Six Stretches For Low Back Pain Or Stiffness

In this blog post, I’ll be sharing six stretches that you can do to help manage flareups of low back pain or stiffness.

If you were to ask me “what is the best stretch for low back pain?” My answer is that some stretches might help some people, some of the time (that’s probably not the answer you’re looking for). That’s because several different structures in the low back could be the source of your back pain. The intervertebral disks, facet joints, ligaments, muscles, bones or nerves could all be pain generators and each would require a different form of treatment.

Before you try to fold yourself into a pretzel to stretch away low back pain, I would like you to think about this simplified concept about the way the body moves. It’ll help you understand why a chiropractor, physio or other healthcare providers might prescribe these stretches. I have discussed this concept in a previous blog post I wrote about stretching before or after a CrossFit WOD, but I feel it’s something important to take into consideration.

The Joint-By-Joint Approach

The body is an extremely complex machine and just a simple task like walking requires a precise balance of stability and mobility. Some joints are required to remain stable and transfer force so that other joints can move through a wider range of motion. Dave Cook and Mike Boyle, two well known physical therapists in the USA and founders of the Functional Movement Systems (FMS) and the Selective Functional Movement Assessment (SFMA), managed to simplify the extremely complex topic of human biomechanics.

The joint-by-joint approach suggests that the body is a stack of joints arranged on top of one another in an alternating pattern of stability and mobility. If that pattern were to change, that’s when we might see injuries or pain occurring. The reason for that is if the mobile joints were to lose mobility because of previous injury, occupational or postural factors, the stable joint will compensate by giving up some of its stability and that’s when problems occur.

Look at the picture above, the pattern from the foot up to the cervical spine is in a pattern of stable-mobile-stable-mobile. The foot is stable, the ankle is mobile, the knee is stable, the hip is mobile, the lumbar spine stable, the thoracic spine is mobile. You get the idea.

By definition, a stable joint can allow controlled movement or limit movement at a certain body part. Stable joints tend to favour moving in a single plane of motion over the other two planes of motion. Mobile joints can move freely in all three planes of motion. The low back or lumbar spine is considered to be a stable segment of the body. The shape and orientation of the facet joints in your lumbar spine allow mostly for flexion and extension to occur, but very little rotation or lateral flexion.

Stable Vs Mobile Joints

By definition, a stable joint can allow controlled movement or limit it at a certain body part. Stable joints tend to favour moving in a single plane of motion over the other two planes of motion. Mobile joints can move freely in all three planes of motion. The low back or lumbar spine is considered to be a stable segment of the body. The shape and orientation of the facet joints in your lumbar spine mostly allow for flexion and extension to occur, but very little rotation or lateral flexion.

Lumbar spine instability can lead to low back pain and compensatory muscle spasms that can be perceived as stiffness or “poor spinal mobility”. This is because the body is trying to create stability in the low back any way it can by abnormally recruiting the postural muscles as stabilisers. Stretching these tight muscles might only give you temporary relief from low back pain. However, if you’re lacking mobility in the thoracic spine and hips, improving mobility in these areas will mean that your low back won’t need to compensate, resulting in improved stability which could be a long term solution to your back pain.

Different Stretching Techniques

The two types of stretches that you may be familiar with are static and dynamic stretching.

In short, a static stretch is the traditional stretch that you might be familiar with. It involves taking a limb or muscle towards its end range of motion and holding it there for 15 to 60 seconds. A dynamic stretch involves repetitively moving a body part or muscle to its end range of motion and back again in a smooth controlled manner.

The third type of stretching is the contract-relax method. It’s a form of Proprioceptive Neuromuscular Facilitation or PNF stretching. It involves putting the target muscle on a gentle stretch and then contracting the muscle for 5-10 seconds, relax and then repeat that cycle two to three times.

