Back Exercises - Level III – Advanced

Exercise emphasis on pelvic stabilization and trunk strengthening.

• One should not progress to this level until leg pain is diminishing and back pain is subsiding.
• Breathing is important, exhaling on the exertion part of the exercise and inhaling on the relaxed stage of the exercise.
• Repeat each exercise 5 times and increase repetitions weekly to maximum number indicated in each exercise. Also, repeat level I and II exercises 2 – 3 times. Exercise daily.

Do not strain to complete the exercise, do the exercise slowly, no fast jerking or snapping (remember the muscles are like rubber bands).

Curl-up Crunches
Lie on your back, legs on ball or chair.
Exhale, do pelvic tilt.
Raise head / shoulders.
Do slowly, do not strain.
Keep low back on floor.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.
Progress to 25 times.

Arm and Leg Extension – Prone
Lie on stomach.
Raise right arm and left leg.
Keep hips on floor, do not rotate hips.
Hold 5 seconds.
Repeat 5 times.
Progress to 10 times.

Arm and Leg Extension – on 4’s
Begin on hands and knees.
Lift right arm and left leg.
Exhale, do pelvic tilt, do not rotate hips, do not arch back.
Alternate arms and legs.
Hold 5 seconds.
Repeat 5 times.
Progress to 10 times.

This level of exercises is for individuals having completed Level II and desire to improve their flexibility further. These exercises should not be attempted by individuals who have had back problems in the past 30 – 60 days.

Hamstring Stretch (Advanced)
Stand upright with one leg raised and resting on an elevated surface.
Exhale, keeping both legs straight and hips squared.
Extend your lower back.
Bend forward from the waist.
Lower the trunk onto the thigh.
Hold the stretch 15 seconds.
Repeat with the opposite leg.

Trunk and Hamstring Stretch (Advanced)
Assume a squat position, hands resting on the floor.
Exhale, slowly extend the knees.
Hold the stretch 15 seconds.

Trunk Stretch (Advanced)
Stand upright, legs straddled.
Back of the heels six inches from the wall.
Interlock the hands behind the head.
Exhale, keep both legs straight.
Extend the upper back.
Bend forward at the waist.
Lower the trunk towards the thighs.
Position the buttocks against the wall.
Feel pelvis rise as you lower down.
Hold the stretch 15 seconds.
Repeat 2 – 3 times.

Trunk and Hip Adductor Stretch (Advanced)
Assume a squat position.
Feet 12” apart and toes turned slightly out.
Place elbows on inside portion of both upper legs.
Exhale, slowly push legs outward with elbows, feet must be flat on the floor.
Hold the stretch 15 seconds.
Repeat 1 – 2 times.

Trunk Side Stretch and Leg Stretch (Advanced)
Assume the stretch position.
Raise one leg on a supporting surface.
Raise the hands overhead, interlock the hands.
Exhale, bend sideways.
Lower the trunk toward the raised thigh.
Keep the legs straight.
Hold 15 seconds.
Repeat with opposite side.

Side Bending Stretch (Advanced)
Stand upright, feet together, your side facing a wall, about an arm’s length away.
Place one hand on the wall, the other hand on the back of hip joint.
Exhale, keep the legs straight.
Contract the buttocks.
Rotate hips slightly forward in toward the wall.
Hold 15 seconds.
Repeat doing the opposite side.

Side Bending Stretch (Advanced)
Stand upright, hands at side.
Exhale, slowly flex the trunk laterally, toward right side, try to touch left heel with both hands.
Hold 15 seconds.
Repeat with opposite side.

Upper Trunk and Back Stretch (Advanced)
Stand upright, feet together.
About 3 feet from a supporting surface approximately to shoulder height.
Keep arms and legs straight.
Bend at waist, flatten back.
Grasp supporting surface with both hands.
Extend the shoulders and press down on supporting surface to produce an arch in your back.
Hold for 15 seconds.
Repeat 2 times.

Back Exercises - Level II – Intermediate

EXERCISES PRIMARILY STRETCHING WITH INTRODUCTION OF STRENGTHENING EXERCISES.

 One should not progress to Level II:

• Until the pain level decreases through out the day.
• You are still experiencing radiating pain, tingling, numbness and neither has decreased.
• Continue with the Level I exercises repeating 2 – 3 times daily along with the Level II exercises. 

Knees to Chest:
Pull both knees to your chest.
Keep head on the floor.
Stretch to the edge with no increased pain.
Hold 15 seconds.
Rest 5 seconds.
Repeat 3 – 5 times.

