McKenzie Exercises for Your Low Back

If you have low back pain or sciatica, you may benefit from the skilled services of a physical therapist to help you manage your pain and improve your overall mobility.  Your PT will likely prescribe postural correction and exercises to do as part of a home exercise program.

Many people with back pain are familiar with the McKenzie Method of Mechanical Diagnosis and Therapy, and they often wonder what the McKenzie Exercises are.  In actuality, the McKenzie Method is more of a specialized assessment and treatment protocol and not so many specific exercises. Regardless, people are often told to perform McKenzie exercises for their back pain or sciatica.

Here is a list of common exercises that can be performed using the McKenzie Method.  The exercises are done in order to help manage a problem called a lumbar derangement or lumbar dysfunction.  A physical therapist who is trained in the McKenzie Method can help you determine the correct exercises to do and the correct order in which to do them.

Before trying any exercise program for your back, check in with your doctor to ensure that exercise is safe for you to do.

1
Prone Lying

The first McKenzie exercise for low back pain is simply prone lying, or lying flat on your stomach. This exercise is used in treating a sudden onset of acute back pain or sciatica.

To do the exercise, lie on your stomach and relax. After a few minutes of prone lying, attempt to move on to exercise 2, the prone prop up. If pain prevents you from propping on your elbows, rest for a day of two, and try again.

2
Prone Props

Photo of group exercise class performing prone prop up.
The prone prop up exercise can help low back pain. Hero Images/Getty Images

Once you are able to lie comfortably on your stomach, you can try the prone prop exercise. To do this, simply lie on your stomach and prop on your elbows. Take a few deep breaths and relax.

While you are propped up, be sure to monitor your symptoms. Centralization, or moving your pain to your spine, is a good sign and is a signal that this is the correct exercise for you.

After propping on your elbows for a few minutes, try exercise number 3, the press up.

3
Press Ups

Shifting your hips to one side while pressing up can help treat back pain.
The press up is one of your main tools to treat back pain. Brett Sears, PT, 2013

Press ups for your back should be one of your main exercises to treat your back pain. To perform the exercise, lie on your stomach with your elbows bent and your hands flat on the ground under your shoulders.

Keep your back and hips relaxed, and then use your arms to press your upper back and shoulders up, similar to the upward dog yoga pose.

Hold the press up position for 2 seconds, and then slowly return to the starting position. Repeat the exercise for 10 repetitions.

Monitor your symptoms for signs of centralization. If your symptoms are moving towards the center of your spine, that is a good sign and you should continue with the press ups.

If your symptoms are not changing or worsening as you press up, you may need to try the prone press up with hips off-center.

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4
The Low Back Side Glide Exercise for Sciatica

The side glide is used mainly in the treatment of one sided low back or leg pain.
Stand against the wall and use your hand to press your pelvis under your ribs. Brett Sears, PT, 2013

If you have tried press ups straight away and with hips off center with no improvement in your symptoms, you may need to perform the standing side glide exercise. To do this exercise, stand perpendicular to a wall with your feet together. You should be about 1 to 2 feet away from the wall. Lean your shoulder against the wall and tuck your elbow into your ribcage.

Place your hand against your pelvis, and gently press your hips towards the wall. You should feel like your pelvis is gliding underneath your ribs. Monitor your symptoms for centralization as you perform 10 repetitions of the exercise.

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5
The Flexion Rotation Exercise for Low Back Pain

Your spine will start to rotate when you reach for your shoulder blade.
Reach your arm up and touch your shoulder blade to start to rotate your spine. Brett Sears, PT, 2012

If you have tried the press up with hips off center and the standing side glide exercise and are still having symptoms, you may want to move on to the flexion rotation stretch for low back pain. This stretch can be done to treat back pain on one side or pain that is traveling down your leg.

To do the exercise, lie on your side (typically on the side with the most pain), and bend your knees. Straighten your bottom leg, and tuck your top foot behind your bottom knee. Slowly reach your upper hand to your shoulder blade, and rotate your spine by moving your top shoulder back and towards the floor. Repeat the exercise for 10 repetitions.

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6
Standing Lumbar Extension

Photo of the sanding back bend.
The standing back bend may help relive your spinal stenosis symptoms. QxQ Images-Datacraft/Getty Images

The standing lumbar extension exercise is a McKenzie exercise that can be done anywhere. It is used mainly in preventing future back problems once your acute pain has resolved. It can also be used as an alternative to prone press ups if social situations don't allow you to lie flat on the floor and exercise, but you need to extend your spine to manage your back pain.

To perform the standing lumbar extension exercise, stand with your feet shoulder-width apart, and place your hands on the small of your back. Slowly bend your spine backwards as far as possible. hold the end position for a few seconds, and then return to the full upright position.

Repeat the exercise for 10 repetitions, and perform it during the day any time you've been sitting or bending for extended periods.

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7
Low Back Flexion Exercise

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

Many people think that McKenzie back exercises consist of only extension, or bending backwards. Some of the exercises for your low back also consist of flexion, or bending forwards.

Flexion exercises may be used for treating various conditions in the back. These may include:

  • Spinal stenosis
  • Lumbar flexion dysfunction
  • A lumbar derangement that reduces with flexion forces
  • During the recovery of function phase of treating a derangement

The first exercise in a lumbar flexion exercise progression is the low back flexion exercise in a supine position. To perform the exercise, lie on your back with your knees bent. Slowly bring your knees up towards your chest, and grab them with your hands. Apply a little overpressure to bring your knees up further, and hold the position for a second or two. Then release your knees and return to the starting position.

Repeat the low back flexion exercise in supine for 10 repetitions.

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8
Seated Lumbar Flexion Exercise

Seated lumbar flexion.
Seated low back flexion can help improve your spinal mobility and decrease low back pain. Brett Sears, PT, 2013

To take the next step in your low back flexion exercise progression, you should perform the seated lumbar flexion exercise. This exercise is performed by sitting in a chair. Slowly bend forward and reach towards the floor.

Once you are fully bent forward and reaching to the floor, grab your ankles and pull, giving your back gentle overpressure. Slowly return to the starting position. Repeat the seated flexion exercise for 10 repetitions. 

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9
Standing Lumbar Flexion for Low Back Pain

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

The final step in your low back flexion program is lumbar flexion in standing, lovingly referred to by Robin McKenzie as "Exercise #7." To perform the exercise, stand with your knees about shoulder-width apart, and then allow yourself to bend forward as far as possible. Hold the end position for a second or two, and then return to the starting position. Repeat 10 times.​

Remember, McKenzie low back exercises are not merely a set of exercises that should be done as a group. The best way to get the most benefit from the exercises is to find a physical therapist trained in the McKenzie Method who can assess your condition and prescribe the best exercise for you.

If you have low back pain, you may benefit from McKenzie exercises for your lumbar spine. The exercises are designed to quickly and safely help you abolish your pain and improve your ability to move normally with no back pain or sciatica.

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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