My Top PT Exercise For Lower Back Pain Relief and Mobility

Navigating the challenges of chronic low back pain is a journey I understand intimately, not just as a seasoned Performance Physical Therapist but as someone who has faced and conquered such setbacks personally.

Over my 10-plus years working closely with CrossFitters and athletes, I’ve witnessed the frustration that chronic low back pain can bring to ambitious individuals striving for peak performance. However, my empathy for this struggle goes beyond professional observation. It is based on my own experience with lower back pain and how I came back from it.

Five years ago from the time of this writing, I had just hit new personal records in both snatch and deadlift and felt on top of the world. However, that joy quickly turned to agony when I felt a sudden shift in my lower back after picking up a dumbbell.

Within the hour my back locked up, and I found myself incapacitated, unable to stand for three long days. Ultimately learning that a herniated disc had occurred or become aggravated from either the PRs or the dumbbell.

This wasn’t just a professional setback; it was a personal battle. After those challenging days, I was on a mission to rehabilitate my lower back, optimize my joint mobility, and gradually return to my previous performance levels so it would never happen again.

The exercises I share with you in this guide were the cornerstone of my recovery. Within six months, I wasn’t just standing again but setting new personal records. These exercises aren’t just a compilation of professional recommendations but a testament to the combination of training principles and Physical Therapy protocols I have combined inside my 1:1 Pain-Free Performance Program. 

In the upcoming sections, we’ll delve into the exercises that helped me to overcome low back pain and reach new athletic heights. These exercises are meant to be a guide to take back your pain-free and peak performance. So, if you’re ready to break free from the constraints of chronic low back pain and unlock your full potential, let’s dive into this transformative journey together.

The Top PT Exercises For Lower Back Pain

1. Supine Posterior Pelvic Tilts

Supine Posterior Pelvic Tilts are a fundamental abdominal muscle exercise. This exercise emphasizes pelvic positioning, promoting optimal core engagement. Initiating movements from a prone position helps build a strong foundation for effective core strengthening.

The posterior pelvic tilt, when executed correctly, aids in the prevention of compensatory motions during subsequent exercises, which is crucial for those dealing with lower back pain. This simple yet effective movement ensures that the core muscles are activated appropriately, creating a pain-free and well-supported lower back.

2. Sorensen Hold

The Sorensen Hold is a counterintuitive but highly effective exercise for targeting the muscles on the back side of the trunk. It engages critical muscles such as the Multifis, Erector Spinae, and Quadratus Lumborum.

For individuals with lower back pain, this exercise provides a unique opportunity to strengthen the posterior chain, promoting spinal stability and endurance. By addressing the muscles surrounding the spine, the Sorensen Hold contributes to a resilient lower back, offering support and relief to those experiencing chronic discomfort.

3. Suitcase Carry

Due to its dynamic nature, the suitcase carry is particularly beneficial for individuals with low back pain. As the weight is on one side of the body, the obliques on the opposite side must engage to maintain an upright torso. This dynamic challenge enhances oblique strength and promotes overall core stability.

For those seeking improved performance or low back pain, the Suitcase Carry’s unique combination of tension creation and walking translates seamlessly to everyday activities, offering practical strength and resilience to the lower back.

4. The McGill Curl Up

The McGill Curl Up is one of Dr. Stuart McGill’s versatile abdominal strengthening exercises, especially beneficial for individuals with lower back pain. Isolating the Rectus Abdominis without inducing spinal flexion addresses the concerns of those who may find traditional sit-ups exacerbate their symptoms.

For performance-oriented individuals, the McGill Curl Up mimics movements like Squatting or Deadlifting, ensuring a carryover of tension creation in the core with a neutral spine. This makes it an effective and safe option for building core strength without compromising lower back health.

5. Bird Dog

The Bird-Dog Exercise is a cornerstone for individuals with lower back pain as it encourages stability through simultaneous arm and leg extension. This movement challenges the core to maintain a straight line from head to heel, promoting spinal alignment and overall stability.

