| Another article has covered the goals and rationale | | | | your balance and then deep knee bend until you are in |
| behind setting and observing a lumbar exercise | | | | a full squat. The lumbar spine will stretch at the bottom |
| programme and in this article I go over the specifics of | | | | of the movement as you let it go, performing the |
| lumbar exercises and their performance. Exercise | | | | movement for a half minute at a time. |
| performance varies greatly between patients but the | | | | As this is a relatively severe exercise it would be |
| aim is smooth movement with steadily timed motions, | | | | useful to work at the earlier flexion exercises in lying |
| moving through the full ranges and holding at the end | | | | first before tackling this. |
| of the movements for a short time. Pain is to be | | | | Lying on the front |
| expected to some extent with exercising but this | | | | Sometimes the ability to extend the lumbar spine is |
| should not be more than moderate nor should it last for | | | | restricted and then prone lying, lying on the front, is a |
| too long afterwards. Successful exercise programmes | | | | useful starting exercise as even this can stress the |
| involve daily repetition over a long period. | | | | joints when they are stiff. The back is more extended |
| Pulling one leg to the chest | | | | in this position that it appears on the surface. |
| Lying down on the bed, get hold of one knee and pull it | | | | Elbow supported prone lying |
| up towards the chest, holding it at the full bend for a | | | | A progression from lying on the front is to get the |
| short time. Keep the other leg flat down. This exercise | | | | patient to support themselves up on their forearms to |
| mobilises and stretches the sacroiliac, hip and low back | | | | increase the extension stretch on the lumbar spine. |
| joints, muscles and ligaments. | | | | The lumbar spine is placed in greater extension than |
| Both knees to chest exercise | | | | prone in this position, stressing the tight structures and |
| Lying on the back, pull both your knees up to your | | | | forcing them to give. |
| chest, holding the top position for two seconds. This | | | | McKenzie Repeated Prone Extensions |
| exercise stretches the hips and sacroiliac joints less | | | | McKenzie technique is a form of manipulative |
| than the previous one but increases the flexion stretch | | | | treatment at affecting disc dysfunction and |
| on the lumbar spinal structures. | | | | derangement. Lying on the front with the hands placed |
| Stretching in the Child Pose | | | | near shoulder level, the patient pushes until their arms |
| This pose stretches out the whole of the spine by | | | | are straight whilst leaving the pelvis down on the bed, |
| using the bodyweight to stretch the back out over the | | | | involving a significant lumbar extension. |
| bent thighs in a kneeling down position, ending up in a | | | | This exercise can be aggravating as it is a strong |
| curled up position with the face near the ground. | | | | passive extension movement, so physiotherapists test |
| Full Squats | | | | the exercise carefully to make sure there is a positive |
| Because the bodyweight is used to stretch out the | | | | response before recommending it. |
| low back structures in this movement the effect is | | | | Knee roll exercise for rotation |
| mechanically more severe and should be done only on | | | | Lying flat on the back with the knees bent and the |
| advice from a professional therapist or after the easier | | | | feet on the surface, the knees are rolled side to side |
| exercises have already been performed. Advice is | | | | whilst being kept together. The movement is taken as |
| typically to perform extension movements after an | | | | far as the joints will comfortably go and a little further. |
| prolonged time of sitting but end range flexion can also | | | | The lumbar spine has very limited rotation but other |
| be useful to flex the lowest spinal segments. | | | | spinal structures may be restricted and respond to |
| Use a block under your heels if you need it to maintain | | | | movement. |