What Is The Single Best Stretch For Back Pain And Back Health Long Term?

Issue 37

A quick search online will come up with many stretches touting to be the best for lower back pain or sciatica, with so many results coming up, surely they cannot all be the best stretch you can do? When it comes to a daily practice of stretching for your back pain we do believe there is a “best stretch” but it’s perhaps not what you’d initially think of. This week we’ll compare some of the stretches that have been put forwards as the best for back pain relief, and we will compare these to our choice, hopefully by the end of this, you’ll have a robust understanding as to why we choose this simple little stretch, that everyone can do, as the best stretch for your back health. Not only is it a vital option when you’re in pain, but for the overwhelming majority of us all, it is an essential stretch that we can do for our long term low back health.

The purpose of a daily stretch that can help your lower back pain & health

It is firstly, helpful to think of a purpose behind what we’re doing, this might sound mundane, but all will make sense. Let us face it, there are many things we could do to help the pain that are not conducive with back health, and many things helpful for back health that are not going to be right when we have a back injury. For example, many with lower back pain will have been prescribed knee hugs or child’s pose to help with the pain, on the other hand doing a loaded squat might work for the back health. But these come with consequences at certain times. 

The former stretch brings excessive rounding of the lower back, in modern life has next to no utility, however it will feel pleasant in many cases. I would however argue that it feels pleasant even if you do not have back pain, that doesn’t mean that it is good, or useful. The latter squat incorporates load to the spine which is great for building resilience and is hugely applicable to the human body’s needs in the real world, however, loaded squats in the early days of a back injury are likely to create more trouble than positive outcomes.

What would the best stretch for back pain look like?

When we’re looking at what would constitute the best stretch for your lower back health it would be helpful if we could identify some characteristics to look for:

Firstly, we would want to look at pain, when we have a back injury, the recognition of how the low back becomes injured is vital. The lower back fundamentally fails in load bearing. The bearing of load either in the extreme, or in the repetitive over long durations, leads to a failure to bear such load. Damage as a result occurs and inflammation builds when this damage occurs to a significant degree. Therefore something that is going to take load off the spine is a must. 

How we take load off is important. If we look at the vast majority of lower back injuries, there is an element, to a greater or lesser degree, of flexion. This forward bending then has the effect of stretching certain tissues, which fail. 

This creates quite the conundrum!

On the one hand we mentioned that there is a compression, but on the other we are talking about a stretch, and at the same segment. You might be thinking, how could you possibly reconcile both of these simultaneously?! 

This is a valid question that we’ll look to later. 

What would the best stretch for back health look like?

Now that the “back injury or pain” side of things is taken care of, we also want to consider the long term back health side of the equation. For this we need to look at the general purpose of stretching or any daily “health practice”.

A daily practice should be something that offsets or counters the way in which we spend most of our time. According to the British Heart Foundation, the average working age adult spends a whopping 9.5 hours per day sitting, as adults move into the 65+ age category, this climbs to 10 hours, and by 75, 11 hours every day sitting. 

Bear in mind the 9.5 is only an average! 

The mechanics of sitting are some of the most detrimental to the lower back health, because of the dual strain they place on the back. The astute among you will start to see familiarities with what we mentioned earlier.

When sitting down, your pelvis will be rocked backwards and your lower back flattened out, this has the effect of creating a forward bending position in the lower back. Two key areas of strain develop. Firstly a compression on the front part of the intervertebral unit, the discs. Secondarily, the back part of the vertebral unit, and to a degree the back part of the disc too, becomes stretched. Sound familiar?

But it doesn’t stop there, because of the frequency, and duration of sitting, especially like this, we start to get a process called creep occurring in the ligaments, this is whereby the ligaments that are being stretched and deform under this continued stretch. It takes approximately 20 minutes for this process to peek but it begins to occur around 10 minutes of sustained stretch. Done repetitively over days, weeks, months and years, this can start to impact the integrity of our lower back as the natural curve that should be present is gradually eliminated. 

This phenomenon that results from our addiction to sitting accumulates, therefore for a stretch to be considered the best, it should be one which can ideally oppose both of these forces, compression of the front and stretching of the back, simultaneously. 

Is there such an exercise or stretch we can do?

The most effective stretch for lower back health and back pain relief

From our investigations into the topic, we now have a number of criteria to look for. We want a daily practice that is going to help oppose the primary strain on our lower back that results from sitting, this peculiar compression and stretching of the lower back that occurs through elimination of the lordosis. We’ve interestingly started to appreciate that much of the ways our lower back is injured, is an extension of this “flexion deformity” and therefore the two, back health, and back injury relief, marry up rather neatly. 

