Lower back pain is a common condition affecting almost 65 million Americans at some point in their lives. It has also resulted in a loss of 83 million workdays every year and is the second most common reason for visits to the doctor.
The causes of low back pain vary but often include osteoporosis, muscle tightness or weakness, arthritis, poor posture, and injury. To reduce low back pain, it is important to target the muscles that are tight or weak with stretching and strengthening exercises.
But which muscles should you target? What exercises are best, and how often should you do them? If you’ve been looking for a guide to lower back pain, keep reading!
Muscles Targeted to Stretch and Strengthen to Reduce Low Back Pain
The body comprises many different muscles that all work together for movement and stability. When one muscle is weak, tight, or injured, it can put extra strain on the others and lead to pain. This is why stretching and strengthening exercises should be tailored to specifically target tight or weak muscles.
To reduce low back pain, it is important to stretch and strengthen the muscles that attach to and support the spine. These muscles include:
- Lumbar spine paraspinals – muscles that run along the sides of your spine, helping your spine rotate, extend, arch, and side bend.
- Quadratus lumborum – a large, deep muscle that runs from the iliac crest to the top of your pelvis and helps you stabilize your lumbar area, supporting good posture and lateral tilting.
- Hip flexors – a group of muscles in the top of your hip that helps you bend your knee and raise your leg towards the chest. They include pectineus, iliacus, sartorius, psoas, and rectus femoris.
- Gluteal musculature – the large muscles in your gluteal region (buttocks) that help you extend your hips and rotate your leg outwards.
- Hamstrings are the muscles in your thighs’ back responsible for hip and knee movements when squatting, walking, bending, and running.
- Abdominal musculature – a set of strong, thick muscles surrounding the abdominal organs that give you trunk stability, help you breathe, and protect your organs.
Low Back Injuries/Impairments That Can Cause Pain and Tightness
There are many different low back injuries or impairments that can cause pain and tightness in the muscles. Some common injuries/impairments include:
- Spinal stenosis – a narrowing of the spinal canal spaces that can cause pain, tingling, numbness, and weakness in the legs
- Disc herniation – a rupture in the outer casing of the spinal disc that can cause pain, radiating numbness, and tingling in the back and extremities. It also weakens surrounding muscles which affects your ability to move properly.
- Degenerative disc/joint disease – as you get older, your discs can start to degenerate and lose fluid which causes pain and stiffness. Joints can also wear down with age, causing pain and loss of range of motion.
- Scoliosis – an abnormal sideways curvature of the spine that can cause pain and muscle tightness.
- Spondylosis – a general term used to describe the changes that happen to the spine as we age, including disc degeneration, bone spurs, and facet joint arthritis.
- Spondylolisthesis – a condition in which one vertebra slips out of place on the vertebra below it. This can cause pain, muscle tightness, and loss of range of motion.
- Impaired core/lumbar spine stabilization – when the muscles that attach to and support the spine are weak, it can lead to poor posture and instability in the lumbar spine. This can cause pain, discomfort, and instability in the spine.
- SIJ dysfunction – dysfunction or inflammation of the sacroiliac joint (SIJ) that can cause pain in the lower back, pelvis, hips, and buttocks.
Top Exercises to Stretch and Strengthen Your Lower Back
Whether you’re looking for a way to decrease the pain you already have or you’re proactively asking how to prevent lower back pain, the answer in both cases is simple: exercise. To treat lower back pain, it is important to stretch and strengthen the muscles that attach to and support the spine. Here are some of the top exercises to stretch and strengthen your lower back:
Bridge exercises strengthen your gluteal muscles and hamstrings. They also help stretch your hip flexors and back muscles. Lie flat on your back with feet flat on the ground and shoulder-width apart. Drive your heels into the ground, lift your torso and hips off the ground, and squeeze your glutes. Hold for 2-3 seconds, and then slowly lower yourself back to the starting position.
