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Health & Exercise Forum

Prevention of Lower Back Pain: Maintain Fitness Level

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Jun 13, 2009

Dr. Paul MackareyAs little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well, exercise regularly and don’t smoke. Smokers have a much higher incidence of LBP and failure from lower back surgery.

Practice Good Posture & Body Mechanics

Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back.

Perform postural exercises throughout the day. Most of the day you are sitting, standing and reaching forwards flexing your spine. These exercises are designed to stretch your back in the opposite direction of extension. Please perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day. One, tuck your chin back to bring head over shoulders. Two, pinch your shoulder blades together. Three, while standing, put your hands behind back, extend lower back 10-20 degrees. Four, lying on belly, prop up on your forearms to extend you back.

Aerobic exercise will help prevent weight gain and stiffness for a healthier lower back. Perform mild aerobic exercise such as walking 3-5 times per week for 30-45 minutes. Core stabilization exercises designed to strengthen the abdominal and lower back muscles will help prevent injury. Some examples of core exercises are: lying on your back and performing a pelvic tilt as you flatten you lower back into the floor; lying on your back, hold a pelvic tilt as you slide your one heel up and down and repeat with the other heel; perform arm exercises such as biceps and triceps with light weight; while trying to hold an isometric contraction of your abdominal and lower back mucles.

Avoid sit-ups! Limit repeated flexion and torque on the lower back by
using core stabilization techniques to strengthen abdominal muscles.

When sitting, use an ergonomic chair and work station with a lumbar support and adjustable heights. Get close to your keyboard and monitor. Stand up and perform above postural exercises every 45-60 minutes.

When lifting, think twice. Be mindful of the weight, size and shape of the object. Also, consider the height of the object, handles or grips, location to place object and foot traction prior to the lift. First bend your knees and arch your back. Then, brace your abdominal muscles. Bend your spine forward as little as possible to pick up the load. Use legs, turn with feet, and do not twist spine with load in hands. When possible, get help to lift very heavy loads and push rather than pull. Immediately following the lift, stand up straight and stretch lower back into extension.

If you walk or stand most of the day, wear good shoes. Avoid high heels and shoes without adequate support like sandals.

If you drive long distances, use a lumbar support to keep an arch, sit close to your steering wheel to prevent bending forward and stop to stretch using the above postural exercises every 45-60 minutes.

Weight Training

Performed 2-3 times per week, 20-30 repetitions with light weights through full range of motion
Avoid spinal loading from overhead lifting such as military or overhead press

Upper Body

  • Bicep Curls – 1 arm at a time with a dumbbell – bend elbow
  • Tricep Extention – lying on back and extend elbow
  • Chest Press – lying on back with dumbbell and extent arm up
  • Shrug – stand with dumbbell in each hand at side and shrug shoulders
  • Shoulder Fly – stand with dumbbell in each hand and raise arm up like a wing to 45 degrees.
  • Rows – stand with theraband in hands and pull like rowing a boat
  • Lats – stand with theraband in hands and pull like sawing wood
  • Shoulder External and Internal Rotation – stand with theraband in one hand and turn arm out against resistance. Repeat turning arm in.
  • Wrist Curls – elbow bent, dumbbell in hand bring wrist up and down and turn palm up and down
  • Grip exercises – squeeze ball or gripper

Lower Body

  • Leg Extension – sit in chair and extend leg up with sandbag weight on ankle
  • Leg Curl – stand and hold onto countertop and bend knee up with sandbag weight on ankle.
  • Calf Raise – stand and hold onto countertop and raise body up on toes
  • Step-Ups – step up  4 to 6 inch step and lower down
  • Wall-Slide – stand with back against wall and slide back up and down wall while bending and extending knees to a 45 degree angle

Aerobic Exercises

3-4 times per week for 30-45 minutes at moderate intensity.

  • Treadmill, bike, recumbent bike, elliptical, walk, cross-country ski

Balance Exercises

  • Stand on discs or pillows to create unstable surface. First stand on two legs, then on one leg.
  • Walk/Run forward, backward, figure eight, and crossover
  • Dance

Core Lumbar Stabilization Exercises

  • Abdominal Strengthening sitting on balance ball while doing bicep curls, shrugs, rows, lats, and leg extension. Contract abdominal muscles and keep balance with using arms and legs.

Visit your doctor regularly and listen to your body.

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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of  Scranton, PT Dept.