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Exercise to help prevent back pain

Back Exercises

Why Do Back Exercises?

Note: If you have a back injury or current back pain read: Post-injury exercise page first.

Weak Muscles Cause Back Pain:

Weak muscles are often at the root of back pain, especially lower back pain. The muscles of the back, the abdomen, and the buttocks all support the spine - these muscles are called the core muscles.

Muscles are the spine's main defense against gravity. Strengthening the muscles that support the spine with exercises, can prevent, reduce and even eliminate back pain.

Strong abdominal muscles (especially the deep abs) are as crucial as strong back muscles for supporting the lower back and preventing lower back pain. Strong quadriceps (front of thigh muscles) is important to prevent back injuries when lifting. Proper lifting techniques involve using your legs and if your legs are weak, you may end up using your back.

Shortened Muscles Cause Back Pain

Shortened muscles can throw the spine out of alignment and cause back pain. Stretching exercises lengthen shortened muscles and relieve back pain. Tight back muscles, tight buttocks muscles, and even tight hamstrings (back of thigh muscles) or quadriceps (front of thigh muscles), can affect the alignment of the spine. Stretching the back with stretching exercises also increases mobility of the joints of the spine.

Strong and flexible muscles help maintain Proper Posture and prevent Back Strain.

Back Exercise Samples

Note: Read: Post-injury exercise page first.

Back Stretching Exercises
Back Strengthening Exercises
Balancing Exercises
Low Impact Aerobics

Stretching exercises may be done daily. Strengthening exercises should be done three or four times per week - the days off give your body a chance to recover. It may take 6 week to 8 weeks to notice results.

To prevent back pain, keep your back fit by doing the following exercises.
(Start with five repetitions of each exercise. If you can handle five repetitions without post exercise pain, then slowly add a couple of repetitions each week until you reach 15 repetitions).

*If you are experiencing back pain or suffer from a back condition, ask your doctor if the following exercises are appropriate for you to do.

Back Stretching Exercises

Warm-up Exercise before Stretching Exercises

Always warm up before stretching exercises. Five minutes of walking, or exercise bike, elliptical trainer, or even marching on the spot is enough. Not warming up before stretching leaves your back susceptible to injuries causing back pain. Warm muscles are more flexible than cold muscles and are less likely to tear.

Check with your physician before doing exercises that involve twisting or arching the back if you have a back condition.

Pelvic Tilt: lower back stretching exercise (also strengthens abs)

Lie on back, knees bent, feet flat on floor. Tighten buttocks and abdomen, flattening small of back against the floor. Hold for a count of five. Slowly relax. Repeat five - fifteen times.

Knee to Chest: Gluteal stretching exercise

Lie on back, knees bent, feet flat on floor. Grasp left leg behind the knee/back of thigh and pull knee towards left shoulder. Hold for a count of five. Switch sides. Repeat 5 times.

Piriformis Stretch: (Stretches Muscles that lie beneath gluteal muscles)

Sit on chair
Place your left ankle over your right leg, just above the knee and lean forward.
Hold for 30 seconds. Repeat on other side.

Basic Twist: lower back stretching exercise.

Lie on back, arms stretched out to the sides.
Bend knees and bring knees up close to your chest
Take a deep breath
Exhale as you slowly lower knees (keep knees together) to floor to the right or as close to the floor as is comfortable.
Pause.
Inhale as you slowly return your knees to chest.
Exhale as you slowly lower knees to left side
Inhale as you return your knees to chest.
Repeat about 5 times.

The Cat: back stretching exercise

Begin on all fours, hands directly under your shoulders and knees directly under your hips.
Inhale as you drop tummy towards the floor and look up over your head.
Exhale as you bring your tummy back up, rounding your back as you tuck your chin in and tuck your tailbone in.
Move slowly back and forth between these two positions pausing on each pose.
Repeat about 5 times.

The Cobra: back and chest stretching exercise

Lay flat on stomach, forehead to ground, with arms bent and palms down on the ground under the shoulders.
Push downward with arms as you raise your upper torso and arch your back.
Hold for 3 full breaths before slowly bringing the upper torso back down to the ground.

