There are a lot of misconceptions and myths when it comes to the proper management and exercise prescription when dealing with low back pain. Dr. Stuart McGill is known as the ‘go-to’ expert for spinal pain and has helped thousands of individuals overcome low back pain without the use of surgery and prescription drugs.
His approach suggests that the core musculature should limit motion of the low back and lumbar spine and as such has recommended 3 exercises that everyone with low back pain should master. We cover them here.
1. Curl Up
The curl up is NOT a sit up (an exercise that should be thrown out of any plan for a patient with low back pain). The curl up is an abdominal activation exercise that has been shown to place minimal stress/load on the low back.
How to Perform: Hands placed palms down under your lumbar spine (low back). Elbows raised off the floor. Head/Neck/Shoulders are slightly raised. Brace abdominals to appropriate level of comfort and challenge for the patient.
2. Side Bridge (Side Plank)
The side bridge strengthens critical spine stabilizing muscles while placing minimal load on the spine as well.
How to Perform: Place elbow directly under shoulder. With knees and hips slightly flixed, come into the side bridge by bringing your hips forward. The body from the knee’s up should now be aligned. Progress to feet (side plank) for more advanced challenge.
Note: For the side plank, feet should be stacked. Placing one foot in front of the other can cause spinal twisting that irritates spinal structures.
3. Bird Dog
The bird dog strengthens important low back stabilizers including our postural muscles (low back extensors)and our hip extensors (glutes) – While also placing low amount of load on our spinal structures (seeing a pattern here?!)
How to perform: On hands and knees with hands directly under shoulders. Tighten abdominals to ensure motion is at shoulders and hips. Raise right arm until in line with body, followed by left leg. Advance by raising right arm and left leg at same time. Repeat on other side.
- Lifting leg too high (causing rotation of the pelvis)
- Arching low back (abdominals not braced)
Another important aspect of exercise prescription for low back pain is the rep scheme. Dr. McGill recommends the following rep scheme to avoid muscle cramping while providing a significant challenge. One rep = 10 second hold.
Set One: 6 reps, resting 20 seconds after 6th rep
Set Two: 4 reps, resting 20 seconds after fourth rep
Set Three: 2 reps, then done
For more information about Dr. Stuart McGill and His Work Check Out the following materials
Back Mechanic: The Secrets to a Healthy Spine Your Doctor Isn't Telling You.
Evolve Performance Healthcare specializes in providing long term relief. We're not into quick fixes, but creating chiropractic and fitness plans to help you take care of back pain for good.