Exercises For Lower Back Pain: A Back Health Masterclass

Overview Of The Masterclass:

When it comes to the right exercises for lower back pain, there is so much confusion out there. Often those struggling with back pain or sciatica, as bad as it can be, are faced with nothing but conflicting information when trying to remedy their symptoms. Our goal here is to give you the formula required to help you better understand what to do, why to do it and how to move forwards. If you follow the complete guidance, you will find you can start doing the right exercises for lower back relief and avoid stretches and other movements that fundamentally undermine the recovery process.

Your body is trying to heal, every day. In addition to doing the right exercises for your low back, you must also get out of the way and stop making the same old mistakes that have stopped your back healing properly and allowed vulnerability to remain.

Personalized rehabilitation for lower back pain relief

One of the most pressing questions on your mind when you embark on any course of action to remedy lower back pain is whether the exercises are right for your back pain? People often want to know how their specific circumstances affect the selection of exercises or stretches necessary to provide relief from the lower back pain they’re experiencing. This is the “personalisation” of the exercises for your specific back pain. Unfortunately this desire searching for something unique stops so many from being able to make progress because it creates a block. 

None of the exercises we will cover will be unsuitable for you, but each and every one of you reading this will find certain aspects of the exercises challenging in different ways. These are your blocks which you must uncover through careful practice, and then resolve through diligent application of technique repeatedly until they are no longer a challenge. By creating a formula for a healthy back, covered later, you will find the “personalisation” is these unique challenges you face in the pursuit of mastering these exercises and principles.

The Pitfalls of Seeking Quick Fixes for Back Pain

One of the major traps that you’ve likely fallen into with your back pain diagnosis is the expectation that there are some special exercises for immediate back pain relief. That this “golden solution” is there for your back pain and if you did just the right combination of movements it would unlock everything. You’ll see plenty of “quick fix movements” like this on YouTube. Again this is another reason your back pain doesn’t get better long term.

Granted your specific diagnosis can help us know what specific movement you can do to make your back pain feel better immediately, great examples of these are knee hugs, or painkillers and other such approaches. These however are fundamental errors as you are sacrificing short term moment to moment relief for lasting resolution of the problem in your back. Ultimately many of these “quick fix” solutions for lower back pain or sciatica will lead to things worsening over time.

The simply truth for nearly all the thousands of members of the Back In Shape Program and patients at our clinics, is that the back vulnerability and injury has been months or years in the making, the expectation that you can just pop the joint back, or do some miracle exercise to undo this needs to be eliminated. We need to be honest with ourselves.

How Much Does Your Diagnosis Affect The Rehab?

Diagnosis does matter in some regard but the diagnosis is not what dictates which exercises are right for your low back pain. You could have 10 people with an MRI validating an L5 disc bulge and those 10 people would have 10 different sets of symptoms, some of them will even have no symptoms. The majority of patients we see and members in the program have L4/L5 or L5/S1 injuries, yet there are variations in the symptoms that are present, and often the “injury” itself has not fully healed long before the majority of the pain has gone.

A great example is a member and patient of ours, Janet, whose story was featured in the national press in the UK. She originally started with us in debilitating pain with a grade 2 spondylolisthesis – an unfavorable diagnosis, which included significant disc injury too! She was able to recover from the day to day pain, get into the gym and do the things she wanted to again although the spondylolisthesis was downgraded to only Grade 1 more recently – an improvement. The “diagnosis” is still there. The reason she’s doing so well is that she’d invested the time and energy to properly rehabilitate and strengthen up the tissues around the injured section of the spine to compensate for this unfortunate change in structure. 

The understanding of the diagnosis was helpful in truly appreciating the scale of injury in the lower back, and triggering an awareness of the importance of proper rehabilitation work and strengthening to rebuild support for this region of the lower back. You can read more about Janet’s story as well as other members on the website backinshapeprogram.com.

In short, your diagnosis can help you understand your own body better, and appreciate the road ahead. It can add extra weight to the importance of proper rehabilitation and building a “strong spine” but it does not dictate which exercises can or should be used to achieve this, as will become obvious later on.

