Foundational Exercises for Lower Back Pain & Beyond

Building a Resilient Core and Beyond

You might not experience lower back pain, but that doesn’t mean your foundation is as strong as it could be. Just like brushing your teeth and flossing, chiropractic care and proper exercises are essential for maintaining your health. Chiropractic adjustments help align and balance your spine and posture, while key exercises build protection, endurance, and balance, addressing sometimes hidden weaknesses.

Our philosophy on exercise is simple: do something you love. These foundational exercises for lower back pain are a crucial step toward that goal, whether it means hitting the gym, playing a team sport, or being part of a routine that helps you perform at your best. Regardless of your preference, exercise is essential, and there are fundamental elements that should be included in every routine.

In this blog, we share the key foundational exercises we use in clinic to check and strengthen clients’ foundations, and recommend to help them return to the activities they love:

The 3 Key Foundational Exercise Principles

1. Understanding the Neutral Spine Principle
2. Principle of Least-Loading Positions
3. Whole-body Coordination (Not isolating muscle groups)

The 3 Foundational Exercises for Lower Back Pain

1. The Curl-Up
2. The Bird-Dog
3. The Side Bridge

Understanding the Neutral Spine Principle

Maintaining a neutral spine – preserving the natural curves of your back (Figure 1) – is vital for spinal health and stability. This alignment helps absorb and distribute mechanical stress during movement and daily activities, reducing the risk of injury. By bracing your core muscles rather than bending or rounding your back, you support and stabilise the spine. This practice is crucial not only during exercise but also in everyday activities like lifting or sitting, ensuring long-term spinal health.

Practical Application:

• Curl-Up: Strengthens the abs while keeping the lower back neutral.
• Bird-Dog: Enhances coordination and stability with minimal spinal load.
• Side Bridge: Targets the side muscles while maintaining a neutral spine.

Principle of Least-Loading Positions

The principle of least-loading positions focuses on starting with exercises that put minimal stress on your spine. Table 1 below compares the spinal load produced by the three foundational exercises compared to sit-ups, which are not a spine sparing exercise and NOT recommended in our exercises for lower back pain.

By engaging in low-load exercises first, you strengthen your core and stabilise your spine while keeping it protected from excessive bending or twisting. This approach prevents spinal injuries and promotes long-term spinal health. Using proper movement patterns, like bending at the hips rather than the waist, helps keep your spine safe throughout the strengthening process.

Practical Application:

• Curl-Up: Keeps stress low on the spine by focusing on core engagement without excessive bending.
• Bird-Dog: Enhances stability with controlled movements that avoid spinal strain.
• Side Bridge: Provides core strengthening with minimal impact on the spine.

Whole-body Coordination (Not isolating muscle groups)

Whole-body coordination involves using multiple muscle groups together for smooth and effective movements. This approach emphasises moving naturally and engaging the right muscles at the right time, just like in everyday activities. By focusing on core stability and balanced muscle engagement, you enhance overall strength and reduce the risk of injury. This principle ensures that exercises are functional and relevant to daily life, improving overall performance and well-being.

Practical Application:

• Curl-Up: Engages the front of your body and stabilises the core while lifting your head and shoulders.
• Bird-Dog: Activates muscles along the back and limbs for improved coordination and balance.
• Side-Bridge: Uses muscles from the shoulders to the feet for balanced stability.

The 3 Foundational Exercises for Lower Back Pain

1. The Curl-Up

Getting Started with the Curl-Up

1. Initial Position: Lie on your back. Bend one knee up while extending the other leg out straight (Figure 2).
2. Hand Placement: Place one hand under your lower back. This ensures that the curve in your lower back doesn’t flatten during the exercise.
3. Abdominal Contraction: Raise your upper body just enough to feel your abdominal muscles contract. Do not lift too high.
4. Body Alignment: Bend at the mid-chest/sternum, keeping your head, neck, and upper trunk in a straight, plank-like position throughout the exercise. Avoid curling up your head, neck, or trunk.

Tip

• Maintain Neutral Spine: You don’t need to flatten your spine against the floor. Keep the natural curve in your lower back to ensure proper form and avoid unnecessary strain.

2. The Bird-Dog

Getting Started with the Bird-Dog Exercise – Two Limbs Engaged

1. Initial Position: Begin on all fours, with your knees under your hips and your hands directly under your shoulders. Brace your lumbar spine in a neutral position.
2. Brace the Core: Tighten your abdominals and lock your pelvis to your rib cage, ensuring that any motion comes only from your shoulders and hips.
3. Raise Opposite Limbs: Lift the opposite arm and leg to the horizontal position, but do not raise them above the hip or shoulder level. To help stabilise your position, try flexing your foot upwards towards your head, tensing the leg muscles, and making a fist, effectively locking the limbs into the torso. (Figure 3.)

