DISCLAIMER: Just like the strength training strategies for low back health, this article assumes no structural damage to the spine. If you have structural damage such as fused or herniated discs, please consult a medical professional before attempting some of these exercises.
In our last article where we talked about Strength Training Strategies for Low Back Health., we unraveled one misconception about low back pain. Low back pain rarely originates wholly in the low back, but rather low back pain is often caused by an improperly functioning collection of muscles referred to as the posterior chain. If you missed that article, do yourself a favor and read the first half of that article before continuing on here as we’ll be relying on the same approach of the interconnected posterior chain.
Low back pain is often caused by an improperly functioning collection of muscles referred to as the posterior chain
Strength training strategies are very simple and there’s really only one general principle: use resistance to help a muscle become stronger and more capable of work. On the flip side here, mobility and flexibility strategies, collectively just referred to as mobility from here on out, are going to include far more options and have different goals or outcomes. Traditionally and most commonly, people think of mobility as stretching. Although that can be helpful, it’s really going to be the least productive and therefore the last thing we’ll mention. For mobility, we’ll go over a breathing drill, self-massage, lumbo-pelvic dissociation, spinal decompression, and finally static stretches. The majority of the eleven exercises will be aimed at realigning or freeing up motion not just at the low back directly, but along the posterior chain as a whole. The strategies are also going to be listed in order of most effective for the most people. When using these, start at the first demonstrated exercise and continue on down the list until you find relief.
BREATHING DRILL
This one I affectionately call a $500 magic trick. A few years back, I attended a weekend seminar on Myokinematic Restoration put on by the Postural Restoration Institute that showed me this drill, and I’ve been blown away ever since (excuse the pun) by it’s quick and meaningful results that it’s given clients with constant back tension.
For this drill, as you’ll see in the video below, you lie on your back and breath out as much as you can. Holding your breath with no oxygen in your lungs will be uncomfortable, but the results can be dramatic. Now, there is a lot of theory behind what this does for the body, and for brevity I’m going to ignore almost all of it and bastardize the bit I do share. If you’re a physical therapy professional, I encourage you to take a course through PRI, but for everyone else, let’s keep it simple. Essentially what occurs is throughout day to day life, we start to hold some of our muscles tenser than they should be (this should sound right if you’ve ever said you hold tension in your neck, shoulders, or back). Our respiratory muscles and those that assist can also fall victim to this trend and when they do, they subtly rotate the hips in a way that can add tension to the back and lock up range of motion of the hamstring muscles. By breathing and flattening the left half of your ribcage to the floor, you give those muscles a chance to relax and that resets some alignment. Watch the video for a demonstration and more directions on how to perform.
I have to admit. My default with most fitness trends falls towards skepticism, especially when something seems too productive. However, I’ve seen this give enormous results instantly with dozens of clients, and now I swear by this. It’s a crazy drill that can dramatically improve your flexibility and decrease tension along your hamstrings, hips, and lumbar spine. Most importantly, it’s safe, fast, and effective. Start with this exercise and see how it can affect you. It’s always seemed like magic when I’ve given to clients with back pain, and I’m sure it will be equally surprising for you.
SELF MASSAGE
Recently, self-massage tools have become increasingly popular in gyms, and for pretty good reason. They make you feel incredible immediately. The way most self-massage techniques seem to work is by releasing tension in the muscle and allowing for more free movement immediately after. Here we’ll focus not on the low back, but rather the muscles near the low back, particularly the glutes and the hamstrings. Often times, these muscles can get tight from sitting a lot or by standing a lot (kind of a damned if you do, damned if you don’t scenario). When those muscles tighten up, they pull on that posterior chain and yank on the low back causing discomfort there. By using a self-massage technique, we can release the tension that yanks on the back subsequently giving relief to your back. For all of these, we recommend about 30 seconds or 15-30 passes with the roller.
For the glutes. Pretty simple. We’ll use a foam roller as demonstrated below.
Next, we recommend doing self-massage on the hamstrings. The hamstrings can be incredibly difficult to actually get sufficient pressure to because of their location. If you don’t have a hand-held self-massage stick, the next best thing is a medicine ball. The medicine ball will be a little difficult to balance on, but because of it’s shape does a great job of being effective for the hamstring.
Another option that we don’t often recommend but have found success with sometimes is foam rolling on the mid to upper back. I want to stress, the low back is NOT an area we recommend direct foam rolling to. However, if you’re feeling tension in your low back and your upper back (especially between the shoulder blades), this can be effective for you. You can even increase amount of pressure during this self massage by raising the hands above your head as shown near the end of the video.