Lower Trunk Rotation (LTR)
LTR exercises stretch and strengthen your abdominal muscles, hip flexors, and gluteal muscles. They also help improve your posture. Start by lying flat on your back with your knees up and feet flat on the ground. Rotate your knees to one side, keeping your upper body flat on the ground. Hold for 2-3 seconds, and then rotate to the other side and repeat.
Single Knee to Chest (SKC)
SKC exercise stretches your hamstrings and helps to relieve tension in the lower back. Start by lying flat on your back with your feet flat on the ground. Bring one knee to your chest and hold for 2-3 seconds. Return to the starting position and repeat with the other knee.
Posterior Pelvic Tilt (PPT)
This exercise strengthens your abdominal and gluteal muscles. It also helps to improve your posture. Start by lying flat on your back with your feet flat on the ground. Slowly raise your legs, keeping your hands and back flat on the ground. Hold for 2-3 seconds, then slowly lower your legs back to starting position.
Transverse Abdominis Stabilization
These exercises strengthen your abdominal muscles and help to improve your posture. Start by lying flat on your back with the knees up. Place your hands on your stomach to feel your transverse abdominis (TVA) muscles contract. Place a ball or towel under one of your heels, then slowly straighten your leg while keeping the TVA muscle contracted. Return to the starting position and repeat with the other leg.
Bird Dog/Dead Bug
Bird dog exercises help improve your posture and stability and strengthen your abdominal, gluteal, and erector muscles. Start with your hands below your shoulders and knees below your hips. Tighten your abdominal muscles and raise one arm and the opposite leg. Hold for a few seconds, then return to starting position and repeat with the other arm and leg.
Open Book Stretch
This stretch helps improve thoracic mobility while also stretching your frontal shoulder and chest muscles. Start by lying on one side with your knees bent and your hands straightened. Gently raise your hand and stretch it over your head while keeping your shoulder down. Return to the starting position and repeat with the other arm.
A relatively simple exercise, pallof punch helps improve your rotational stability and strengthens your core. Start by anchoring a band around a sturdy post. Step away from the post, so there is tension on the band.
Hold the band with both hands and pull it towards your chest. Keep your abdominal muscles pulled in and your chest up. Rotate away from the band, keeping your core engaged, and then return to the starting position.
Intensity and Frequency of Lower Back Stretches and Strengthening Exercises
While exercises offer many benefits, it is important to note that they should be performed safely and with the correct intensity and frequency. When done correctly, low back pain can improve significantly. However, if exercises are done incorrectly or with too much intensity, they can actually worsen the pain. Here is the recommended frequency and intensity for the exercises listed above
- LTR, SKC, PPT, and Bridge: 1-2 sets, 10-15 repetitions with 2-3 second hold, 2-3x/day
- Transverse abdominis stabilization: 1-2 sets, 10-15 repetitions, 2-3 second hold, 2-3x/day
- Bird dog/dead bug: 1-2 sets, 10 repetitions, 2-3x/day
- Pallof punch: 1-2 sets, 15-20 repetitions, 3 second hold, 2-3x/day
- Open book stretch: 3-5 repetitions each side, 10-15 second hold, 2-3x/day
Cawley Physical Therapy Can Help Strengthen Your Lower Back
Cawley’s physical therapists are trained to develop a plan to improve your strength, range of motion, and posture and also decrease pain. Our physical therapists can create a personalized back physical therapy treatment plan to help you reach your goals. Your therapist will also guide how to properly perform the exercises above and ensure you are doing them correctly.
Additionally, our trained physical therapists can easily identify other possible impairments and prevent any future injuries or occurrences of pain. If you are currently experiencing low back pain, don’t hesitate to seek medical help.
At Cawley Physical Therapy & Rehabilitation, our team of experts will work with you to get you back to your prior level of function and help you live a pain-free life. With 19 years of experience and five convenient locations, we are here to serve you. Contact us today at 570-208-2787 to schedule an appointment.