Patient Resources
Flexion Exercises For Low Back Pain
The following is a comprehensive series of low back pain exercises modified and expanded from several different sources. Their purpose is to stabilise the trunk posture by stretching and elongating tight muscles such the back extensors, hamstrings and hip flexors (i.e. Psoas and Quadriceps), while also strengthening the abdominals and gluteals. It is suggested for people with deep, tight back curves, weak abdominal muscles, or those with a posture that is classified as “lower cross syndrome”. It is NOT for those in severe pain, active disc bulges, or where there are pins and needles, strange sensations or pain down your leg. For those conditions please visit the page Low Back Pain Extension Exercises.
While we have graded the exercises as being appropriate for beginners, those of intermediate functional abilities andadvanced abilities, always consult your therapist for professional assessment before attempting these exercises, since they are not necessarily appropriate for all situations. We have aimed these pages mainly for the average person who wants to improve their back.
At our clinic most chronic back pain patients will be given various combinations of the exercises rather than the whole lot, so it is not necessary to do them all to get some improvement. This page should serve as a resource where you can start with beginners exercises and then move into the more challenging intermediate and advanced intensity exercises.
Always remember that the best time to do these stretches is when you feel GOOD or are on your way to recovery. Do not provoke a painful episode by stressing inflamed tissues and always go on the advice of your practitioner.
1.Pelvic Tilt
In this beginners exercise the aim is to flatten the curve of the low back (here the model has also placed his hand under the small of his back and is told to “squash his hand by pushing the back downwards”). The gluteal muscles (backside muscles) should also be squeezed simultaneously and the pelvis tilted drawing in the abdomen.
This can also be done with the knees bent, which further facilitates lumbar flexion.
2. Pelvic Raises
Good for beginners and intermediate levels. Laying on your back, bring your feet back, with knees bent. Then push your abdomen upwards, keeping your shoulders on the ground, and back straight. Hold for 10 seconds, then return your pelvis to the ground. Repeat 3 times.
3. Belly-button retraction
Another good beginners exercise. Place the blunt end of a pencil on your navel (umbilicus / belly button). Draw the pencil inwards toward the floor and feel the contraction of muscles as you do so. These are the Transverse Abdominals, which act as a corset that support your spine and pelvis. This muscle is particularly weak in many people owing to their sedentary lifestyles. As you become more aware of the contraction, you can eliminate the use of a pencil.
4. Single knee to chest
A gentle beginners exercise. First of all raise one knee toward your chest, by actively contracting your hip muscles. Hold for at least 3 seconds.
Then grasp your knee with both hands and pull toward your chest. At the same time, be sure to push your back into the floor, flattening it out. Hold for 5 seconds.
Finally try extending your other leg so it lies flat on the floor. Hold for 5 seconds.
5. Both knees to chest
Good for beginners. Begin by raising both knees toward your chest, by actively contracting your hip muscles. Hold for 5 seconds. Now grasp both knees with your hands and pull towards your chest. Push the small of your back into the floor while doing so. Hold for 5 seconds.
6. Curl-ups
An intermediate difficulty exercise. Start by tucking your chin and lifting your head upwards. You may feel some tightness along your spine.
Bring one heel towards your buttock for an extra stretch.
Then bring both knees toward your chest, while you squeeze your abdominal muscles.
7. Rifle Bolts
For intermediate levels only.
Bring one knee up by actively contracting your hip muscles. Hold for 5 seconds. Then send the knee over to the opposite side, as close to the ground as it will go, being sure to keep your shoulders on the ground. Feel the twist-stretch in your low back, hold for 5 seconds, then return the knee up before lowering the leg back to the ground. It is important to UNTWIST your back before lowering the foot again!
8. Windshield wipers
For intermediate levels.
Bring both knees towards your chest by actively contracting your hip muscles.
Then, keeping your shoulders on the ground, roll both knees across to the other side. Hold for 5 seconds, then return to the midline. Do the other side and repeat three times each.
9. Lumbar rolls
For intermediate levels.
Bring both knees towards your chest by actively contracting your hip muscles.
Then, keeping your shoulders on the ground, roll both knees across to the other side. Hold for 5 seconds, then return to the midline. Do the other side and repeat three times each.
