The ‘Big 3’ exercises for your lower back

Low back pain - what is it?
Low back pain, simply put, is something that most people will experience at least once in their life. It usually occurs when the capacity of your lower back has been exceeded and pain ensues. There are many different structures that may become irritated and cause lower back pain. 

These episodes can vary in severity and duration. Generally speaking, in the majority of cases symptoms subside over a 4-6 week window, although on occasions it may take longer. This in itself is not something to be concerned about. 

During episodes of lower back pain it can be hugely beneficial to understand the triggers that increase your back pain, and just as important, the things that alleviate your pain. Once these are managed well it can have a significant impact on controlling your symptoms. This in turn enables you to return to your normal activities as soon as possible. 
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How could a Physiotherapist help
A physiotherapist can help identify and correct predisposing factors to your back pain and hasten your recovery, using methods such as massage, mobilisation, taping and exercise prescription.
 
If you have had an episode of lower back pain the chances of it reoccurring are higher. This is due to weakening of the stabilising muscles of the back. A physiotherapist can guide you through a rehabilitation program aimed at preventing future episodes.
 
Important - Consult your physiotherapist or doctor if;

• Your back pain wakes you at night
• You have difficulty controlling your bowels or bladder
• Pain travels down your leg below your knee
• Your leg, foot, groin or rectal area feels numb or tingly
• Your legs feel weak

Below are three exercises that Dr Stuart McGill, a Canadian world-renowned researcher in spine biomechanics has devised to assist in increasing the capacity of your back, without putting undue stress through your spine. 
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These can be done during periods of pain and also on an ongoing basis. It is important that the correct regressions/progressions are prescribed by a skilled progressional to make sure the technique is correct and symptoms controlled.

The ‘Big 3’ exercises ​
1) The Modified Curl-Up
Set-up requires the hands (palms down) under the lumbar spine. This helps to maintain the natural curve of the spine during the exercise. Keeping one leg extended, bring the other up into a bent position, with the foot planted in line with the knee of the extended leg.

The abdominal muscles are braced and the elbows are slightly raised off the ground. Then elevate your head and shoulder blades off the floor. Imagine trying to lift from your sternum, not curling up through your neck. Movement is minimal and should only be a few centimetres. Maintain this for a few seconds and then slowly lower back. 
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It may not look like you’re doing much but if done properly you will feel your abdominal muscles working. Also make sure you breathe during the exercise and don’t hold your breath.

2) The Side Plank
Begin on your side with your elbow underneath your shoulder and your feet in a scissor position, with the top foot on front. 

Tense your trunk muscles, then lift your hips up and forward so that your body is in a straight line. Make sure your body is not rolled forward by keeping your shoulders/chest open. Hold for a few seconds and then bring your hips back and down to the floor. 

If you have shoulder problems try placing the upper hand over the shoulder and pulling the elbow down across the chest. 
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The side plank can be performed from the knees if you have decreased strength or an inability to engage the abdominal wall without pain. 

3) The Bird Dog
Whilst kneeling in the all-4 position have your hands underneath your shoulders and your knees underneath your hips, with your spine in neutral position.

Gently tense the abdominal muscles, ensuring all the movements come through the large ball and socket joints of the hips and shoulders. 

​Simultaneously raise the opposite arm and leg. The aim is to hold both limbs parallel to the floor. Hold for a few seconds and then return them to the ground without losing the abdominal control.

Any Questions?
Let us know if you have any questions/queries, or if you need guidance with managing your lower back pain.

​Reference:
McGill, S. (2015) Back Mechanic - the secrets to a healthy spine that your doctor isn’t telling you.