Shoulder, Back, Arms Stretch:
Stand with knees slightly bent. Interlace fingers, extend arms forward at shoulder level. Turn palms out and reach your arms further until you feel a stretch. Hold 10 - 20 seconds. Repeat.

Chest Stretch:
Stand with knees slightly bent. Hands behind the back, fingers interlaced. Turn palms up extend arms backward. Do not arch the back. Hold 10 - 20 seconds.

Sides, Waist Stretch:
Stand with knees slightly flexed. (Can also be done sitting down) Place your right hand behind your head. Grab your right elbow with your left hand and pull gently. Bend slowly to the left until you feel a gentle stretch. Hold 10 - 20 seconds. Switch sides. Repeat.

Shortened hamstrings can contribute to sway back

Hamstring (back of thigh) Stretch:
Sitting on floor, extend right leg, place left foot against right knee. Lean forward (keeping back straight), reaching for foot until you feel a slight pull on you hamstring. Hold for 10 - 20 seconds. Switch sides. Repeat

Hamstring (back of thigh) Stretch:
Lying flat on back. Raise left leg up. Grab leg and pull up further until you feel a gentle pull in the hamstring Hold for 10 - 20 seconds. Switch sides. Repeat.

Shortened quadriceps can contribute to sway back

Quadriceps (front of thigh) Stretch:
Stand up. Bend your knee behind you, grab your ankle and gently pull your heel toward you buttocks until you feel a gentle pull on the front of your thigh. Hold for 10 - 20 seconds. Switch sides. Repeat.

Wall Back Stretch: back / neck stretching exercise

Stand up with your back against the wall. Try to press the small of your back and the back of your neck toward the wall. Hold for 10 - 30 seconds. Do not overstretch!

Neck Roll:
To loosen up the neck, where many people carry their stress: Stand or sit up straight with the bottom of your spine turned under. (Do not arch your back) Let your head fall forward, keeping the neck and shoulders relaxed. Slowly roll your head to one side, then let it drop and roll to the other side. Be careful not to overstretch. Do not roll the neck backwards.

Stretching using an Inversion Table

Inversion therapy has been around for a couple of thousand years. Your feet are securely supported as your body hangs upside down - and the spine is stretched by the weight of your body. For more information see Inversion Tables Page.

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Back Strengthening Exercises

Many people tend to overdo it when starting strengthening exercises for the back, resulting in back strain. Back pain caused by doing too much too soon sets one back even farther. But the ultimate goal is to be able to do the back strengthening exercises. Strengthening the back can't be rushed. It takes patience but it well worth the effort

Warm-up Exercise before Back Exercises: Be sure to warm up before doing back exercises with five minutes of walking, or using an exercise bike or elliptical trainer, or even marching on the spot. Warm-up exercises prepare your back for strength exercises or stretching exercises by increasing circulation to the muscles.

*Activate the Abs First.
To activate your deep abdominal muscles, cough once (or pull in and tense your stomach). Hold this contraction during the following exercises to give the deep abs and other core muscles a simultaneous workout. Do not overdo the abdominal tensing. It should not be difficult. Do not hold your breath. This is what "tighten abs" in the following exercises refers to.

The Bridge: Strengthens several core muscle groups - buttocks, abs, back

Lie flat on back; bend knees at 90-degree angle, feet flat on floor. Tighten abs. Raise buttocks off floor, keeping abs tight. Shoulder to knees should be in straight line. Hold for a count of five. Slowly lower buttocks to floor. Repeat five times.

The Plank: Strengthening exercise for back, abs and neck (also strengthens arms and legs)

Lay on stomach, place elbows and forearms on floor. In a push-up position, balance on your toes and elbows. Keep your back straight and legs straight. (Like a plank) Tighten abs. Hold position for 10 seconds. Relax. Repeat five to ten times. If this exercise is too difficult, use balance on your knees instead of your toes.

The Side Plank: Strengthens the obliques (side abdominal muscles)

Lie on right side. Place right elbow and forearm on floor. Tighten abs. Push up until shoulder is over elbow. Keep your body in a straight line – feet, knees, hips, shoulders, head aligned. Only forearm and side of right foot are on floor (feet are stacked). Hold position for 10 seconds. Relax. Repeat five to ten times. Repeat on left side. If this exercise is too difficult, balance on stacked knees (bend knees and keep feet off floor) instead of feet.