Before you stretch

Please take note that you should feel no pain at all while performing these stretches. It’s important to stop right away if you experience any pain and get advice from a trusted healthcare professional that deals with musculoskeletal disorders. Let’s discuss the different stretches

#1 – Cat / Camel

The cat camel is a dynamic stretch because you are repetitively moving your lumbar spine through flexion and extension. This is a really useful mobility exercise because you’re encouraging controlled movement of the spine in a non-weight bearing manner. This stretch can be performed daily or during acute flare-ups of low back pain or stiffness.

Recommended: 1-2 minutes in the morning or during acute low back pain episodes.

#2 – Double Knees To Chest

This is a contract-relax type stretch. By pulling your knees towards your chest you cause posterior tilting of your pelvis and place the lumbar paraspinal muscles on a gentle stretch. Hold that for 5-10 seconds then try to extend your hips by pushing them into your arms for another 5-10 seconds. Relax and pull your knees closer towards your chest and repeat the cycle another two to three times.

Do not perform this stretch if you have or suspect you may have an intervertebral disk bulge or herniation. This position places the lumbar spine into end range flexion and could potentially aggravate the disk.

Recommended: 3 sets of 3 x contract-relax cycles (5-10 second contract, 5-10 second relax)

#3 – Prone Extension

The prone extension is a dynamic stretch that we prescribe for patients with lumbar intervertebral disk herniations or bulges. If your back pain has a discogenic component (pain that is caused by the intervertebral disks) this may help.

Do not perform this stretch if you have been diagnosed with lumbar spinal stenosis. Stenotic lumbar spines do not like moving into extension and this position can be rather uncomfortable. Acute lumbar facet joint (the joints between your vertebrae) pain could also be aggravated by this movement so please don’t push through any pain when doing this stretch.

Recommended: 10-15 reps, 2-3 x daily.

#4 – Open Books

The open book is a dynamic stretch that helps improve thoracic spine (mid-back) mobility. By pulling your knees towards your chest you lock the lumbar spine in slight flexion which prevents it from rotating. The result is that most of the rotation occurs in the thoracic spine while protecting the lumbar spine from rotation.

Recommended: 3 sets 15 reps on both sides.

#5 – Figure 4 Stretch

This static stretch targets the Piriformis muscle and short external rotators of the hip. They are the Superior Gemellus, Obturator Internus, Inferior Gemellus, Obturator Externus & Quadratus Femoris.

If these muscles are tight and painful, the underlying cause is often due to a lack of hip stability. The body compensates by tightening up these short rotators to improve stability of the hip. This stretch may help relieve tension in these muscles. If not, you need to consider improving your hip stability to offload these compensatory muscles.

Recommended: Hold for 15 seconds x 3 sets on each leg.

#6 – Hip Flexor Stretch

This static stretch targets the muscles that we collectively call the hip flexors. It’s no secret that as humans we sit far too much (I say this while sitting at my desk writing this blog). Over time this will cause shortening of the hip flexors muscles and stiffness of the ligaments surrounding the hip. A lack of hip extension has been linked to abnormal pelvic biomechanics which can lead to compensatory muscle stiffness or pain in the low back.

These stretches are also important for patients with spinal stenosis as your lumbar spine isn’t able to extend comfortably, so therefore your hips need to be able to.

Recommended: Hold for 15 seconds x 3 sets on each leg.

Conclusion

Constantly stiff muscles are usually a sign of an underlying biomechanical abnormality that needs to be addressed. Mobility deficits in the hips and thoracic spine are extremely common and need to be corrected to prevent compensatory muscle stiffness in the low back.

Sometimes stretching alone isn’t what your body needs. Hip stability is also an important factor that I haven’t discussed in too much depth in this blog but is vital for proper lumbar spine biomechanics. By improving your hip stability, you’ll be reducing your body’s need to rely on the postural muscles in the low back for additional support.

A proper assessment with a healthcare professional who understands musculoskeletal biomechanics is always a good place to start. Feel free to reach out to our clinic if you need help figuring out what the cause of your back pain is and how to go about treating it.