LUMBO-PELVIC DISSOCIATION
The lumbar spine, your low back, very obviously sits on top of the hips/pelvis. In a well functioning body, the lumbar spine is not supposed to create a lot of movement. That joint section is more responsible for stability than mobility. The hips however, are supposed to be wildly mobile and able to generate a pretty incredible range of movements. In a lot of people, we find that these two joints can often get sort of stuck together. This forces the lumbar spine to move and twist more than it’s designed to, and the hips become more rigid and stable preventing it from moving properly. Locking of the lumbo-pelvic region can aggravate one or both areas and lead to some pain and achiness.
The next two exercises are geared towards separating this joint junction so that the hips can move freely and so that the back can stay more stable. This makes both of the areas happier and makes you feel better overall.
The first exercise is a classic among American football players. It’s an exercise known as “Scorpions” and will be performed both face down and face up. Laying down with the arms to your side, kick your foot across your body and towards the opposite hand. Return and repeat on the other side. After doing 6-10 on each side, turn over so you’re face up and repeat the exercise. When face up, focus on keeping your shoulders on the ground.
The next move is a classic from Yoga called “Cat Cows.” From the hands and knees, you’ll push your sternum up to the ceiling, then reverse by pulling your belly button to the floor. Don’t go so low with the belly button that you pinch your back or feel pain in the low back. As you do this, you should feel the hips start to tuck and turn. When you push the sternum to the ceiling, you should notice the front of your waist tuck in towards your belly button. When you drop the belly button to the floor, you should feel the hips rotate so the back of your waist tilts forward towards your low back.
SPINAL DECOMPRESSION
Sometimes, low back discomfort happens because gravity pushes down all day and jams up the spine. What we do in that scenario is a couple of exercises that pull the spine and forces some elongation as we do the motion. We’ll accomplish this two ways, one by a rolling exercise and one by a hanging exercise. It’s not uncommon to hear or feel a popping sound in the back as you do these.
With the first rolling exercise, we accomplish some decompression as the spine rolls downwards. This is a dynamic take on a classic hurdler stretch you probably did in gym class. As you roll backwards on this exercise, you want to lift the hips high towards the ceiling. Be careful with your neck as you do this and note how we use our hands by our head to give more stability and protect our neck. Here is a rolling hurdler stretch. Perform 6-10 on each leg
Another way to accomplish some spinal decompression is with an almost dead hang. This exercise does require a bit of starting strength though. We want to do an ALMOST dead hang. A full dead hang could be hazardous on the shoulders if you let the arms droop into the neck. However, you’ll notice that as we hang, we do just the tiniest of pullup motion to protect the shoulder and keep the arm packed firmly in the shoulder joint. If you’d like, you can add a small rotation to this motion as shown near the end of the video for a little extra back relief.
You’d want to ultimately hang for a total of 60-90 seconds. Depending on your strength levels, that may take 1-5 sets to accomplish.
TRADITIONAL STATIC STRETCHES
Finally we get to the traditional static stretches. Like I mentioned earlier, I view these as the least effective overall, but they still do have a positive effect. As a back relief strategy, they can create an immediate release in discomfort and will make you feel better. However, they have the most benefit as a post-workout cool down to relieve any tension you may have created during a workout. Doing these AFTER a workout is also more productive as the workout will have increased the temperature and blood flow to these muscles before you begin yanking on them. I strongly recommend using these primarily as a post-workout prophylactic strategy instead of active therapy or treatment of back pain.
One thing worth noting right away is you’ll notice again these stretches aren’t always directly focused on the low back. Remember the low back tends to hold tension because it does the job of larger muscles around it. We’ll address those more and allow the low back relief through off-loading onto the bigger muscles of the posterior chain.
The first stretch will be a Straight Leg PNF stretch. For this, you’ll need some time of cord to grab your foot with. You can use a towel, a jump rope, a band, a nylon strap, etc. As you do this stretch, it’s more important to keep your knee straight than it is to get the foot high. Make sure to breath deeply and only GENTLY pull on your foot. Hold this stretch for 6 deep breaths.
After completing that stretch, I recommend moving right into an Across Body Hip Stretch. Again hold this stretch for 6 deep breaths.
Finally, I recommend finishing the post workout stretch routine with a classic Child’s Pose. From the hands and knees, sit the hips back, then crawl the fingers forward. Keep pushing the hips and fingers in opposite directions to elongate and stretch the entire back. (This one also works well for spinal decompression). Some people may feel more comfortable getting the knees spread out wider than their ankles during this.
NOW ONTO MAGIC
I have to confess. When filming all the stretches and exercises for this article, I finished feeling magical. I don’t walk around with complaints of tension or aches in my back, but that didn’t stop me from feeling light as a cloud after doing all these exercises. If you suffer from tension or pain in your low back, I know you’ll find a lot of relief and a lot of incredible relaxation through these mobility strategies. Even if you don’t have back pain or tension, doing these exercises will help you feel reinvigorated in a way you didn’t know you could.
If you have any questions or follow-up for these exercises, feel free to email me at [email protected]