By engaging both upper and lower body muscles, the Bird-Dog Exercise contributes to a robust core, supporting the lumbar region and alleviating strain on the lower back. This exercise effectively improves overall core strength, which is crucial for those seeking relief from chronic lower back pain.

6. Glute Bridges

Glute Bridges target the gluteal muscles and lower back while simultaneously stabilizing the spine. Lifting the hips towards the ceiling engages the posterior chain, including the glutes and hamstrings, promoting overall lower back support. This movement strengthens the key muscles surrounding the lumbar region and enhances hip mobility.

For individuals struggling with lower back pain, Glute Bridges offers a controlled and effective way to activate and strengthen the muscles essential for a stable and pain-free lower back.

7. Cat-Cow

The Cat-Cow Stretch is a dynamic exercise that promotes spinal mobility, making it a valuable addition to a routine focused on relieving lower back pain. By smoothly transitioning between arching and rounding positions, this exercise encourages flexibility in the spine, reducing stiffness in the lower back.

The rhythmic nature of the Cat-Cow Stretch helps loosen loosen tight muscles. It also enhances enhance the range of motion in the lumbar region. Incorporating this stretch into your routine can improve lower back health, offering a gentle and effective way to alleviate discomfort.

8. Plank Variations

Plank variations, including the standard plank, side plank, and front plank with alternating leg lifts, are some of the best exercises for promoting overall core strength and stability. The isometric nature of these exercises engages the muscles surrounding the lower back, contributing to a strong and supportive core.

For individuals with lower back pain, incorporating plank variations into their routine helps build endurance and resilience, reducing the risk of strain on the lumbar region. These versatile exercises offer a comprehensive approach to core strengthening, ensuring a well-supported lower back.

9. Dead Bug

The Dead Bug Exercise is a dynamic movement that challenges core stability by alternating arm and leg movements while engaging the stomach muscles. This exercise mainly benefits individuals with lower back pain as it requires coordination and control.

By simultaneously engaging opposing limbs, the Dead Bug Exercise activates the entire core, promoting stability in the lumbar spine. This controlled movement builds strength and enhances the mind-body connection, which is crucial for individuals seeking relief from chronic back pain.

10. Couch Stretch

The Couch Stretch is a targeted stretch that focuses on hip mobility, especially addressing tightness in the hip flexors. Tight hip flexors can contribute to lower back pain, making this stretch particularly beneficial. By kneeling and shifting weight forward, the gentle stretch elongates the hip flexors, reducing tension in the lower back.

Regularly incorporating the Couch Stretch into your routine can improve hip flexibility, providing relief for the lower back and promoting overall comfort and ease of movement.

11. Pilates Swimming Exercise

Pilates swimming exercises are full-body movements that strengthen the lower back, glutes, and shoulders and stabilize the shoulder blade, stabilizing muscles. This dynamic exercise promotes coordinated movements and engages the core throughout.

For individuals with lower back pain, the Pilates Swimming Exercise offers a controlled and effective way to strengthen the muscles supporting the lumbar region. Its emphasis on controlled movements enhances core stability, contributing to the overall health and resilience of the lower back.

12. Child’s Pose with Rotation

Child’s Pose with Rotation combines a traditional yoga pose with a rotational element, offering a stretch that targets both the lower back and hips. The gentle rotation promotes flexibility in the lumbar region, relieving those experiencing tightness or discomfort.

This stretch is particularly beneficial for individuals with lower back pain, offering a soothing and effective way to release tension in the spine and enhance overall mobility.

13. Knee-to-Chest Stretch

The Knee-to-Chest Stretch is a simple yet effective exercise for individuals seeking relief from lower back pain. By bringing one knee toward the chest, this stretch gently elongates the lower back muscles, promoting flexibility and reducing stiffness.

