Now that we’ve established what not to do/how to find relief, and selected a few simple movements to start back into activity, it’s time to work at finding some low back activation exercises.
These are intended to engage muscles, establish control and resiliency, and provide a link between exercise movements and everyday activities. Most importantly, when completed appropriately these exercises also spare the low back of too much strain, compression, or otherwise irritable movements while still recruiting muscles sufficiently.
The three exercises outlined are sometimes referred to as “The Big Three”, as their ability to help develop resiliency and fundamental strength in the core and low back have been extensively studied. It is especially helpful that between the three exercises we are able to engage muscles at the front, sides, and back of the core and lower back — a 360º engagement. They may not be as exciting as Olympic lifts or absolute maximum heavy squats, but done diligently and scaled to the appropriate level, these exercises can help develop nearly anyone’s low back health.
The Partial Curl Up
Start your low back activation segment with 3a) the PARTIAL CURL UP. I prefer the phrase “partial” curl up because it helps distinguish that this is NOT a sit up. At the end of a partial curl up movement, the shoulder blades should just be coming off the floor, at most.
The partial curl up has much lower compression forces on the spine (which is safer) but still creates enough muscular activation to be helpful in developing resiliency (which is effective). The movement here is small, but beneficial.
Things to watch for are pressing your lower back into your hand or floor (try not to let your spine flatten out), leading movement by tucking the chin or “chin-poking” towards the ceiling (the neck is along for the ride only), and pulling up with the thigh/legs lifting off the floor (movement is centred around contraction of the core only).
Despite all these things to watch for (!!), if you brace your core in a neutral position and go to lift your shoulder blades slightly off the ground, but nothing happens… that’s still ok! You will have successfully activated the muscles you need to perform the movement, you just haven’t developed the strength or activation to actually move yet. Don’t sweat it, that’s why we do exercise — to improve.
The SIDE BRIDGE (3b) is another very effective low back activation exercise for creating sustained engagement of spinal stabilizers — an important factor in building endurance. You can do this with either the knees contacting the floor (recommended) or the legs straight and the feet contacting the floor (significantly more difficult). I strongly advise patient’s to master the knee contact first before advancing — even if you’re an experienced gym-goer.
Maintaining a static position, while not exciting, makes sure you are able to create constant muscle activity. A lot of day-to-day activities are more repetitive in nature, and you require the ability to constantly or repeatedly engage muscles as a result — something this can be helpful with.
Holding the bridge position without moving is ideal. A few things to watch for while completing a side bridge are twisting the upper or lower body forwards or backwards (think of keeping the shoulders and hips stacked on top of each other), the hips slumping towards the floor as time progresses (the straight line you should have created from the feet to the head “dips”), and the low back arching or flattening at any time (maintain your neutral, braced position).
Finally, a BIRD DOG (3c) exercise integrates some of the activations you just achieved, as well as more specifically engaging posterior muscles. As this is not strictly a static exercise (like the side bridge), there are also benefits that you get by having to coordinate limb movement with core contraction. This is a very similar movement pattern to common activities like walking, bending, lifting, etc., so mastering an activity like the bird dog will help make those potentially injurious activities safer overall.
There are many variations to the bird dog, as you can modify which limb moves, how it moves, what surface perform it on, etc. So this can be progressed or regressed as needed depending on the individual.
For now, the variation included here is an intermediate level bird dog. If you need to regress, try doing only a single limb at once (leg, or arm), and build back into this version.
To make sure you are getting the most out of a bird dog, there are two main things to keep in mind. Most importantly, you want to maintain contraction of the core (bracing) throughout the movement. This is the same principle stressed in 3a) and 3b) as well! Secondly, when moving the limbs it is easy to end up creating twisting through the back or shifting side to side. Try to limit this as much as possible! Image you have a glass of water positioned on your lower back before you begin — if you twist or shift during the movement, you will spill the water all over you.
Don’t spill the water.
As always, please remember that movements and exercises are dynamic, and what works for many will not work for all — so if you assume any of these positions and experience MORE discomfort, remember the principle of 1a) (AVOID IRRITATION) and move on to something else.
Between the general principles of 1), building a routine to get moving in 2), and now activation exercises to build resiliency discussed above, we should have the foundation of a daily routine for getting out of, and avoiding the development of, low back pain.
There will be more on that in the next post.