Your Back Pain Diagnosis

So many with back pain that’s lasted longer than 6 months desire a diagnosis but often the understanding of such diagnoses is very limited. When it comes to the low back there are limited things that can go wrong, as there are only so many structures in the region. There are two main classifications of diagnosis in our experience and we’ll cover them briefly here.

Pseudo-Diagnosis

These diagnoses are common but they don’t actually tell us anything useful and are about as helpful as saying “you have back pain”. Patients often do not understand these diagnoses, or the fact that they are not really telling you the whole picture in the slightest. Examples include the following:

• Chronic Low Back Pain
• Non-specific Back Pain
• Stenosis (of varying subcategories)
• Sciatica
• Piriformis Syndrome

All of the above tell us nothing of the injured tissues, they merely state, “there is back pain”. In the case of the first two, or that there is leg pain in the case of sciatica, or that “holes in the back are smaller than they should be” in the case of the varying stenosis sub categories. These must be combined with the second classification of back pain diagnosis for effective understanding of the cause. 

Real-Diagnosis

These are actually referring to a structure that is supposedly injured or damaged, the “tissue” that is compromised. These injuries can then give rise to the “pseudo-diagnoses” above.

• Lumbar disc herniation or bulges
• Degenerative disc disease
• Spondylolisthesis (various grades)
• Sacroiliac joint injury
• Facet joint injury
• Vertebral fracture (very uncommon)

As you’ll see above, there are a limited number of tissues that can actually be injured in the lower back. However because back pain is so poorly treated it leads people to fall for the illusion that it is more complex than it needs to be.

Simply put, you might have: an L5-S1 disc bulge, which results in stenosis of the lateral recess on the left side with sciatica down your left leg.

Your Back Pain Journey Is Unique

Where personalisation is made is less in the diagnosis and more in the journey. Know that your back should be stable and resilient, when it fails to do this, injuries happen. When we do not correct these issues, injuries become chronic and easily re-appear. When following a structure that promotes spine stability and strength, through doing the exercises required for good spinal health, you will discover specific movements that prod at the weaknesses you have. That is the personalisation. That is where we can drill down to understand why you cannot protect your spine, or L4, L5 disc herniation, in the necessary way, understand what element of control is missing, and start to rebuild that specific weakness through the exercises for your lower back pain.

Why Common Back Pain Interventions Fail

So why have things not worked so far? The simple answer is that you’ve probably been relying on health care practitioners, be they a GP, Osteopath, Chiropractor or Physiotherapist, or other specialist who just doesn’t know any better. This is not to degrade your practitioner, it is simply to say that many do not know what they do not know. 

We covered our story about how Back In Shape came about and our history, clinically, in the Back In Shape Story Podcast episode, however the short of it here is as follows. We were very fortunate to practice in London, the UK and see many thousands of low back pain patients over the years, all of whom had accompanying spinal imaging. This culminated in the creation of our clinic “The Mayfair Clinic” which featured in national media such as the prestigious Daily Telegraph newspaper. The clinic itself was awarded the Queens Award For Enterprise Innovation in 2020 an amazing achievement. This unique experience was only really possible in such a busy capital city. Helping thousands of patients, all with spinal imaging allows for the development of a unique insight into how the spine works.

Your Average Practitioners Often Misunderstand Back Pain

Your average practitioner around the rest of the country simply doesn’t have this exposure, and cannot develop the same degree of knowledge. Many will very rarely work with imaging on patients, and are simply unaware of the major flaw in their understanding of low back pain.

The simple truth is that the average practitioner is not aware of how the low back works and how inaccurate their physical examination is. They don’t know what they don’t know because they’re not routinely exposed to the imaging accompanying the patient presentation. They’re forced to do their best with the tools at their disposal and they do a good job for many. But when it comes to having a deep understanding of what’s a priority for lower back health, they fall short.