Hip Outside Thigh Stretch:
Lie on back, place left leg on the outside of the right knee.
Keep shoulders flat on the floor.
Pull left knee down toward floor with right hand.
Avoid over stretching.
Alternate legs.
Hold 10 seconds.
Repeat 3 – 5 times.

Hamstring Stretch:
Lie on your back at doorway.
Place the left leg on side of door, extend right leg through doorway, slide buttock towards wall.
Keep left leg straight.
Stay in pain free range.
Alternate legs.
Hold 1 minute.
Repeat 3 – 5 times

OR
Lie on your back.
Extend left leg upward.
Use belt or towel.
Keep left leg straight.

Bridging:
Lie on your back, hands at your side.
Exhale, complete pelvic tilt.
Push arms into floor.
Slowly lift trunk from floor.
Body is in line ankles with shoulders.
Stay in pain-free range.
Do not arch back.
Hold 10 seconds.
Rest 5 seconds.
Repeat 3 – 5 times.

Wall Slides:
Exhale, do pelvic tilt.
Keep head and back against wall.
Feet slightly wider than shoulder width.
Slowly lower buttock, sliding down wall until thighs are parallel to floor or until pain in back starts.
Slide up the wall keeping your back flat.
Hold 5 – 10 seconds.
Rest 5 seconds.
Repeat 5 times.

Trunk Stability – Unilateral Isometric Hip Flexion:
Lie on your back.
Exhale and tighten stomach (pelvic tilt).
Raise knee to outstretched arm.
Gently push, keep arm straight.
Keep head down and trunk rigid.
Hold 5 – 10 seconds.
Repeat alternate legs 5 times each.

Back Extension Standing:
Standing with hands on waist.
Bend backwards at the waist.
Avoid excessive bending.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

You have now completed Intermediate Level II and you make continue on to Level III – Advanced

Back Exercises - LEVEL I - Beginner

PAIN WITH TINGLING AND NUMBNESS RADIATING TO THE LEG MIGHT BE AN INDICATION OF A DISC HERNIATION. YOU SHOULD AVOID POSITIONS WHICH INCREASE LEG PAIN AND NUMBNESS.

ALMOST ALL BACK INJURIES ARE THE RESULT OF:

1)      POOR POSTURE AND POOR BODY MECHANICS WHEN BENDING AND LIFTING
2)      STRESSFULL LIVING AND WORK HABITS
3)      LOSS OF FLEXIBILTY AND DECLINE OF PHYSICAL FITNESS.

• These exercises are primarily stretching exercises.
• Stretching to the edge is proper. Increased pain is an indication the stretching of the muscles is improper.
• Stretching should NOT cause increased pain 10 – 15 minutes after the stretching is completed.
• Do the exercises 2 – 3 times a day.  

Prone on Elbows:
Rise up on the elbows as high as possible, keeping the hips on the floor.
Do not bend head backward.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

Press-Up:
Press the upper body upward into the position shown, keeping the hips on the floor.
Keep the low back and buttocks relaxed.
Do not bend the head backward.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

Pelvic Rotation:
Assume position on hands and knees.
Exhale and tighten the stomach muscles.
Push the lower back upward.
Do not move the mid-back.
Inhale and let the back sag.
Return to the neutral position.
Raise and lower the pelvis area only.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

Back Stretch on all 4’s:
Begin on hands and knees.
Lean back towards your heels.
Keeping your hand placement, not moving your hands.
Hold 10 – 15 seconds.
Rest 5 seconds.
Repeat 5 times.

Hip Flexor Stretching:
Lie on your stomach.
Wrap strap around the ankle.
Pull the foot to the buttock.
Stretch until you feel slight pulling in low back.
Keep the hips on the floor.
Hold 10 – 15 seconds.
Rest 5 seconds.
Repeat 5 times.

Pelvic Tilt:
Lie on back with knees bent.
Exhale, tighten stomach, squeeze stomach, flatten the low back and tilt it under.
Arch back upward, pushing stomach upward, inhale, return to neutral position.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

Lower Trunk and Neck Rotation Stretch:
Lie on your back, bending knees.
Keep back flat and feet together.
Rotate knees to left.
Rotate neck to right.
Alternate.
Hold 10 seconds.
Repeat 5 times.

This concludes the Beginner Level I and you may now continue on to the next Level II – Intermediate