10. Hamstring Stretch
Intermediate difficulty exercise. Begin by bringing your knees up to your chest, and grasping them with your hands. Then gently roll backwards and forwards along the spine. For an extra “rolling pin effect” on your spinal muscles, try leaning slightly off centre so that you are not in the midline, and alternately roll on the left side and right side muscles 1cm to each side of the spine. Try 30-40 rolls.
11. Forward lunges
For beginners and intermediate. Sit on the floor and tuck one foot into your centre. Then, keeping your back straight, lean forward with your chest. You should feel a stretch in the rear of your thigh.
Remember not to bend out of your back muscles, but rather lean forward.
There are several variations of the hamstring stretch, which can be done on your back, standing, and with the assistance of a towel.
12. Quadriceps Stretch
An exercise that may be a little difficult but still important for beginners to try. Here we demonstrate the lying down as well as the standing up versions. Hold each position for 10 seconds. For those with knee arthritis or surgery, please do not do this without the approval and guidance of your therapist.
13. Slump Arch
This exercise is an intermediate level exercise, and is good for those who sit for long periods. It moves the lumbar spine through its full range of flexion and extension and is convenient enough to do anywhere.
Begin by sitting up straight and arching your back. Hold that position for 5 seconds, then slouch so that the curve in your back is reversed. Hold for 5 seconds and repeat 5 times.
14. Wall slides
A good exercises for beginners, which strengthens the thigh muscles. It can be increased in depth and duration to provide a greater challenge to those of intermediate level ability. In this exercise stand with your feet slightly apart, leaning against a wall. Flatten your low back into the wall. This can be better aided by shuffling forward with your feet and bending your knees slightly. Then gradually slide down the wall till your thighs are parallel to the ground. Hold for 10 seconds then slide back up the wall. Repeat 3 times.
15. Lumbar flexion bobs
An intermediate to advanced level exercise, not to be done if there is any pain. Stand with your feet shoulder width apart, knees slightly bent and the small of your back flat up against a wall. Bend slowly forward from your back and be sure to stop just before you feel your pants start to slide up the wall. Be sure not to tilt forward with the pelvis. Maintaining this position, lightly bob 20-30 times, no more than 5 or 6 centimetres in depth, provoking a stretch in your low back. Return to your original position and then lean obliquely (over one knee), first to the right and then to the left, repeating the bobbing procedure. Make sure you do not lift your hips off the wall.
Stop immediately if it provokes pain or symptoms down your leg
16. Gluteal Stretches
For beginners or intermediate levels. Sit with your leg crossed over the other. Keeping your back straight, lean forward until you feel a stretch in your backside on the side of the crossed leg. Hold the stretch for 20-30 seconds. Try varying the tension by either pushing the crossed knee parallel to the floor, or alternatively light it up slightly towards your chest.
The gluteal stretches can also be performed on your back.
17. Gluteal Kickbacks
A beginners exercise designed to strengthen weak backside muscles. Stand with your back straight, on one leg with the other slightly off the ground. Hold onto a chair for support if necessary. Gently swing your heel back 30 centimetres or so and at the end, squeeze your butt-cheek on that side for a second or so, then allow the leg to swing back to neutral. You do not need to swing forward.
Be careful not to arch your back, or conversely lean forward as you swing your heel.
Repeat 20-30 times for each leg, then try the same thing again but this time with the foot turned slightly outwards. Be careful to keep your body facing forward, and not twisted as you swing through.
18. Side lying leg lifts
A good beginners or intermediate level exercise. Laying on your side with your head supported, raise your upper leg as high as you can, keeping it straight at the knee and the toes pointed forward. Hold for 10 seconds, then lower the leg. Repeat 3 times then turn over and do the other leg.
19. Prone planks
For intermediate and advanced levels. Lie face down and prop yourself up on your elbows, with forearms on the ground.
Then lift yourself up onto your toes, keeping your back rigid and stomach tight. Hold for 10 seconds. Repeat 3 times.
20. Side planks
Intermediate and advanced levels only. Lay on your side, with feet together, and your upper body propped up on your elbow, forearm along the ground.
Lift your hips off the ground so that your back is straight, and your body is supported between the side of your foot and your elbow only. Hold for 10 seconds. Repeat three times.
21. Bird dog
For intermediate and advanced levels. Kneeling down on all fours, with your head pointing straight ahead, lift the opposite arm and leg, keeping them as straight as you can. Hold for 10 seconds. Do the other side, and repeat three times each.