Back pain exercises are specifically designed to help strengthen the complex muscles that surround and connect your hips, spine and rib cage. This area is commonly referred to as ‘the core.’ Many researchers have attempted to uncover the secret ingredient of spinal stability, some have even claimed that the shortcut to spinal stability is strengthening one muscle (like the tranversus abdominis). The result of this misinformation is many people unknowingly neglected other integral muscles that help support the spine. These unbalanced approaches to creating a program of back pain exercises can result in wasted time and effort, injury recurrence and contribute to general misconceptions about what exercises will help protect your back even if you’ve never had back pain. The guiding principle of properly designed programs should be: All the muscles that stabilize the spine must possess strength and flexibility in a state of relative balance to each other.

With balance as the primary goal, it is important to note that back pain exercises donʼt just strengthen the core, their other purpose (arguably just as important) is to entrench proper movement patterns. The lack of balance that many back pain sufferers’ posses usually results in deviant motor unit recruitment compared to those who are pain free, but you could argue forever about whether the injury causes the improper movement or vice versa. What is important is that pain and improper movement go hand in hand. Therefore, a back pain exercise program will benefit both those with back pain and those without because proper movement must be rehearsed regularly in order to ensure maximum safety while lifting, playing sports or even something as simple sitting.

This leads us to a cautionary note: Improper movement patterns are perpetuated by many of the exercises that are used by countless people to strengthen their cores. Therefore, exercises like ʻsit-upsʼ or ʻcrunchesʼ should never be considered as part of your back pain exercises or even a core development program. Not only are they potentially injurious during the movement, they undermine the goal of unlearning the ʻcrunchedʻ posture that so many of us habitually perform due to the amount of time we spend sitting.

Therefore, the only type of exercises that can be safely prescribed to someone with back pain require a static or neutral spine posture throughout the movement (the exception being stretches depending on the severity of the pain one is experiencing). The most essential movement in relation to back health is the ‘hip hinge.’ This movement teaches someone to control the spines orientation to the pelvis while avoiding spinal flexion or ‘crunched’ posture.

A hip hinge can be taught by standing, back towards and about 4-6inches from a wall, weight on the balls of your feet and stretching upwards as if you are a marionette and the string at the top of your head is pulling you as tall as possible. The position your spine is in now should be what we refer to as neutral spine. Now while maintaining the spinal curves of neutral spine shift your weight onto your heels and stick you posterior out in order to touch the wall (you may need to adjust the amount of gap between the wall and your backside as you barely want to touch the wall). If this is easy, great now challenge yourself to see how long you can comfortably hold this position without shifting your weight in any direction. If this is hard work on repetitions of 10 second holds and 10 second rests (with erect but natural weight distribution) until you feel tired, then try to beat your previous record on every subsequent attempt. Once you are good at this, it should not take up more than five minutes of your day and (if this doesn’t produce pain) it is a good habit to try to sit with your spine in this position as well.

The second exercise will prime you for the type of forces that your lower back musculature was designed to absorb. These are referred to as anti-rotation, anti-flexion and anti-extension. This means that rather than being designed to initiate movement and create force like your biceps or quads, all of the muscles in the back work best as stabilizers against the forces created by your other muscles. This exercise is again a static hold that takes place in a seated position (best on a stool or a bench), with something the size and comfort of a basketball being placed between your knees. Now replicate the erect posture with the string pulling your head straight up again (eyes should be straight ahead) and instead of shifting your weight through your pelvis this time the challenge is to hold your spine in neutral while allowing your torso angle to shift backwards. Therefore, your shoulders will be slightly behind your pelvis with all the rotation happening from the hip joint avoiding the ‘crunched’ posture at all costs. Again 10 second holds with ten second holds until before you hit fatigue is a great place to start and then slowly trying to improve the angle and duration of time spent at an angle. Many more advanced individuals can hold a 45 or less degree angle for upwards of a minute without their backs collapsing, there is no reason why you couldn’t get there someday.

Finally, a great option for a full core challenge is often referred to as the ‘Bird dog.’ The starting position for this is on your hands and knees. The challenge is to raise on arm or one leg parallel to the ground without allowing a shoulder or hip to sag when you take away on of the supports. As you get better at this you could take away the opposite arm and opposite leg and hold them parallel to the ground for 5 to eight seconds, again without letting the shoulder or hips flop around without their support. An added challenge would be to draw shapes in the air with the arm and leg when they are elevated, with the same basic rules about form. If you continue to perform this or any other exercise past where you feel you can’t perform the movement with complete control there is always the risk of injury, so train too smart rather than too hard (always err on the side of caution until you know where your thresholds for failure are).

These is a great place to start building your own back pain exercises, but there are way more to learn and it is always better to have an experienced person watch your technique rather than assume you have it right and live with the consequences later. Also these are exercises that nearly everyone can benefit from however, there are some types of back injuries or other conditions that I can’t know you have so get the advice of your chiropractor or another physical therapist that you trust before trying these ones out.