When we have a fresh back injury we definitely do not want more compression, such as is the case in the addition of the loaded squat mentioned earlier, we also do not want to further stretch the structures on the lower back that are already stretched and damaged! 

Take a moment to consider your back pain, if you have been unlucky enough to experience it. Did carrying heavy things make things better? Did your injury happen when you bent forward or backwards? 

By now you’ve probably guessed it, the towel exercise is the best stretch in our opinion. But why precisely?

The towel’s effect on load on your lower back

Firstly, the towel stretch has the effect of taking pressure off the lumbar discs in a subtle way, reducing the burden of load. This can be helpful in the acute back pain case, by taking pressure off a damaged disc for example, or unloading a degenerative disc which is squashing together. 

The towels effect on the stretch of your lower back

Secondly, the towel stretch supports a neutral lordosis, gently, so whilst it is unloading the front part of your discs, it is also taking the stretch off the ligamentous structures and muscles on the back of the spine. These are frequently a source of tightness and stiffness, not because they are tight and short in need of stretching, quite to the contrary! They are exhausted from being pulled apart all day during that 9.5 hours you spend sitting. The towel offers them a brief moment of respite!

The towels effect on the injured tissues in your lower back

Thirdly, as we discussed, a combination of the two above forces are almost always associated with the injury of your lower back, either in the extreme one off case, or more commonly, the repetitive cumulation of forces that the back eventually fails to handle. The towel stretch opposes both of these in a gentle way that requires little in the way of technical skill or ability to achieve. 

It can be done for short periods of 20-30 seconds in the particularly acute individual, it can also be done routinely for 3 to 5 minutes in the individual in pain or who is simply looking for that “healthy back practice”.

How does this special stretch compare to other back stretches? 

You might be thinking that’s all well and good, but what about the other stretches you could do for your back pain and back health. We’ve listed a couple below with some of the key comments to help you better appreciate the critique:

Knee hug or child’s pose:

This stretch simply ignores the mechanisms by which most back injuries occur and actually works to reinforce the strain your back is under on a daily basis. Fundamentally, this stretch might feel nice, but there are plenty of things in life that “feel nice” that are not good for your back health, or other aspects of your health for that matter. 

Hamstring stretch:

This can be a useful stretch to help with lower back pain, when done with correct form, but as far as meeting the criteria we’ve outlined above, this doesn’t come close to having a direct effect on the parameters discussed in the same way the low back towel does.

Cobra stretch:

This is an interesting one, which could at first glance look like it could be a good option. However, because it does not have the presence of the pivot point that the towel has, it does not work in quite the same way. Often those with more degenerative conditions in the spine and some with disc herniations will find that this stretch is simply not helpful and the active action of the exercise makes it more difficult to relax into, when compared to the towel. It really is a glorified backward bend, as opposed to a gentle support for a neutral spine. 

Bear in mind that extension could well have a good role in checking the “back health” category as it does meet the criteria of being directly able to offset the barrage of flexion brought about by sitting all day. It however falls short in the category of helping the more acute back injury side of things as we try to focus on neutral, as opposed to flexion or extension in the early or active days of a back injury and its rehabilitation.

The towel stretch is the best thing you can do for your low back health and back injury.

In the previous section we covered some simple critiques that you could use for a framework, when considering a stretch or exercise not mentioned above. We’re confident you’ll not find another stretch quite like it that you can do from home at no cost! 

Those of you that have been with us in the Back In Shape Program will know this stretch all too well, but hopefully today’s article and podcast has given you the additional information and background to help you commit to keeping up this stretch for the long term, your back will thank you for it!

We do know that some of you will still be saying, “yes, but your back is supposed to bend forwards!”  You’d be right, but when it comes to a stretch you should be doing daily, you need to evaluate how you use your body daily. The reality is that in spite of best intentions, we have a limited ability to eliminate flexion from our lifestyle, even when sitting. As you move out of back pain into back health, you will find that because of your daily life, flexion will creep back in, in spite of your best efforts. 

If you do still believe that you need to do some element of flexion, ask yourself, how that fits into your daily life, and make an informed decision. 99.9% of you will find that there are a whole host of movements, practices, workouts and more that will be infinitely more helpful and necessary to improve your long term back health, than doggedly persisting with more formalised flexion.