We have this edge because of the thousands of sets of images that have accompanied patients with all manner of lower back pain diagnoses. Through this thoughtful practice, you begin to understand the spine and how it fails in a new light, and more importantly how to restore its strength and recovery. This means you avoid certain exercises and movements, in the short term, and focus on others. It means you realise the futile approach of certain practices that are all too commonly used. Which leads us nicely into the next section.

The Key Challenge in Recovering from Low Back Pain

A normal healthy spine should have a natural lordosis, this is an arch, which can be measured on a standing X-ray very accurately. The presence of this natural lordosis when standing would mean the spine is in the neutral position. When we bend forwards, the lordosis flattens, and the curve becomes reduced. 

When we bend backward the arch in the lower back increases. So the interesting reality is, in fully developed adults, the spine is nearly always bending backwards, just to a greater or lesser degree. 

Much like an elbow, when we bend it into flexion, the movement slowly ends with a stretch, and when we extend the elbow, like bending backwards, we end with a lock. Most of our time however should be spent in that neutral.

This neutral spine however is the biggest casualty of modern life. Flexion, and rounding of the lower back is everywhere in our daily lives. Take a moment if you’re outside now to look around you at those sat down, all with rounded lower backs, slouched in chairs. Maybe it is in the office, maybe a coffee shop, maybe on the commute, it matters little. This action of rounding the lower back for extended periods is a major issue. 

The average adult according to research by the British Heart Foundation, spends around 9.5 hours a day sitting, and you can bet it is not in a “good posture”, it will be with a rounded lower back, exerting more pressure through the discs of the low back, stretching the muscles and ligaments that should be maintaining a neutral spine.

In spite of this pandemic of flexion, the most common exercises for lower back pain all include flattening your lower back to relieve back pain. This misguided approach is borne out of the feeling that so commonly accompanies back pain, stiffness or tightness in your lower back or thighs, and well meaning practitioners that know no better, are all too ready to recommend the same old stretches to provide you with relief. 

If you’ve had back pain for any length of time, you have likely already been prescribed knee hugs or cat cow stretch for lower back pain, or if you have an element of sciatica, sciatic nerve flossing. We know this because practically all the members of the program and patients we see, have been given these before they found a better way!

Exercises That Worsen Back Pain

Although these exercises are pleasant at the time, that does not equate to them being helpful for the recovery of lower back pain. They are like scratching if you’ve been stung by stinging nettles, they feel nice at the time and undermine the healing process allowing the itch to itch more! They interfere with the healing process that is trying to take place. 

If practitioners mentioned earlier had more exposure to imaging and a deeper understanding of the spine, they would adjust their approach and not recommend these sorts of exercises. However, in a world where you want to try to help the patient and need something to provide quick relief, they are all too easily recommended. 

Make no mistake, these offer no rehabilitative benefit and should be eliminated going forwards. If you commit to doing this, you can now move on to replace these bad exercises for back pain with principles, exercises and stretches from an approach that will restore your back health from the inside out!

Four Reasons Your Prescribed Exercises Didn’t Work

Limited Understanding of Spinal Function

For the average physio and GP, anatomical knowledge is often less comprehensive than that of osteopaths and chiropractors. Even at specialist osteopathic universities, education focuses on vertebrae structure rather than detailed spinal alignment and function. This deeper understanding is typically a post-graduate interest that few pursue.

Over-Reliance on Physical Examinations

Many practitioners lack awareness of how little physical exams reveal about the alignment of the lower back or pelvis. Our understanding improved by seeing thousands of patients with accompanying spinal imaging, which highlighted the limitations of physical exams. Common errors include misdiagnosing short legs, anterior and posterior pelvic tilts, and excessive low back curve.

Most Practitioners Lack Specialization

Many practitioners are generalists and lack specialized knowledge and experience in treating lower back issues. While they may see many back pain patients, they don’t have the depth of expertise needed. Our clinic, however, focuses almost exclusively on spine patients, with 80-90% dealing with lower back problems. Our clinics and technologies have been specifically chosen to address lower back issues and spinal injuries.

Focus on Muscles Over Spinal Stability

The final error is concentrating on the wrong tissues. The approach to back pain is often too shallow, focusing excessively on tight muscles and muscle spasms rather than on spinal stability and function.

