We’ve all heard the old adage, “if it hurts, don’t do it,” at some point in our lives. Well, I’m here to share with you that if your back hurts, this popular belief in avoidance as the solution could not be further from the truth.
In fact, avoiding activities may actually lead to more back pain, debility and fear of movement in the long term. The latest evidence on back pain and exercise tells us the best ways to respond to back pain are light stretching and modifying physical activity. Notice that “avoiding activity” and “resting” are not part of these research findings to achieve lower back pain relief.
I get asked every day which exercises are best for the back. As part of my practice, I regularly prescribe home exercise programs, and there’s a reason for that — movement is an essential component of high-value spine care.
The Big 3 exercises for a healthy spine
Although some people respond differently to particular movements during functional assessments performed in the office, there are three main exercises virtually all my patients receive. These exercises, known affectionately in the spine community as “The Big 3,” are heralded as safe and effective ways to build spinal endurance and help reduce lower back pain. They were created with the goal of achieving core stability.
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There are progressions to each exercise for a total of eight different variations. I generally advise three sets of 15 repetitions.
But first, a word of caution: Proper form is vital to the effectiveness of “The Big 3.” You should stop before you get too tired to maintain proper technique and help prevent any additional dysfunctional movement patterns.
1. Bird Dog Procedure
Kneel on all fours with the knees positioned below the hips and the hands under the shoulders. Keep neutral spine posture and light abdominal brace throughout. The key aspect regarding form is the maintenance of a neutral spine posture, as most people will rotate or extend the lumbar spine.
Tip: Balance a short, half-filled plastic water bottle on your back. Any spine rotation or extension will cause the bottle to fall off.
Beginner: Straighten alternate legs in line with the torso, holding each repetition for three seconds.
Intermediate: Straighten alternate legs with the opposite arm in line with the torso, holding each repetition for three seconds.
Advanced: Bring your knees very close together and your hands very close together. Complete 15 repetitions on one side before moving onto the opposite side. In this way, the knee and hand simply brush the floor with each repetition instead of going into a supporting position and alternating.
2. Curl-Up Procedure
Lie on your back with one leg straight, one leg flexed and assume a neutral spine posture and light abdominal brace. Place your hands in the space between the mat and your low back to help support the spine during the exercise.
Beginner: Keeping your elbows on the floor, lift your braced, straight torso a few centimeters off the floor. Your head stays in line with the torso rather than bending forward. Use your elbows/arms to slightly assist the curl-up, and hold each repetition for three seconds.
Advanced: Maintain the same position as Beginner except that each repetition is performed with the elbows raised off the floor, making the curl-up more demanding.
3. Side Bridge Procedure
Lie on your side resting on your elbow with the knees flexed and the pelvis (hips) posterior to the knees. Place your free hand on the supporting shoulder so that it can be used to compress and stabilize the shoulder during the exercise.
Beginner: Assuming a neutral spine posture and light abdominal brace, lift into a side bridge from the knees by raising the pelvis (hips) and pushing them forward, so the thighs and torso form a straight line. Hold the side bridge for five seconds in each repetition before resuming the starting position.
Intermediate: This is the same as Beginner, but the side bridge is performed with straight legs and with the upper foot in front of the lower foot.
Advanced: After holding each side bridge for five seconds, go straight into the plank position (without resuming the starting point), then into a side bridge on the opposite side without any twist in your torso or lumbar spine.
Remember, not all back pain is created equal. Sometimes, back pain does not respond to do-it-yourself exercises or home remedies.
If you are experiencing functionally limiting pain lasting several weeks, numbness progressing into the legs or pain causing you to miss work, see your healthcare provider to find spine care near you. Chiropractic care is a safe way to get you back on your feet with a plan to improve your function, strength and endurance moving forward.
Discover how you can move better today.