The Prone Press Up with Hips Off Center

A low back stretch to help treat pain on one side of your back.

The prone press up with hips off center.
The press up with hips off center is used to treat back pain that is on one side of your back. Brett Sears, PT 2013

Low back pain is a common occurrence that strikes up to 85% of people at one time or another. It is one of the most common diagnoses seen in physical therapy clinics, and it is one of the leading causes of lost time at work.

If you have low back pain, then you know how difficult it can be to move, work, or enjoy recreational time. When low back pain strikes, you likely want to take control of it quickly to make it go away and stay away.

First Steps to Take When Back Pain Strikes

If you are having an acute attack of back pain, there are a few things you should do first to take control of your situation. First, contact your doctor, especially if you have certain symptoms like bowel or bladder changes or sudden weakness or paralysis in your leg. These may be a sign of a medical emergency that requires treatment right away.

To start treating your back, some basic first steps should be undertaken. These include:

  1. Relax. Most low back pain eases quite rapidly.
  2. Lie face down on hard surface, like the floor. If that is difficult, lying on your bed should be fine.
  3. Try a few press up stretches to help restore the normal position of your spine. Lie face down, place your hands flat on the floor, and press up while keeping your back relaxed.
  4. Monitor your symptoms. Look for centralization, or the movement of pain to a location close to your spine. Centralization of your symptoms as your perform the press up is a good sign.
  1. Be vigilant about maintaining proper posture. Performing the slouch-overcorrect exercise can help you train your body to attain proper posture.

Next Steps to Treat Your Back Pain

If you have tried the press up exercise and have kept proper posture but your symptoms have persisted on one side of your spine, then you should move on to a new exercise: the press up with hips off center.

The press up with hips off center is a McKenzie Method exercise that is great at treating low back pain and sciatica that is located on one side of your spine. Here is how you do it:

  1. Lie face down and prop onto your elbows.
  2. While propped up, shift your hips to one side while moving your feet and legs to the opposite side. If your pain is on the right side of your back, shift your hips to the left. If your pain is on the left, shift your hips right.
  3. Lower yourself down while maintaining the shifted position. Your body should be in a crescent shape.
  4. Place your hands flat on the floor under your shoulders, and perform a press up. Be sure to keep your hips off center to one side and keep your back relaxed.
  5. Press up as far as you can, hold the end position for one second, and then slowly lower down. Your hips should remain shifted the entire time.
  6. Repeat this exercise 10 to 15 repetitions while monitoring changes in the location or intensity of your back pain.

Monitor Your Symptoms

While performing the press up with your hips off center, be sure to monitor your symptoms.

Remember that centralization of your pain as you exercise is a good sign. If your symptoms are centralizing, keep performing the exercise. It can be done several times a day, in conjunction with postural correction, to help improve your low back pain.

If the press up with your hips off center causes your pain to worsen, try the exercise with your hips shifted to the opposite side. Again, monitor symptoms and look for centralization.

If you are feeling improved mobility and decreased pain with the press up with hips off center, keep doing the exercise until symptoms go away. Then, switch to the press up straight away to keep the pain away.

If your pain gets better but persists, and you feel like your progress stalls, you may need to try a different exercise to treat your back pain. The flexion-rotation stretch is a reasonable progression from the press up with hips off center.

Low back pain can be a scary experience. By attempting to self-treat with exercises like the press up with hips off center, you may be able to take control of the pain and quickly return to your normal activity and function.

Of course, if your low back pain persists, a visit to your local physical therapist may be in order to help sort things out for you

Source: McKenzie, Robin. Treat Your Own Back. 8. Raumati Beach: Spinal Publications New Zealand, 2006. Print.

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