Ultimately, the principles we’re about to discuss are logical, tested, and based on real-life spinal function. This is why many healthcare practitioners, from GPs to surgeons, osteopaths, and chiropractors, refer their patients to the Back In Shape Program. It complements their clinical work with a robust rehabilitation approach that delivers results.

Effective Back Health Recovery Principles

The principles we’re about to cover are drawn from the full Back In Shape Program, they form the basis for the help and guidance we offer our members and why what we say works the way it does. As we move into this section, consider that your spine has an injury, that is why you have back pain. If you’ve been unfortunate enough to be told that tight muscles are causing your back pain, you’ve been misled.

Muscles do not cause back pain and they do not tighten for no reason, they go into spasm because you have injured a joint, this is something that we explore in great detail in the podcast episode on why your tight muscles are not the cause of your low back pain, it should help you rethink muscle spasm in your lower back from this point on!

Stability: Build A Stable Spine

The first principle is about maintaining a neutral spine, learning to safely control the spine. Your injury in the lower back, let us say the L5, S1 segment, is not going to be helped by moving around lots! When you have an injury the stabilizing structures of the joint have been damaged, so movement can occur uncontrolled in that joint. Your first step needs to be to help provide stability to the spine as a whole and the segment as best you can.

It is the failure to control these movements that catches you out daily and is the reason for recurring relapses from ordinary daily tasks. Building stability in the spine and control enough to maintain the neutral spine is vital.

Strength: Prioritise Hip Strength Over Flexibility

So many get focused on stretching the muscles of the hips, gluteals, hamstrings etc, trying to relieve their back pain. The way in which they do these stretches, rounding the low back or twisting it, makes things even worse. In the early days strengthening comes long before flexibility. The majority of people are terribly inadequate in their hip strength and cannot move through good ranges of motion with their own bodyweight, let alone anything more. 

Focusing on building good strength in the hip region, whilst also observing a stable, neutral spine is the next principle that must be observed.

Real-Life Rehab: Mimic Everyday Movements

This is to say that the movements that you’re doing must be reminiscent of real life movements. The squat for example is used every day. Learning to get out of a chair with a good squat is vital to starting to eliminate your back pain for the long term. Doing peculiar movements that are not true to real life is futile.

Starting to control yourself the many times you fall or crash into a chair, each day can have immediate benefits insofar as you stop causing unnecessary strain on that injured low back.

Safety: Choose Safe Exercises 

Whenever you’re rehabilitating your lower back pain, safety must be the first concern. We need to do the movements correctly, and the exercises should have clear benefits, for example doing a burpee is just not at all necessary. Even jumping squats is not a clever move, although you might be doing this well it offers almost no additional benefit to regular squats but lots of complicating factors and unnecessary risk!

When we put together the full Back In Shape Program, these principles and a few others were front and center when structuring the program and the progression that we used over the course of the program. So let’s get into it.  

Stage One: A Strain Relieving Protocol

It is important to draw the distinction between relief for your immediate pain and relief of the strain on your injured back. This is the distinction between knee hugs and what we’re about to cover. The former simply relieves the pain, like scratching the itch we mentioned earlier. On the other hand, these next 4 practices, exercises and stretches relieve the strain in your lower back and help healing take place, relieving the pain properly! You will continue to do the practices in this stage in stage two and three as well.

The four exercises, practices, and stretches form the basis of this relief routine. This is a way to relieve strain on the injured tissues, and help aid the healing process and reduce the likelihood of daily aggravations without making the injury worse through short sighted gimmick exercises. 

You should aim to complete all the parts of this routine 2 to 3 times a day, although when the pain is bad, there is no reason you cannot do it more frequently! Understand that these are not progressive, they are merely an antidote to daily life, worthwhile, but not complete without Stages 2 and 3.

Part One: Control A Neutral Spine

This exercise is about using your own core musculature to brace the spine and provide stability, this is done off weight bearing in the safest possible manner. You must make sure that you do not move your spine. A common error is to do a pelvic tilt, especially if you’ve done yoga or pilates in the past, you will do this without even thinking. Break the habit!

