Low Back Strain Rehabilitation

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your back. These exercises also help to relieve pain, numbness, and tingling.

Exercise A: Single knee to chest

1. Lie on your back on a firm surface with both legs straight.
2. Bend one of your knees. Use your hands to move your knee up toward your chest until you feel a gentle stretch in your lower back and buttock.
   1. Hold your leg in this position by holding onto the front of your knee.
   1. Keep your other leg as straight as possible.
3. Hold for __________ seconds.
4. Slowly return to the starting position.
5. Repeat with your other leg.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Prone extension on elbows

1. Lie on your abdomen on a firm surface.
2. Prop yourself up on your elbows.
3. Use your arms to help lift your chest up until you feel a gentle stretch in your abdomen and your lower back.
   1. This will place some of your body weight on your elbows. If this is uncomfortable, try stacking pillows under your chest.
   1. Your hips should stay down, against the surface that you are lying on. Keep your hip and back muscles relaxed.
4. Hold for __________ seconds.
5. Slowly relax your upper body and return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your back. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise C: Pelvic tilt

1. Lie on your back on a firm surface. Bend your knees and keep your feet flat.
2. Tense your abdominal muscles. Tip your pelvis up toward the ceiling and flatten your lower back into the floor.
   1. To help with this exercise, you may place a small towel under your lower back and try to push your back into the towel.
3. Hold for __________ seconds.
4. Let your muscles relax completely before you repeat this exercise.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Alternating arm and leg raises

1. Get on your hands and knees on a firm surface. If you are on a hard floor, you may want to use padding to cushion your knees, such as an exercise mat.
2. Line up your arms and legs. Your hands should be below your shoulders, and your knees should be below your hips.
3. Lift your left leg behind you. At the same time, raise your right arm and straighten it in front of you.
   1. Do not lift your leg higher than your hip.
   1. Do not lift your arm higher than your shoulder.
   1. Keep your abdominal and back muscles tight.
   1. Keep your hips facing the ground.
   1. Do not arch your back.
   1. Keep your balance carefully, and do not hold your breath.
4. Hold for __________ seconds.
5. Slowly return to the starting position and repeat with your right leg and your left arm.

Repeat __________ times. Complete this exercise __________times a day.

Exercise J: Single leg lower with bent knees

1. Lie on your back on a firm surface.
2. Tense your abdominal muscles and lift your feet off the floor, one foot at a time, so your knees and hips are bent in an “L” shape (at about 90 degrees).
   1. Your knees should be over your hips and your lower legs should be parallel to the floor.
3. Keeping your abdominal muscles tense and your knee bent, slowly lower one of your legs so your toe touches the ground.
4. Lift your leg back up to return to the starting position.
   1. Do not hold your breath.
   1. Do not let your back arch. Keep your back flat against the ground.
5. Repeat with your other leg.

Repeat __________ times. Complete this exercise __________ times a day.

Posture and body mechanics

Body mechanics refers to the movements and positions of your body while you do your daily activities. Posture is part of body mechanics. Good posture and healthy body mechanics can help to relieve stress in your body’s tissues and joints. Good posture means that your spine is in its natural S-curve position (your spine is neutral), your shoulders are pulled back slightly, and your head is not tipped forward. The following are general guidelines for applying improved posture and body mechanics to your everyday activities.

Standing

• When standing, keep your spine neutral and your feet about hip-width apart. Keep a slight bend in your knees. Your ears, shoulders, and hips should line up.
• When you do a task in which you stand in one place for a long time, place one foot up on a stable object that is 2–4 inches (5–10 cm) high, such as a footstool. This helps keep your spine neutral.

Sitting

• When sitting, keep your spine neutral and keep your feet flat on the floor. Use a footrest, if necessary, and keep your thighs parallel to the floor. Avoid rounding your shoulders, and avoid tilting your head forward.
• When working at a desk or a computer, keep your desk at a height where your hands are slightly lower than your elbows. Slide your chair under your desk so you are close enough to maintain good posture.
• When working at a computer, place your monitor at a height where you are looking straight ahead and you do not have to tilt your head forward or downward to look at the screen.

Resting

• When lying down and resting, avoid positions that are most painful for you.
• If you have pain with activities such as sitting, bending, stooping, or squatting (flexion-based activities), lie in a position in which your body does not bend very much. For example, avoid curling up on your side with your arms and knees near your chest (fetal position).
• If you have pain with activities such as standing for a long time or reaching with your arms (extension-based activities), lie with your spine in a neutral position and bend your knees slightly. Try the following positions:
  • Lying on your side with a pillow between your knees.
  • Lying on your back with a pillow under your knees.

Lifting

• When lifting objects, keep your feet at least shoulder-width apart and tighten your abdominal muscles.
• Bend your knees and hips and keep your spine neutral. It is important to lift using the strength of your legs, not your back. Do not lock your knees straight out.
• Always ask for help to lift heavy or awkward objects.