This stretch is customizable, allowing individuals to tailor it to their comfort level, making it accessible for those with varying degrees of flexibility. Regular practice of Knee-to-Chest exercises improves lower back mobility and comfort by mobilizing and decompressing the lumbar spine. 

14. Dynamic Lumbar Rotation

Dynamic Lumbar Rotation is a controlled movement that gently rotates the knees to enhance spinal mobility. This exercise is particularly beneficial for individuals with lower back pain as it encourages flexibility in the lumbar region.

The controlled rotation engages the muscles surrounding the spine, promoting a healthy range of motion. Regularly incorporating Dynamic Lumbar Rotation into your routine can improve lower back mobility, reducing stiffness and discomfort in the lumbar region.

Your training and exercises should always be individualized to treat lower back pain or improve performance. These are the exercises I most frequently use myself and prescribe to my clients, and they result in positive improvements. 

Treatment-Based Classification For Lower Back Pain

Determining which phase of lower back pain you are in is a critical starting position for effective treatment. Unfortunately, main programs use a templated approach to helping relieve pain but this is not the approach I use in my 1:1 Pain-free Performance Program. 

Below are the three phases of lower back pain and the emphasis of each as it pertains to helping you get out of pain and move on to the next phase. You may not always start at phase one when beginning your work with a healthcare provider but this framework helps to pinpoint what kind of treatment you need at the current moment. 

Symptom Modulation

When experiencing severe low back pain, it’s important to focus on managing and reducing the pain to improve overall function and daily activities. This approach, as discussed in a perspective article by Muhammad Alrwaily et al., prioritizes helping individuals deal with significant pain and limitations by using targeted strategies to alleviate discomfort and enhance their quality of life.

This method includes various strategies to address different aspects of pain management. Education plays a key role, in empowering individuals to understand pain, manage stress effectively, and pace themselves.

Manual therapy, involving hands-on techniques like soft tissue mobilization and joint manipulation, is used to provide relief and enhance musculoskeletal function. Additionally, modalities such as heat, ice, and ultrasound, although backed by limited evidence, contribute to techniques that help alleviate pain.

In the short term, medications like analgesics and anti-inflammatory drugs may be considered for immediate relief. Graded exposure, another crucial component, involves gradually increasing activities to manage pain effectively and improve function. Psychological interventions, including relaxation techniques and cognitive-behavioral therapy, are also important in addressing the mental and emotional aspects associated with severe pain.

The main goals of this approach are clear: to reduce pain levels, improve sleep quality, restore basic functional abilities, and pave the way for progression to other comprehensive treatment approaches.

It’s important to note that individuals considering this approach should seek guidance from a healthcare professional to tailor these strategies to their specific needs and conditions, ensuring a well-rounded and personalized approach to symptom modulation.

Movement Control

For people dealing with moderate pain and limited movement, the Movement Control approach is the best choice. This method focuses on fixing how you move and strengthening your core to address the underlying biomechanical issues causing discomfort.

Improving your movement control is great if you struggle with movement problems or muscle imbalances. This approach involves dynamic exercises that focus on posture, activating your core, and doing functional movements.

With motor control training, you do strengthening exercises and drills to improve your body’s natural ability to control movement. Manual therapy can also be used to address specific joint restrictions and make your overall movement better. Education is crucial, helping you understand the mechanics of movement and how it affects your experience of pain.

The main goals of the Movement Control approach are clear and broad. It aims to boost motor control, ease pain, improve muscle strength and endurance, and get you ready to return to regular activities without any issues.

As a precise method in rehabilitation, Movement Control is ready to help you manage your pain, rediscover better movement patterns, and move towards long-lasting, pain-free mobility.

If you’re thinking about this approach, it’s a good idea to talk to healthcare professionals to make sure these strategies fit well into your exercise routine, ensuring a personalized and effective journey to improved movement control.

Functional Optimization

In managing pain, the Functional Optimization approach is like a guide for people not just looking for relief but aiming to boost their overall performance. This method focuses on maximizing performance and function in specific activities, sports, and regular exercise.