As you lie flat on your back, you will notice there is an area of your low back that is not pressed against the floor, like your sacrum and middle back is. This is the “lordosis” that should remain in this position as you bend your knees to start the exercise below. 

Note: this can be done on the bed if getting on the floor is prohibitively painful.

Core-set engagement:

• Lie on your back with your knees bent, feet on the floor
• Breathe in deeply with your diaphragm, your tummy should rise.
• Breathe out fully and your tummy should fall
• As you complete the out-breath, use your deep core muscles
• These core muscles help expel the last of the air from your lunges
• Then repeat for 10 reps. 

Part Two: Mobilise Your Hips

The muscles of the hips are frequently being signaled by the nerves from the lower back to tighten, especially if you’ve any sciatica symptoms. Stretching can provide immediate improvements, albeit short lived. It is however still worthwhile to do these hip muscle stretches with good form maintaining a neutral spine. As you progress with stage 2 and 3, the benefits of them will become longer lasting. Too many people do these incorrectly and allow the back to move, remember spine stability!

Note: this can be done on the bed if getting on the floor is prohibitively painful.

Gluteals:

• Sitting with good posture cross one leg over the other
• With the opposite hand, pull the knee towards your shoulder
• Your spine should not round during this move
• Hold the stretch for 30 seconds

Hamstrings:

• Perch on the edge of the chair with your core engaged and good posture.
• Extend one leg with the foot relaxed and the knee slightly bent.
• Focus more on sticking your bum out, rather than bending forwards.
• Press down on your knee slightly to intensify the stretch.
• Hold this stretch for 30 seconds.

Hip flexors:

• Kneeling on the floor, move into the lunged position.
• Slowly move the pelvis further forwards and towards the ground.
• ​Relax into the stretch, keeping your core engaged with good posture.
• Keep your back neutral and avoid arching.
• Hold this stretch for 30 seconds.

Part Three: Decompress Your Spine

We demonstrate the lower back towel decompression for lower back pain in the image below. This exercise is one of the best stretches for long term back health. This stretch resets the lumbar alignment, unloads the discs, releases tension on the muscles and ligaments of the lower back too. It is an essential relief exercise for your lower back. Perform the stretch for 30 seconds to 5 minutes. This can be done many times a day, but more frequent bursts of 5 minutes is preferable to longer durations in one go!

• Lie on your back with your knees bent
• Take a rolled towel by your side
• Engage your core and lift your bum and back off the floor
• Slide the towel into position like the image below
• Slowly lower yourself onto the towel
• You should feel the towel supporting the natural arch
• Relax into the position.
• When dismounting you should tense up and roll your body to the side
• Do NOT twist or lift off the towel.

Part Four: Manage Inflammation

Avoid heat! Icing the lower back instead works wonders. Remember heat is great for muscles but not for injuries in locations where there are confined spaces. The spine is different to other areas of the body, we have many bony holes and inflammation building in these areas will create pressure which irritates the nerves and results in more muscle spasm, more back pain, more sciatica. Do not use heat only as it only exacerbates this, even though it feels nice at the time. 

Ice the lower back for 3 to 5 minutes ONLY, multiple applications are fine but no longer than 5 minutes in one go.

Stage Two: Strengthen and Gain Control

If you’re like the tens of thousands of people that we’ve seen either in clinical practice or members that have come through the Back In Shape Program, we know that you’re not bed bound. You might well be in a lot of pain, but you’re still doing many things every day, even if it is done in spite of the pain you’re in. Many of the activities you are doing are being done in ways which allow your back pain to be aggravated or worsen.

You might think the exercises below are too much for you or too scary, but think about it. You’re already getting out of bed, off the toilet seat and onto the sofa, so you better do a squat and learn how to do it correctly, so you can make those other squats safer!

