a glute activation exercise. After stepping back with your right leg, bring the left together with the right one. Pause briefly before stepping back with the left leg. You should feel this burning in your rear end and a little bit in your quadriceps (“quads”).
Activation Vs Strength: There is an important difference.
Activation is essentially ‘waking a muscle up’ or ‘turning on the light switch’ by doing slow, specific exercises that target individual muscles. Strengthening, on the other hand, is a process in which a muscle can structurally change in size and tensile strength in order to withstand and generate more force.
Activation of underactive muscles is essential for that muscle to gain strength without getting injured and so less stress gets placed on other joints and other muscles. Glute activation is much-needed and very safe for the majority of people with lower back pain.
If you are not sure if one of the exercises above, or any exercise for that matter, is appropriate for you, seek help from a qualified back pain specialist. If trying any exercise intended to help with low back pain provokes your symptoms, either during or after, it's best to find someone who can show you proper form, offer safer modifications and teach you alternative options. As always, consult your medical doctor and injury recovery specialist if you are unsure and for guidance.
Special thanks to Stacey Weinstein for modeling in the exercise videos.