The Wall Squat: Strengthening exercise for back, hips and quads.

Stand with your back against a wall, heels about 18 inches from the wall, feet shoulder-width apart. Tighten abs. Slide slowly down the wall into a crouch with knees bent to about 90 degrees. If this is too difficult, bend knees to 45 degrees and gradually build up from there. Count to five and slide back up the wall. Repeat 5 times.

Leg and arm raises: Strengthening exercise for back and hip muscles.

Lie on stomach, arms reached out past your head with palms and forehead on floor. Tighten abs. Lift one arm (as you raise your head and shoulders) and the opposite leg at the same time, stretching them away from each other. Hold for 10 - 20 seconds. Switch sides.

Leg lifts: Quad Strengthening Exercise

Lie flat on back. Bend left knee at 90-degree angle, keeping foot flat on floor. Tighten abs. Keeping the right leg straight, slowly lift it to the height of the left knee. Hold for a count of 3. Repeat 10 times. Switch sides.

*Safety Tip for Leg lifts:
Lifting both legs at the same time causes excessive stress on your lower back so only lift one leg at a time; the opposite leg should be kept slightly bent with foot on floor.

Basic Crunches: upper abdominal exercise

Lie on back, knees bent. Do not anchor feet. (Anchoring the feet or keeping the legs straight along the floor can strain the lower back). Arms may be folded over chest or kept at sides or hands can be held beside ears with elbows out. Tighten abs. Keep the lower back flat on the floor and neck straight. Keep chin tucked - looking at ceiling helps prevent tilting head up or down. Exhale when raising your torso off the floor and inhale when lowering. Just raise your head and shoulder off the floor - three to six inches is enough. Sitting up all the way is hard on your lower back. Do ten repetitions.

Neck muscles may tire out before the abs. You can use your hands to help support your neck - but be very careful not to pull on your neck or you could overstretch a neck muscle. Keep elbows out to the side to help avoid pulling neck forward. Don't start out doing too many crunches - the number of crunches performed should be increased slowly.

Move slowly when performing crunches- do not rely on momentum.

Rotational Crunch: obliques exercise (sides of the abdomen)

Rotational crunch is a slight variation of the regular crunch. (The variation - the direction you raise your head and shoulders off floor is diagonal). Lie flat on back, knees bent, feet flat on floor. Do not anchor feet. Tighten abs. Keep the lower back flat on the floor and neck straight. Rotate your body so that the weight rests on left shoulder. Then, keeping chin tucked, bring your head and shoulders upward and raise your right shoulder higher than the left. Move slowly.

Reverse Crunch: lower abdominal exercise
Lie flat on back, feet in the air. Bend knees 90 degrees. Place hands under buttocks for support and make sure your lower back remains flat on the floor. Tightening your lower abdomen, lift your buttocks a few inches off your hands. Hold for a moment and lower back down. Do 5 to 15 repetitions.

Leg Lifts: lower abdominal exercise

Lie flat on back. Bend left knee at 90-degree angle, keeping foot flat on floor. Tighten abs. Keep right leg straight, and slowly lift to about 45 degrees. Pause. Slowly lower leg to floor. Repeat 10 times. Switch sides.

Backward Leg Swing: Gluteal exercise (The muscles of the buttocks help support the spine)

Stand, holding onto the back of a chair for support. Tighten abs. Swing leg back at a diagonal until you feel your buttocks tighten. Tense muscles as much as you can and swing leg back a couple more inches. Return leg to floor. Repeat 10 times. Switch sides.

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Balancing Exercises

Balancing exercises also help to strengthen the core muscles (back. abs, and buttocks), which are used in balancing. Doing a variety of exercises will ensure you target different muscle groups.

Opposite Arm and Leg Extension: balancing / stabilization exercise: Strengthens muscles running down sides of spine, back of shoulders, and buttocks

Begin on all fours, hands directly under your shoulders and knees directly under your hips. Keep the back flat. Keep buttocks and abdomen tight. Lift one arm up and forward that it is parallel to your back. Keeping the arm extended, lift the opposite leg in the same manner. Keep your face down, head aligned with spine. Keep arm, spine, and leg aligned as if they are forming a flat tabletop. Balance yourself for a count of ten, relax, switch sides and repeat. Remember to breathe. Do a couple repetitions.

