3 Exercises You Can Do To Reduce Your Low Back Pain – Part 1
Do you have low back pain? Have you been told you need to strengthen your core but aren’t sure where to start? Try these 3 exercises and work through their progressions to increase your core strength and reduce your low back pain! Today I will be introducing you to the first 3 progressions for each exercise. Once these are mastered look forward to Part 2 where I will show you how to continue to progress your core strength!
Before you can start any of these exercises you need to make sure you are able to contract your transverse abdominus (TA) muscle. This is a deeper core muscle that runs along the front of your torso underneath the rectus abdominus (6-pack) muscle. The TA is important for core stability and strength.
Laying on your back with your feet flat on the floor (see photo above) place your hands on the bony part of your hip bones. Move your fingers in about 1-2 inches and slightly press in. Draw your belly button in, don’t forget to breath. A good way to think of this is that you are getting your picture taken and you want to appear thinner so you suck in while still breathing normally so no one notices. This is what we are doing here. You should be able to feel your TA contract underneath your fingers. Now draw up and in from your pelvic floor as if you are trying to stop yourself from going pee. This helps to create core stability. Practice this by holding each contraction for 10-30 seconds. Complete 3 sets of 12-15 repetitions with a 1 minute rest period in between sets.
This exercise needs to be mastered before moving onto the next exercises!
This first exercise focuses on core stabilization and muscular endurance through movement. Before starting each set be sure to contract the TA muscles, as outlined above. Make sure to master each progression before moving on. The GOAL is quality NOT quantity. Anytime you notice that your form is starting to falter it is time to take a break. You will NOT gain anything by continuing with poor form because other muscles are being recruited instead of using the muscles we are trying to strengthen. Work on progressing up to 3 sets of 12-15 repetitions (each side) with a 1 minute rest between sets.
Dead Bug Progression 1:
Laying on your back with your fingers 1-2 inches inside the bony parts of your hips. Contract your TA muscle (as outlined above). Draw your pelvic floor muscles up and in. Remember to BREATHE! While maintaining this position slowly lift one leg up to 90 degrees. Pause for a second and slowly lower it back to the ground. Be sure to gently place your foot back on the ground rather than letting it make a thud. Alternate legs. Make sure your low back does not lift off of the ground. Your torso should maintain the same position throughout the exercise. If you notice that your TA muscles become loose, pause, reset, and continue. Complete as many reps as possible, up to 15, with good form.
Dead Bug Progression 2:
Continuing with the same form outlined above, add in the opposite arm by extending it over head. This creates longer levers and becomes more difficult for the core muscles to control.
Dead Bug Progression 3:
Up to this point we have been keeping the knees bent at 90 degrees. Now you are going to focus on extending the leg as it lifts off of the ground. Again, increasing the lever so the core has to work harder to maintain control. It is okay to lower the straighten leg down to the floor however, keep the low back against the ground. If you notice the low back is starting to lift off of the ground you do not have the core strength to lower your leg that far. Work within your abilities and slowly work on progressing as your muscles tolerate. Remember QUALITY not QUANTITY.
The second exercise also focuses on core stability and muscular endurance. The same principles outlined for Dead Bug apply to Bird Dog including TA and pelvic floor engagement and quality versus quantity. Work on progressing up to 3 sets of 12-15 repetitions (each side) with a 1 minute rest between sets.
Bird Dog Progression 1:
This exercise is in a table top position on your hands and knees. It is important that the knees are directly underneath your hips and your hands are directly underneath your shoulders. Contract your TA and pelvic floor muscles (as outlined above) and keep your spine in a neutral position. By a neutral position I mean that your back will be relatively flat with slight curves in the low back and the mid (thoracic) back areas. You want to maintain as stable as a position as possible, I like to pretend there is a hot cup of coffee on my back and I can’t spill it. Once stabilized, slowly lift one arm out from underneath you and lift it forwards. Make sure the shoulder does not drop and the core muscles (TA and pelvic floor) stay engaged. Complete as many reps as possible up to 15 with good form.
Bird Dog Progression 2:
Starting in the table top position. Engage core muscles, as outlined above. Slowly remove one leg and extend it backwards. Make sure to keep the hips level. Focus on keeping your body weight in the center instead of letting it shift to the supporting leg. Start by only lifting the leg off the ground a little bit and gradually moving towards full extension. Remember to visualize a hot cup of coffee on your back and you do not want to spill it on yourself! Another key reminder with this exercise is to slide the knee in and out of place.
Bird Dog Progression 3:
Now we are going to combine progression 1 and 2 together alternating between arm and leg movements. Don’t worry about lifting your arms or legs really high off of the ground. Focus on keeping the TA and pelvic floor activated and the body in a stable position, supporting the hot cup of coffee. It becomes extremely important to focus on technique and not number of repetitions. Do as many as you can with good form and progress up to 15 repetitions on each side.
The third exercise focuses on gluteus medius strengthening. This muscle is our medium sized glute muscle and helps with core stabilization by stabilizing the pelvis. This exercise is completed in a side lying position, feel free to put a pillow under your head or use your arm for support.
Clamshell Progression 1:
Laying on your side with a 90 degree bend in your legs and your knees slightly tucked (see picture above). Roll forward slightly so that your belly button is starting to point towards the ground. Keep your feet touching and lift your top knee up away from the other one. The easiest way to find your glute medius is to place your hand on your bum at the top of where a pocket would be located on a pair of jeans. Place your top hand here to feel this muscle engage as the top knee is lifting upwards. Make sure to maintain your position and do not lift your knee high enough that it causes you to rotate backwards. Remember quality is more important than quantity! Complete as many as you can and progress to 15 repetitions on each side.
Clamshell Progression 2:
To progress the clamshell you will want to use a resistance band. These come in a variety of colors, with each color representing the strength of the band. Place the resistance band just above the knee to increase the resistance.
Clamshell Progression 3:
The third progression doesn’t involve the clamshell movement but it prepares you for Progression 4 (coming in PART 2). The side place focuses on gluteus medius strength as well as core stability and muscular endurance. Start in a side lying position with your elbow directly underneath your shoulder. Have the knees bent to 90 degrees. Engage your core muscles (TA and pelvic floor) prior to pushing through your elbow and knees to lift your bum and torso off of the ground. Your shoulders, hips, and knees should be in a straight line. Place the top hand on your hip for balance and look straight ahead. Work on completing 3 sets, 30-60 second holds, working up to 3 repetitions, with 1 minute rest between sets. Complete on each side.
PART 2 of this article will take each of these exercises and add three more progressions so that you can continue to work on your core strength and reduce your low back pain! Look for PART 2 coming soon!
Author: Lorelle Warr, B.Sc., M.Sc., P. Kin, Kinesiologist