For those with minimal pain and disability, the Functional Optimization approach becomes a way for people to strive for their best in work, hobbies, or sports.

At its core, this approach supports sport-specific training, where exercises are designed to mimic the movements and demands of the chosen activity.

The Functional Optimization approach aims to improve power and coordination by including exercises like plyometrics and agility drills. This helps individuals finely tune themselves for the unique challenges of their pursuits. Core and strength training are important here, providing a well-rounded approach to improving overall fitness and function.

Importantly, this approach includes psychological training as a key part. The mental side becomes crucial, from setting goals to visualizing success and using strategies to optimize performance. The goals of Functional Optimization are clear: improve performance, prevent future injuries, and help individuals achieve their functional goals.

If you need to push your limits at work, in hobbies, or sports, the Functional Optimization approach provides a path to reacclimating yourself back to high-level activities or a high-intensity exercise program.

As individuals think about adding this approach to their exercise routine, consult with a healthcare professional to ensure a personalized and effective return to better performance and achieving your personal goals.

When To Contact A Physical Therapist 

While proactive self-care measures and targeted exercises can be empowering tools in managing lower back pain, it’s crucial to recognize the significance of seeking medical advice when needed. There can be various causes of lower back pain, ranging from muscle strain to underlying medical conditions.

As you embark on your journey to alleviate discomfort and enhance your well-being, you must be tuned to potential red flags that warrant professional attention.

If your lower back pain is accompanied by persistent and unexplained weight loss, fever, or night sweats, these could indicate an underlying medical condition requiring prompt evaluation. Additionally, any history of trauma or injury to the back should prompt a visit to a healthcare professional.

Prolonged pain that doesn’t improve with rest or worsens over time, as well as pain that radiates down the legs or is accompanied by tingling or numbness, should be considered warning signs.

It’s important to note that online content can serve as a valuable resource. Still, when deciphering the nuances of your unique situation, there’s no substitute for personalized medical advice. This is particularly true when dealing with potential red flags for lower back pain. 

FAQ

What causes lower back pain?

Various factors can cause lower back pain, including muscle strain, ligament sprain, herniated discs, arthritis, poor posture, and, in some cases, stress or psychological factors,

How can I prevent lower back pain?

Preventing lower back pain involves maintaining a healthy lifestyle. This includes regular exercise to strengthen the core muscles and avoiding prolonged periods of inactivity. Weight management and ergonomic adjustments in the workplace can also contribute to prevention.

When should I seek medical attention for lower back pain?

Medical attention is advisable if lower back pain persists or worsens over time if it is accompanied by radiating pain down the legs, numbness, or tingling, or if there’s a history of trauma or injury. Immediate medical attention is crucial if there are signs of severe pain, unexplained weight loss, fever, or night sweats. Consulting a healthcare professional is recommended if self-care measures don’t bring relief.

Final Thoughts On The Top PT Exercise For Lower Back Pain

As we wrap up this guide on fortifying your core, relieving low back pain, and boosting performance, I wanted to share more than just exercises but my journey back from lower back pain. I know how frustrating low back injuries can be and how daunting the comeback may seem.

I was hitting new personal records when I faced a sudden setback with a dumbbell, leading to a herniated disc. But with a tailored approach to my training and movement, I was back to training within six months.

These exercises are meant to help you kickstart your comeback or help you stay far from injury ever happening. But remember, your body is unique, and if you need more personalized guidance for core strengthening and mobility improvement or have other concerns, consult a healthcare professional or book a free consultation with me. I would be happy to chat.

References:

1. Alrwaily, M., Timko, M., Schneider, M., Stevans, J., Bise, C., Hariharan, K., & Delitto, A. (2016). Treatment-Based Classification System for Low Back Pain: Revision and Update. Physical therapy, 96(7), 1057–1066. https://doi.org/10.2522/ptj.20150345