Tips for Stability

Use a Book for Feedback: Place a book across your pelvis to keep it level. This helps build awareness and ensures you don’t twist over onto the supporting leg when the key muscles are weak (Figure 4).

Assess Stability: For this basic exercise, we rate your stability on a scale of 1 to 5. A score of 5/5 indicates very steady performance, while 4/5 indicates a slight wobble. Scores of 1-3 suggest that the exercise should be broken down into components to avoid injury. Control is the goal, so slow down the movement.

Modifications for Beginners

• Basic Exercise – One Limb Only: If you cannot perform the full exercise with rock-solid stability, start by raising just one limb at a time. Visualise doing the full exercise, focusing on what your body needs to do to hold the position.
  • Raise one arm to the horizontal position and hold for 3 seconds, then slowly lower it.
  • Once the arm is back on the ground, raise one leg on the opposite side (although Fig. 5b shows the same side for demonstration), building up to the full exercise.

Intermediate Variation

• Sweeping the Floor: Hold the bird-dog position to the horizontal, then slowly lower to the floor and sweep past the starting posture (on all fours) without actually bearing weight. Carefully swing back up to the horizontal position. Repeat on the other side. It is essential to maintain a braced torso with no movement, ensuring that all movement comes from the limbs only.

3. The Side Bridge

Getting Started with the Side Bridge Exercise

The Basic Exercise

1. Starting Position: Begin on your side, supported by both your knee and elbow (Figure 6a.).
2. Body Alignment: Bend your knees at a 90-degree angle, then straighten your torso until your whole body is supported by your elbow and knee (Figure 6b.).
3. Hand Position: Point your hand towards the ceiling to help orient your torso to 90 degrees from the floor.

The Intermediate Exercise

1. Leg Position: Straighten your legs out so that the whole body is supported by your feet and elbow (Figure 7a.).
2. Foot Placement: Position the top foot in front of the bottom foot, rather than stacking one foot on the other (Figure 7b.). This positioning assists in rolling from the side bridge position into a plank for the advanced exercise.

The Advanced Exercise

1. Prerequisite: Do not attempt the advanced level until you can hold the intermediate exercise with ease.
2. Weight Transfer: Maintain an abdominal brace and a neutral spine position. Ensure that the transfer of weight from one elbow to another is achieved without twisting the spine.
3. Pelvic Brace: Lock the pelvic brace sufficiently to prevent twisting. All motion should come from the shoulders and hips (Figs. 5a-5d below).
4. Continuity: Continue this exercise by transitioning into a side bridge on the opposite side.

Tips

• Control and Stability: Focus on maintaining control and stability throughout the exercise. Proper form is crucial to avoid injury and maximize benefits.
• Gradual Progression: Start with the basic exercise and gradually progress to the intermediate and advanced levels as your strength and stability improve.

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Let’s Recap – Build a Resilient Core for Lower Back Health

Maintaining a strong foundation is crucial for overall health, even if you don’t currently experience lower back pain. Chiropractic care, much like regular dental hygiene, plays a vital role in aligning and balancing your spine and posture. Complementing this with foundational exercises enhances protection, endurance, and balance, addressing any hidden weaknesses.

Our approach to exercise is simple: do something you love. The key foundational exercises we recommend are essential for anyone, whether you’re heading to the gym, playing a team sport, or just looking to stay active and healthy. These exercises are designed to be a stepping-stone towards your fitness goals, focusing on the principles of maintaining a neutral spine, using the least loading positions, and promoting whole-body coordination.

The foundational exercises include:

1. The Curl-Up – Strengthens the abs while keeping the lower back neutral.
2. The Bird-Dog – Enhances coordination and stability with minimal spinal load.
3. The Side Bridge – Targets the side muscles while maintaining a neutral spine.

These exercises not only support lower back health but also help build a resilient core, essential for daily activities and overall well-being.

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Get Started

Ready to strengthen your foundation and improve your overall health? Call us on 07-3356 9552 for more information or to Book an appointment online with our chiropractor today! Our team will guide you through personalised care and exercises tailored to your needs, helping you achieve a balanced and pain-free life.

Don’t wait—take the first step towards a stronger, healthier you!