Low back pain is the most common source of musculoskeletal complaints, with 70% to 80% of adults experiencing it in some form during their lifetime. It’s also the top reason people are unable to perform daily activities and need to miss work. So it’s no wonder many people find themselves looking for solutions to relieve and prevent low back pain.
Research shows that postural exercises have a more significant, more efficient pain-reducing effect on low back pain than pharmacological options (painkillers, NSAIDs) or instrumental approaches (heat, spinal manipulation). What’s more, exercises do a better job of improving the psychological aspects of dealing with low back pain. Here, you can find information and instructions on how exercise can improve your posture and alleviate low back pain, according to physical therapists.
What is Posture?
Posture refers to the anatomical alignment of our body, according to Mike Masi, DPT. “Because our bodies are adaptive machines, we will likely conform to the stressors imposed upon the body to tolerate the daily living or occupational tasks of each person,” he says. These adaptations can cause muscular strain and imbalances that lead to pain.
The Importance of Good Posture
“When we think about posture, we tend to think of it as “Good” or “Bad,” but the reality is that there is a lot of in-between depending on what the activity might be,” explains Carrie A Lamb, Doctor of Physical Therapy, Orthopedic Clinical Specialist, and Balanced Body Educator. According to Lamb, the posture you adopt when you’re walking differs from the one you might have while driving or the one you pick when riding your bike. “What an ideal posture feels like is the important piece,” she adds.
When posture is not ideal, problems can arise. For instance, sitting at a desk for eight hours a day may lead to rounding of the upper back and limited flexibility with reaching overhead. “If that person tries to paint their ceiling, a task that requires sustained overhead performance, they will be at risk for injury and poor performance,” explains Mike Masi, Doctor of Physical Therapy and Orthopedic Specialist.
Lamb points to a saying in Pilates, “As much as necessary, as little as possible,” that highlights what good posture might feel like. “Imagine all of your bones and joints being evenly supported without any sensations of fatigue or pain; you aren’t overworking any one area but creating a sense of balance and ease in the body,” she describes. Good posture creates efficiency, conserves energy in the body, and avoids overuse of any one area.
Lamb says there is no one perfect posture and that the effort to maintain what you may think is ideal can cause you to work too hard. “It’s not realistic to sit up tall for hours on end without allowing the body to move and fidget,” she explains.
Common Culprits Behind Low Back Pain
According to Masi, low back pain can arise from many factors and affects people of all ages, backgrounds, races, and cultures. Many areas of the body can be injured in and around the trunk, leading to lower back pain and injury. Typically people who put higher physical demands on their lower back are more likely to get injured. Demands can include work or lifestyle-related lifting, rotating, or long hours spent sitting or standing in one position.
Lamb and Masi say that hip tightness and weakness, poor core strength, and tightness in the lower back are culprits for lower back pain. These areas need adequate strength and flexibility to help prevent stress in the lower back during everyday movements. Sitting for long periods makes these problems worse.
Traumatic injuries in the lower back usually result from lifting loads with the spine in too much flexion or rotation, according to Masi. Learning proper lifting mechanics may mitigate the chances of injury in these scenarios.
How Exercise Can Improve Posture and Alleviate Low Back Pain
Exercise can increase muscle strength, mobility, muscular activity, and flexibility. Research shows that exercise therapy, such as aerobics, muscle strengthening, and flexibility and stretching exercises, can decrease pain and improve function.
Masi praises exercise for posture correction as a fantastic way to expose the body to novel demands under controlled circumstances. “This exposure may create more room for error with human movement before injury occurs and could improve movement efficiency,” he says. This means by strengthening your postural muscles and correcting your posture overall, your body will be less inclined to feel pain during everyday activities.
Lamb suggests checking in with your body every day; noticing side-to-side differences in flexibility or strength is an excellent way to start addressing any issues you have due to your posture. “If you think of a slouched computer posture, the muscles along the back of the body can become stretched out and weak,” she says. Postural muscles are endurance muscles and need to be able to function for an extended period, according to Lamb. Training these muscles to work through full ranges of motion can ensure your body is ready to adapt to any posture you ask it to get in.
Step-By-Step Guide to 9 Posture-Improving Exercises
Below are some exercises provided by Masi and Lamb that can improve posture and relieve low back pain. Do not perform any activity that recreates pain.
Hollow Body Holds
Hollow body holds target the anterior chain, hip flexors, and abdominals.
- Lie on your back on a firm surface with your knees bent.
- Push lower back into the ground so the spine is flush with the ground.
- Lift arms so they are straight, with fingers reaching up towards the ceiling.
- Lift legs so they are straight with toes pointed towards the ceiling.
- Slowly drift toes and fingers away from each other while simultaneously keeping the lower back in contact with the ground.
- Stop and hold at a challenging position.
- Hold 10-30 seconds for 3-10 sets.
