Low Back Flexion Exercise Step-By-Step Progression


Photo of woman stretching her back on the couch.
Your PT can help you set up a home exercise program for lumbar spinal stenosis.. PhotoAlto/Milena Boniek/Getty Images

Performing lumbar flexion, or bending forward, may be the right exercises for your back pain or sciatica. But how do your properly progress with low back flexion exercises?

If you have low back pain, then exercise and postural correction are two simple things that you can do to help decrease your pain and improve your mobility.  A visit to your physical therapist can help you determine the correct exercises to do and can help you perform the correct exercise progression.

Sometimes, low back extension exercises are warranted to treat your back pain.  Extension of your spine occurs when you bend backward. 

Occasionally lumbar flexion, or bending forward, is the best direction of motion to treat your back pain.  People with conditions like degenerative disc disease and spinal stenosis typically-but not always-benefit from forward bending.

If you do require lumbar flexion to treat your low back pain, there is a safe and effective way to progress your bending exercises.  Following the correct progression ensures that the forces you place on your back are safe and effective for your condition. This step-by-step exercise progression for your back focuses on how to properly progress your lumbar flexion and is typical of the way your PT may progress your back exercise program. This program is part of the McKenzie Method, a specialized method of treating back pain.

Remember to check with your doctor or physical therapist before starting this, or any other exercise program, to ensure that it is safe for you to proceed.

Supine Lumbar Flexion

Lumbar flexion in lying
Perform low back flexion by pulling your knees towards your chest.. Brett Sears, PT, 2013

The low back flexion exercise while lying on your back is the safest of the back flexion exercises.  This exercise bends your spine, but the amount of force and pressure on your back is minimal.

To do the exercise, lie on your back with your knees bent, and slowly bring your knees up towards your chest. Grab your knees with your hands, and give a gentle tug. Hold the position for a second or two, and then release your knees and return to the starting position.

This exercise can be done several times per day to manage acute back pain that responds positively to forward bending.  It may also be done to maintain spinal health and prevent problems with back pain once your symptoms have resolved.

Seated Lumbar Flexion

Seated lumbar flexion.
Seated low back flexion can help improve your spinal mobility and decrease low back pain..

Once low back flexion has become easy while lying on your back, you can progress to seated lumbar flexion. In the seated position, gravity can add a bit of force to your spine, thus increasing the amount of flexion obtained.

Simply sit in a chair, and then bend forward as far as possible. When you perform this exercise, the stretch to your back can be increased by grabbing your ankles and giving a gentle pull.

Remember to monitor your pain when performing this exercise. An increase in back pain indicates that caution should be used and continuing with this exercise may cause worsening of your condition. Many people benefit from a few repetitions of lumbar extension press ups after this exercise to keep things in balance.

Standing Lumbar Flexion for Your Low Back

Lumbar flexion in standing.
You can perform lumbar flexion in standing to improve your spinal mobility and stretch your hamstrings.. ©Brett Sears, PT, 2013

When the lumbar flexion in lying and in sitting exercises become easy and painless, the standing lumbar flexion exercise should be performed.

Standing low back flexion is a great exercise to maximize your spine's ability to bend.  In the standing position, gravity can really add quite a bit of extra force to increase the amount that your spine can flex. Simple stand up, and bend forward as far as possible. Hold for a second or two, and then return to the starting position. Repeat about 10 times.

In the standing position of lumbar flexion, your hamstring muscles will also be elongated, and this exercise can be used as a method to improve your overall hamstring flexibility.

If you have back pain and require lumbar flexion to help manage your symptoms, you should follow the lumbar flexion progression.  This may help ensure that your spine remains safe while you are improving your spinal mobility or restoring spinal motion after injury.

Visit your doctor or physical therapist to see if progressing with lumbar flexion is the correct (and safe) way to improve your overall spinal health.

Source: McKenzie, R., & May, S. (2003). The lumbar spine mechanical diagnosis and therapy. (2nd ed., Vol. One). Waikanae: Spinal Publications New Zealand

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