Exercising Using an Exercise Ball

Exercising with or without equipment is effective, but the exercise ball is often used by physical therapists. Also called the Stability Ball because you have to stabilize or balance yourself on the ball. Stability ball exercises are great for strengthening the back and abs as these core muscles are activated by the act of balancing.

Pick an exercise ball where your legs are parallel to the floor when sitting on it. Exercise balls are over inflated balls. The softer the exercise ball, the easier it is to balance on it. The further the ball is from your body, the harder the exercise. When doing exercises using an exercise ball, keep the abdomen tight.

Doing exercises with an exercise ball activates the muscles than run up and down the spine, and other deep core muscles.

Stabilization Exercises Using An Exercise Ball

The following stabilization exercises are performed while sitting on the exercise ball:

Feet flat on floor with hips and knees bent at a 90-degree angle. Tighten abs. Keep back straight.

Raise and lower one heel at a time.
Raise and lower one foot at a time a couple of inches off the floor as if marching.
Raise and lower arm, alternating sides.
Raise and lower arm while lifting opposite heel off floor.

The following stabilization exercises are performed while lying on the exercise ball:

Lie with stomach over ball. Place hands flat on floor. Tighten your abdomen and keep your back straight.

Place hands flat on floor. Walk on hands away from ball until ball is under legs. Walk back to starting position.

Place hands flat on floor. Walk on hands away from ball until ball is under legs. Slowly raise and lower alternating arms.

Place hands flat on floor. Walk on hands away from ball until ball is under legs slowly perform push-ups.

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Low Impact Aerobic Exercise

Doing low-impact aerobics is a relatively safe way for persons with recurring back pain to begin strengthening their back and abdominal muscles. For those with weak back or abdominal muscles, strength must be built up gradually to avoid re-injury and more back pain.

Aerobic exercise also helps keep weight down, which relieves back pain, especially lower back pain. Aerobic activities also help relieve muscle tension and back pain by relieving stress.

Low-impact aerobics tone the muscles that support the back without causing undue strain on the back. Besides strengthening muscles, low impact aerobics increase circulation, which aids in healing and improves the health of the intervertebral discs. Low impact aerobics include: swimming, walking, using a stationary exercise bike or an elliptical trainer.

High-impact aerobics (where both feet leave the ground at the same time) such as jumping rope or running puts undue stress on your back. When your feet hit the ground extra stress is placed on the intervertebral discs and joints of the spine. If you suffer from lower back pain, or want to prevent back pain, stick to low-impact activities.

Water exercise is especially beneficial for those with back pain caused by osteoarthritis of the spine or disc problems. The buoyancy of the water supports the majority of the body weight, taking pressure off the joints and intervertebral discs. The resistant properties of water make the muscles work harder to perform movements such as walking, marching, or other water exercises. You can strengthen the muscles that support the back without stressing the joints and discs. The pressure the water exerts on the body prevents an injured joint from further inflammation and post exercise back pain.

Always warm up for at least 5 minutes with of walking or performing the same activity as you are about to do but at a slower pace. This slowly increases your heart rate, breath rate and body temperature to allow your body to adjust to the higher demands of aerobic exercise. Cooling off in the same way for another 5 minutes allows your body to adjust to its resting state and prevents blood from pooling in your extremities. 5 minutes of walking can help flush waste products from the muscles and prevent post exercise soreness.

Tip: Wear proper footwear. Wearing footwear with adequate cushioning and support help absorb shock and decrease the risk of back pain. For more information on how footwear can affect back pain click here .

Tip: Stay Hydrated. Drink plenty of water before, during and after aerobic activity to replace water lost by perspiration. Dehydration can cause muscle aches - plenty of water is needed to help the body flush out the acidic waste products that can build up in the muscles during exercise.

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You Will See Results

Keeping fit with an exercise plan that includes back stretching and strengthening exercises is very effective for the prevention of recurring back pain. Exercises for all the muscles that support the back, especially the abs, are also important.

Increase the duration of back exercises gradually to avoid overuse injures. It may take a couple of months, but if you stick with it, you will see results.

*Check with your physician before doing back exercises if you have a back condition or other medical condition.

Shoulder Exercises

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