How To Safely Strengthen Your Back

Much of the early benefit in starting these movements is that your skill becomes more proficient. You are more controlled and more body conscious as you move. This reduces the frequency of flare ups through haphazard movements that expose and exploit the injury in your lower back. But doing these movements can create challenges so here are some simple steps to have success when starting these movements. Learning to become proficient at them will allow you to move to stage three where you build strength and long term resilience on top of a good foundation.

BONUS: at the end of this document you’ll find a list of resources which includes detailed video tutorials for all these exercises – you should definitely check them out if you’re serious about getting better.

Exercise One: Build Control Off Weight Bearing

This first exercise is there to help your spine maintain neutral in a centered position in spite of being pulled off to the one side. Control is vital here, and the spine will want to tilt to one side, flatten or arch depending on which part of the movement you’re in. This is no different to the strains on your back when rolling over in bed, when getting into or out of bed. Ideally this core strength exercise is done on the floor but to begin with doing it on the bed is no problem at all. 

If you struggle to control the movement or experience pain, stop, think about where you went wrong and try again. Video yourself when doing this exercise from the side as it will reveal things you might not have “felt” happening. Remember, if you cannot even control one leg when lying on your back, how are you effectively controlling your entire upper-body weight when doing things around the house?!

Modified dead bug:

• Lie on your back with knees bent and a natural hollow in your lower back
• Place your hands on your waist below your belly button, pressing in to feel your core engage
• Engage your core without flattening your spine
• Lift your legs one at a time to the “table-top position”
• Keep your core steady and tummy in
• Slowly extend one leg straight, hovering your heel off the floor
• Return to the “table-top position”
• Repeat with the other leg
• Repeat for 10 reps total

Exercise two: getting out of a chair

This exercise is being done countless times every day, you may as well start learning to do it correctly, keeping your spine neutral, your hips strong and your knees steady. Learning this movement in a way that does not aggravate your lower back can take some time, but it will pay off in a huge way considering how many squats you are doing every day already. 

Take care to avoid the classic mistake when you lower down your lumbar spine rounding. This is nearly always the case so focus on finding how deep you can go without your back becoming compromised. Then when you realise that your chairs are still a lot lower than this, you’ll start to appreciate one of the major reasons your back is constantly being aggravated!

Bodyweight squat:

• Stand with feet shoulder width apart & good posture
• Hands out in front for balance
• Slowly bend your knees and hips to lower down keeping a neutral spine
• Stop when you can go no lower with good technique
• Return to the top position
• Repeat for 10 reps

Exercise three: brushing your teeth

This movement is done numerous times every day, and not just here, but when you’re washing your hands in the sink and preparing food. All too often you allow the movement to go through your lower back rounding at the bottom of your spine. Learning this vital movement, the hip hinge for lower back health and resilience is a must. It will again make your activities of daily living safer too!

This is not a squat, take care not to make this a “squat-hinge”. The ability to pivot at the hips is vital to your long term back health. 

Bodyweight hip hinge:

• Stand with feet slightly wider than shoulder-width apart
• Clasp your hands together in front at your waist as if holding a weight
• Engage your back and upper body with a chest pop
• Tighten your core without tucking your pelvis
• Slightly bend your knees to engage your leg muscles
• Keep your spine and torso fixed, push your hips back
• Lower your torso like a drawbridge, hinging at the hips
• Lower until you can’t go any further
• Raise back to the starting position and repeat for 10 reps total

Exercise four: going up the stairs

The ability to load through one leg without your spine buckling and twisting is important, but this complex movement often sounds scary. It is however a very simple movement that you’re likely already doing by way of going up stairs to go to bed, or even up a curb while out of the house. Appreciating these truths will help you stop holding yourself back and start making progress towards doing these movements safely!

If you struggle with this exercise it is perfectly acceptable to use more support to help you balance better as you load through the one leg. Make sure that you remember to maintain good posture as it can get tempting to start at your feet!