Rack slides target trapezius muscles and thoracic paraspinals.
- Grab a wooden dowel or PVC pipe and approach your door frame or the front of a squat rack.
- Place the dowel horizontally against the doorframe at the level of your collarbone with your hands just slightly wider than shoulder width.
- Stand close to the dowel with a slightly staggered stance.
- Keep your elbows under the wrists the whole time.
- Slide the dowel up the rack until your arms are straight.
- You can simultaneously shift weight into the front foot to help achieve an overhead position and get an added stretch.
- Hold at the top for a few seconds and perform 10-30 daily.
Pass-throughs target pec minor and major, coracobrachialis, and short head of bicep.
- Standing or sitting, grab a 5-foot dowel or PVC pipe with a wide grip (typically, the wider, the easier this is).
- Keep the arms straight and rotate your shoulders so the dowel moves over your head and slightly behind you.
- If facing a mirror, you will see the dowel move behind your head to about eye level.
- This should result in a big stretch at the front of your chest, shoulders, and arms.
- Do not descend beyond that point. Instead, hold that position for 3 seconds, then return to the start position.
- Repeat 10-20 times.
- Move hands closer together for a more intense stretch.
Hip hinges target the posterior chain, lower back, glutes, and hamstrings.
- Stand with your feet directly under your hips, with your toes facing forward (ideally in front of a mirror).
- Push your hips back and reach your hands forward as if raising them overhead.
- The knees may slightly bend during this movement.
- The goal is to keep the spine neutral while slowly lowering it to parallel the ground. You may also feel a stretch behind your legs.
- Hold the position for 3 seconds, then return to the start position.
- Repeat 10-30 times throughout the day.
The baby swan is a great exercise to counteract the forward sitting posture and works on the spine’s mobility and strength of the mid-back.
- Start by lying on your belly with your arms out to your sides in a goalpost position.
- Imagine (or place) a small ball under your sternum. Gently hug the ground with your arms, then roll your ball forward to lift your heart and head forward.
- Try to keep the movement in your mid-back. If you don’t have a ball, imagine one to get the movement going. While it may be tempting to lead with your head, remind your body that your heart is in charge.
- Progress this exercise by holding the lifted position and trying to lift one or both arms without lowering your body.
Windshield Wiper Hips
This exercise increases hip mobility and control.
- Sit in a “z-sit” with knees pointing opposite to feet.
- Lean back slightly and change to an opposite z-sit where knees point in the other direction.
- Try to keep your spine tall as you do this. If you need a modification, consider leaning back and using your hands for support or trying this lying down, to begin with. Note: sometimes full rotation is contraindicated following certain hip surgeries, so check with your medical provider before attempting.
- If you can do the seated version, try to come up to kneeling from the z-sit before you switch sides as a way to add strengthening to the move.
Swimmers help strengthen the lower back while boosting mobility in the spine.
- Lie on your abdomen with arms stretched out in a “v” shape and legs straight.
- Start by slowly lifting the right arm and left leg, then switch to the left arm and right leg. Ensure you are not holding your breath and not trying to lift the limbs from your lower back. Placing a pillow under your hips can help if you feel strained in the lower back.
- Progress by picking up your pace and avoiding touching the arms and legs down to the ground as you alternate sides. Modify by starting from a hands and knees-position instead of on your belly.
The bridge is a great exercise to get the spine and the core talking to one another and finding support with movement.
- Lie on your back with your knees bent and hip distance apart. Keep your arms at your sides as you curl your pelvis and roll up your spine one vertebra at a time into a bridge.
- Hold at the top, then retrace your steps by rolling down the spine one vertebra at a time.
- Progress by using only one leg at a time as you roll up and roll down.
Roll-ups should feel like work in the abdominal muscles and this exercise is excellent for building a resilient spine. This exercise may not be a good choice for people with osteoporosis or some acute lower back conditions, so if something is painful, stop.
- Start by lying flat on your back with legs straight and pulled together. Take a breath in as you reach your arms overhead.
- As you exhale, press the arms down, pick up the head, roll yourself up to sitting, and reach for your toes.
- Sit tall, then roll yourself back to the starting position thinking one vertebrae at a time. If you get stuck on the way up you can roll up a towel and place it at your shoulder blades to help with roll up or you could start sitting and roll back a short distance (what you feel like you can support) and come back up.
Integrating These Exercises into Your Daily Routine
Which exercises you perform and when will depend on your needs and abilities. Trying to implement some movement every day is ideal. Lamb uses the saying “motion is lotion,” meaning movement and exercise help hydrate muscles and joints, eliminate waste products generated by overuse, and over time help to restore the body’s balance.
Tailor the types of movements you do to your needs. “If stiffness is the issue, exercises should focus on loosening tight hips or a stiff spine. If lack of support is the issue, then exercise should be focused on strengthening and endurance-type work,” she says.