Moving Well, Part 4: Back to Basics

Orthopedic Injuries, Pain

Working our way up from the foot, through the knee and hip, we now get to one of the most common sources of pain: the low back.  Upwards of 60-70% of people experience low back pain at some point in their life.  In the United States we spend more money each year treating back and neck pain than we do on combating cancer.  The good news is that research is proving that the most effective treatment for back pain is exercise and getting physical therapy before other interventions such as an MRI, pain medications, or injections can save you on average $3000 and often prevent surgery.

For one sided back pain, the cause is often related to an inability to properly bear weight on that side as compared to the other. Please refer to our hip blog for more about this and how to treat it.

This blog will focus on pain that is equal across both sides of the back.  We often lose proper mobility in the low back, meaning we can’t either arch the low back all the way  or we can’t flex, or round, the low back all the way. Most often we lose the ability to do both.  This loss of motion can be a trigger for low back pain.

To assess your ability to extend the lumbar spine, try do a standing back bend. You should be able to go all the way back without bending your knees, without pushing your hips out far in front of you, and without twisting towards one side. Any of these deviations may indicate that you are unable to fully extend the lumbar spine.

The prone press up is a simple trick to aid improving lumbar extension. Lying on your stomach, place your hands flat on the floor level with your shoulders and press up until your arms are straight. Then look up with your head. Try your best to keep your hips on the floor. It is okay if the hips come up some in order to get the arms completely straight. Lower yourself back down and repeat ten times.

To assess the ability to flex the lumbar spine, stand next to a mirror and try to touch your toes. Look in the mirror and see if the low back is flat or curved up. When bending forward the low back should round up, but often times we stay flat backed and let the mid back do all the rounding. This too can contribute to low back pain.


To encourage low back flexion, a quadruped pelvic tilt can be used. To do this start on  all fours and round your low back (not your mid back). Visualize a spot on your low back and push it up to the ceiling as you slightly tuck your hips. Try to keep the mid back relaxed through the entire exercise.