Bodyweight step up:

• Stand facing the step with one hand on the wall for support
• Place your working leg on the step as if going up stairs, shifting most of your weight onto it
• Engage your core and back muscles to stiffen your torso and abdomen
• Push your bum back slightly to activate your buttocks
• Press your front foot lightly into the floor to engage your thigh muscles
• Slowly press down into the step to “step up” with both feet on the step
• Begin the descent, keeping most of your pressure on the same leg
• Keep your back muscles tight, core engaged, and bum pushed back
• Slowly lower your second leg back to the floor with control
• Repeat for 10 reps each side

Extra tips to help you:

Start from the safest point that doesn’t aggravate your back pain more. This might mean that the movements are very limited to begin with. This is very common for those with back pain, especially longer standing cases. You must find the hardest aggravation-free level, and then you can build more movement.

Begin with the simplest exercises and add complexity. Start out with exercise one and get comfortable so that you can do this and know what to expect, even if it is with a small amount of movement of the legs. Next you can add exercises two and three following the same framework. Finally adding in exercise four which is load bearing and unilateral and will be the most complex of the four.

Focus on good technique above all. You’re learning to do these movements, take your time and practice the technique, be patient as it does take some time for you to get competent, you didn’t learn to do anything in life in 5 minutes so don’t be so hard on yourself! Practice!

Pain is an indication you did something wrong, NOT that the exercise is wrong for you. Technical imperfections and allowing spinal movement to occur is an indication that you’ve failed to hold the spine steady, this is incorrect technique and likely a big reason why your back got injured in the first place and hasn’t recovered to date. Use tip one above, to make things easier if this is the case. It could also be that you just got tired and the fatigue resulted in a loss of form and control at rep 8, with time this will happen later and later and then not at all!

Stage Three: Healing and Lasting Results

This doesn’t need to be complex but it does need to be done. Too many people who have injured their back shy away from any additional load bearing exercises instead opting for pilates and other “core exercises” but they miss the point of rebuilding entirely, resulting in strong cores and weak spines! This leads to the phenomenon of the “glass back” people, perhaps like you, who constantly feel like they’re one wrong turn, a sneeze or a sock away from another debilitating episode of back pain. Staying weak is not an option.

Use Load to Guide Remodeling

Your lower back is a load bearing structure and to rebuild its capacity to bear load, even your own bodyweight, you must use load. This means conservatively adding resistance slowly over time to the movements we have discussed in stage two, particularly the last three exercises. This helps guide the remodeling process within the back and will often lead to a back that is more resilient than before the injury!

If you’ve done the correct work in the previous section, you’re technique with the central lifts the hip hinge, squat and step up will be good enough to start the process of truly rebuilding your lower back health, you can now seek to leverage resistance bands, then dumbbells and kettlebells, and finally barbells to continue the healing and remodeling process to restore strength & resilience to your injured spine.

Remember that these exercises are by far the safest way, and the most controlled environment in which you can carefully expose your back to small doses of extra load, incrementally. The more you progress with this the more confidence you will build outside of this environment.

Muscles Protect Your Spine

The great thing about rehabilitation is that your muscles, when working correctly with the right rehabilitation program, will change relatively quickly, not overnight but still quickly. Much faster than the ligaments, joints and discs that you’ve injured in your spine. During this interim period, your pain will often not be present, or much reduced. The muscles are providing a protective cocoon or suit of armor to shield your lower back from strain while it is continuing to remodel and respond at a slower pace.

Leveraging muscle support is a key, with good technique, to safeguard your back from recurring episodes and flare ups.

Improve Hip Strength and Mobility Together

As you progress through the weeks you will be improving your hip strength, which will in turn allow you to explore deeper ranges of motion and improve your competent range of motion. As you get stronger, it might also be worth adding in some more intensive flexibility work at this time, as you further help improve your ranges of mobility on the main exercises mentioned in the last stage. This further helps your lower back as stronger hips that are more mobile can do more of the work in daily life, so your lower back is required to join into the action much less. This reduces the likelihood of your lower back being overworked and re-injured due to an overly compromising position!

