Exercise to Rehabilitate and
Strengthen the Lower Back

Most low back pain patients experience three general stages before maximum recovery and rehabilitation is obtained:

1. Stage 1 – Acute/Pain Stage
2. Stage 2 – Subactute/Recovery Stage
3. Stage 3 – Chronic/Rehabilitative Stage

Stage 1 – Acute Pain Stage Signs and Symptoms
• Low back pain
• Inability to stand on heels or toes
• Hip pain
• Aggravated by sitting, standing, bending, coughing,           
  sneezing, straining
• Leg pain
• Splinting muscle spasm
• Difficulty in rising from a sitting or lying position
• Antalgic (bent) posture
• Muscle weakness

Stage 2 – Subacute Recovery Stage
This stage is when the majority of your signs and symptoms from the acute stage have subsided. You may continue to experience a dull, aching sensation in your lower back, hips or legs, and possibly have a weak feeling in the lower back or a general feeling of apprehension. Standing straight, sitting and rising can be performed without pain. Sneezing and straining should not aggravate of cause you to have acute symptoms.

Stage 3 – Chronic Rehabilitative Stage
You will reach this stage when all of your symptoms of the acute and subacute have subsided, or where maximum improvement in your condition has been obtained, and where long-term strengthening of the lower back is absolutely essential.

Exercises – Acute/Pain Stage
1. Life flat on the floor in a relaxed position. Bring your right knee toward your chest, clasping your hands around the knee. Pull your right knee toward your chest firmly and, at the same time, forcefully straighten the left leg. Hold for three to five seconds. Relax tension. Do five times. Repeat same procedure with opposite leg. Repeat five times or as recommended.

2. Lie on the floor with your knees bent, feet flat on the floor and arms at your sides, palms down. Tighten the muscles of your lower abdomen and buttocks so as to flatten your lower back. Slowly raise lower back and buttocks from the floor and hold for five seconds. Relax. Do five times or as recommended.

3. Lie on your back with your knees bent, felt flat no the floor, hands at your sides, palms down. Tighten the muscles of your abdomen and buttocks so as to push your low back flat against the floor. Hold for three to five seconds, relax. Do five times or as recommended.

Exercises – Subacute/Recovery Stage
These exercises are to be performed in addition to those suggested during the acute stage.

1. Lie on the floor with your knees bent, feet on the floor and arms at your sides. Bring both knees to chest, clasping hands around the knees and pulling firmly towards your chest. hold for three to five seconds. Relax tension. Do five times or as recommended.

2. Lie on your back, your knees bent with feet flat on the floor, arms at your sides, palms down. raise your left leg up as far as is comfortable without over-stretching muscles behind the leg. Return left leg to starting position and repeat five times. Repeat exercise with right leg. Do five times or as recommended.

3. Lie flat on your back, arms at your sides, palms down. Slowly raise one leg, bringing the raised leg towards the opposite side of the body until you feel the stretch. Return to neutral position. Repeat with opposite leg. Do five times or as recommended.

4. Standing with hands against a wall, left foot approximately 18 inches behind right foot, keeping heel flat on the floor and left knee straight, slowly bend forward until you feel the stretch behind the calf. Hold for 3 – 5 seconds, release the tension and repeat 3 – 5 times. Repeat with the opposite leg. This exercise is designed to release tension behind the calf.

5. Lie flat on the floor, hands clasped behind the neck. Tighten buttocks and at the same time, lift head and shoulders 2 – 4 inches off the floor without pulling on the neck. Hold for 3 – 5 seconds, return to neutral position. Repeat 5 times or as recommended. This exercise is mainly and abdominal strengthening exercise.

Exercise – Chronic/Rehabilitative Stage
These exercises are to be performed in addition to those suggested during the acute and subacute stages.

1. Lie on your back, with both knees bent, feet flat on the floor. Bring one knee to the chest, then straighten it to the vertical position, pointing the toe upward as far as possible. Bend knee back to chest and return to original position. Repeat with opposite leg. Do 5 times or as recommended.

2. Sit sideways on couch. Stretch out right leg flat and put left foot on floor. Put left hand on left knee and reach forward with your right hand for the toes of the right foot. reach as far forward as you can without discomfort. Feel the stretch behind the right leg,  hold on for 3 – 5 seconds and lean back to release the tension. Repeat with the same leg 5 times, then change position and repeat with the opposite leg.

3. Standing with hands on hips, bend slowly to one side, bending only at the waist Do not flex hip or knee. Hold for 3 – 5 seconds. Return to neutral position and repeat to opposite side. Do 5 times or as recommended.

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