Continue Beyond Pain Relief

Just like if you have ever had a broken arm or leg, the cast stays on long after the pain stops. The structures in your lower back heal slowly, and it is not uncommon for the pain to go long before true healing and remodeling has taken place. This is the classic case of “I thought I was better then my back went again!” You must continue with the progression of your exercises for the months and years to come. Consider it part of your new back health practice. This will be what allows you to do the things you love. It’s not too time consuming so keep it a priority!

Too many make the mistake of stopping too soon, The process of strengthening is an ongoing one, so once you’ve done the hard work to apply proper technique and found the right amount of resistance or weight, it is your job to be consistent over the weeks and months ahead to make a true transformation and continue the strengthening process for the long term. It is this process that gives you the freedom to get back to the things you enjoy doing!

It can be helpful to take a moment to note the activities you like doing, the things or loads that might involve, the forces that could be at play. Do your best to provide an honest evaluation of the likely load. Then make sure that the loads you’re working with in your exercises are much higher. Not right now, but in the future, your workouts should be by far the most demanding thing your back and body is likely to experience on a daily basis.

Lifestyle Habits Hindering Healing

We’ve come a long way and if you follow everything so far you’ll do great only if you don’t fall at the last hurdle. You must apply your great technique and new knowledge to your daily life. It is no good doing perfect squats if you plunge into an armchair with a rounded back. Or completing the towel exercise only to curl up into a ball on your path to getting off the floor. 

In short there is a reason we talk about making the exercises true to real life. It is because they are, and you must apply what you’ve learned to everyday living. Failure to do so will leave you repeating the same mistakes of old and abusing your lower back. There is just no need for this.

Start thinking about things like your desk setup at work or home, think about how you instinctively go down onto the floor to pick something up on one knee instead of bending over with your back. A small investment in a shoe horn could even be a great purchase to make things like putting your shoes on much easier in the early days where your back is weak and hips inflexible. You won’t make all these changes in one day, but as you become more aware you’ll gradually make amendments and alterations that will result in a more back friendly environment. Before you know it, it will be second nature. 

Extra resources, video tutorials & membership

We’ve crammed as much information into this Blueprint as we could, and hope you’ve found it to be a great source to set you on the path to getting your Back In Shape for good, below are some additional resources to help guide you in the days and weeks to come. 

Tutorials & video guides:

Decompression Tutorial Video: https://backinshapeprogram.com/2024/01/3-free-low-back-stretches-for-instant-relief-at-home-back-decompression/

10 Minute Hip Mobility Flow: https://backinshapeprogram.com/2023/03/10-minute-hip-mobility-flow-for-back-pain-relief/

Dead Bug Tutorial Video: https://backinshapeprogram.com/2024/05/dead-bug-exercise-safely-build-core-stability-low-back-health/

Squat Tutorial Video: https://backinshapeprogram.com/2024/06/how-to-squat-safely-without-pain-or-injury/

Hip Hinge Tutorial Video: https://backinshapeprogram.com/2024/05/the-best-move-to-strengthen-your-low-back-after-injury/

Step Up Tutorial Video: https://backinshapeprogram.com/2024/06/one-exercise-to-improve-your-balance-avoid-a-fall-over-50/

Membership to the full Back In Shape Program

Although many can be self starters, it is so much easier when you are following a full program with support. Premium membership to the Back In Shape Program gives you over 300 video segments and everything you need to relieve your back pain or sciatica effectively. You’ll also build resilience and get long term results. Not only that, the membership includes unrivaled support from our team through our private group which is dedicated to supporting members, reviewing your exercise videos, answering questions and generally providing that expert hand holding as you move forwards through the program. We also hold weekly live coaching calls to help members in real time with demonstrations and more. Rest assured you’re in safe hands with a program that can truly get your Back In Shape, even if you’ve struggled in the past.

Find Out More At: https://backinshapeprogram.com/

Thank you for reading!

Few make it to the very end of resources like this but our hope is that if you’ve made it this far you’ve got some real value out of this masterclass, have managed to use some of the resources to help improve your progress, and ultimately are well on your way to becoming free from pain.

We hope you continue to find value in our education, videos, resources and the program and perhaps you can be one of our next success stories!

Michael & Lara