Avoid Back Pain: Best exercises to strengthen your back

As per research, low back pain is one of the leading causes of activity limitation and absenteeism from work worldwide. Sitting for long periods can lead to weak core muscles and a stiff low back. Exercising regularly, focusing on specific muscle groups, can help you strengthen your back and avoid back pain. Having said that, if you have suffered an injury recently or have chronic back pain, I would suggest consulting a doctor or physiotherapist to get the correct diagnosis.

While the reasons for back pain and spinal injuries could be many, it is in our interest to embrace the age-old saying – Prevention is better than cure 

The exercises that I will demonstrate in this article worked wonders for me while recovering from a slipped disc injury. And after coaching numerous clients, I realised these are effective and feasible for the vast majority of individuals leading a busy, sedentary lifestyle. These exercises place a very low load on your spine, so you can do them every single day to stretch and stabilise your spine. The best part is that these exercises require no equipment and can be a great home workout routine. 

If you wish to know more about my recovery journey, check out this podcast:

How I recovered from a Herniated Disc (Slipped Disc) injury?

You can also add these exercises to your warm-up or cool-down routine during cardio workouts, strength training or even while playing sports as they target various muscle groups that promote core strength and stability.

WHAT IS MEANT BY ‘CORE’?

You must have heard or read terms such as “core strength” or “core stability” in various fitness articles and videos, and will continue to read them in this article.

So, what is ‘core‘ exactly?

The muscles that surround our spine are considered the ‘core’ of our body. It is composed of the abdominal muscles on your front and sides, the erector muscles of the back and even the larger muscles that span multiple joints (like the lats and psoas muscles). Even glutes (muscles in the buttocks) are also an important part of the ‘core’. The highlighted muscle groups in below images together comprise the ‘core‘ of our body.

Each and every one of these muscles work together to hold your body upright against gravity and perform day-to-day activities such as standing, walking, twisting or lifting objects. When the core fails to meet the stability demands placed on the body during daily activities or while lifting weights, parts of the spine will be overloaded which can increase risk of injuries and cause pain in different parts of the body (including low back). In essence, core strength and stability are essential for a healthy spine and working on it will help avoid back pain.

Now that we have realised the importance of our ‘core’, let’s dive into the fun part. Here are my favourite beginners friendly stretches/ yoga poses to prevent back pain. I still perform them during my rest days or when I feel stiff after sitting for prolonged hours.

1. GLUTES BRIDGE

The gluteal muscles (the muscles in your buttocks) are responsible for hip extension, i.e. the action of moving your thigh backwards. Therefore, it provides stability and support to your low back while performing day-to-day activities such as walking, running and jumping. When the gluteal muscles are strong, you have a stable pelvis and the low back doesn’t bear the brunt of your motion.

However, when you sit for prolonged hours, you are no longer depending on your lower body to hold you up. As a result, the muscles of the gluteal region (primarily gluteus medius) tend to weaken and get stiff which may lead to low back pain. Sometimes, this may also cause knee or ankle pain as they try to compensate for pelvic instability. Glutes bridge is an excellent exercise to improve glute activation and strengthen the gluteal muscles. It engages the entire posterior chain which includes glutes, hamstrings, calves, erector spinae (the little muscles surrounding the spine), and the lower and upper back muscles – which will give you a stronger back and potentially prevent back pain.

Steps to perform the Glutes Bridge: 

• Lie on your back, with your knees bent and feet flat on the ground.
• Keep your arms beneath your head or at your side with your palms facing down
• Press your feet into the floor and lift the hips off the ground
• Engage the legs and buttocks to lift the hips higher
• Exhale as you lift your hips toward the ceiling
• As you pause at the top (for about a sec), you should feel the contraction in your glutes and focus on squeezing your glutes
• Make sure you don’t overextend your back to the extent that it starts hurting
• Inhale as you bring your hips back on the floor
• Use a resistance band around your knees to increase the difficulty
• Repeat 10-15 times and perform up to 3 sets

2. COBRA POSE OR BHUJANGASANA

When you spend hours sitting hunched over in front of computers and smartphones, your chest muscles tighten, pulling the shoulders inward (rounded shoulders) and spine forward. The muscles in the upper back lengthen and stretch, while the neck constantly slants forward. This can potentially lead to chronic neck and back pain.

Cobra pose helps you reverse the effects of these muscle imbalances as it opens up your chest, shoulders and neck. It strengthens the spine and back muscles while improving flexibility of the upper and middle back. The pose is relaxing, and it can help reduce fatigue and stress. Regularly performing this pose can help strengthen your spine and avoid back pain due to continuous sitting.

Steps to perform the Cobra Pose or Bhujangasana:

• Lie flat on your stomach and place your palms flat on the floor under your shoulders, with forehead resting on the floor
• Lift your head, chest and abdomen keeping your naval on the floor
• Lift only up to a height such that you can keep your hips on to the floor
• Keep breathing with awareness as you peel yourself off the floor one vertebra at a time
• Roll your shoulders back to open up your chest
• Extend your neck backwards as per your comfort level and keep your mouth closed
• Try to distribute the backbend evenly throughout the entire spine
• Breathing out, gently bring your abdomen, chest and head back to the floor
• Repeat 10-15 times and perform up to 3 sets

If you are new to Cobra pose, start by keeping your elbows touching the floor as you lift your upper body. Gradually, increase the backward arch as you get comfortable. Watch this video and read the captions for details.

3. CHILD’S POSE OR BALASANA

Our backbone (or spine) is a collection of small bones, called vertebrae, stacked on top of each other. Between adjacent vertebrae, there are jelly-like structures called intervertebral discs. These discs function as a shock absorber and act as a ligament to hold the vertebrae together. The discs get compressed continuously, as we perform our day to day activities such as walking, sitting, running, jumping etc.

Child’s Pose or Balasana is an excellent exercise to decompress and lengthen your spine. It stretches the QL muscle (Quadratus Lumborum) which often gets stiff and strained due to prolonged sitting, leading to back pain. Holding this pose also helps in stretching the muscles around your hips, knee, thighs and ankles. Allowing the forehead to rest on the ground has a calming effect on the brain and, can help alleviate stress and anxiety as we breathe through this pose. Perform child’s pose every morning to stretch your spine and avoid back pain.

Steps to perform Child’s Pose or Balasana:

• Start on all fours, then lower the hips to the heels and forehead to the floor
• Keep the knees together or if more comfortable, spread the knees slightly apart
• Extend arms overhead with palms on the floor
• Extend your arms further using your palms and fingers to feel a stretch in your lats and upper back while actively pressing the belly against the thigh to feel the stretch in your low back
• Keep your neck relaxed in the neutral position allowing the forehead to rest on the ground
• Breathe and hold this position for about 10-15 secs
• Come back on all fours slowly and repeat
• Repeat three times and perform up to 3 sets

Avoid this pose if you have spine or knee injuries and consult a doctor or physiotherapist before trying this exercise again.

4. SINGLE LEG RAISES

Sitting for long hours throughout the day can lead to tight hamstrings and hip flexors. Hip flexor muscles, the muscles at the top of your thigh, may weaken over time due to prolonged sitting as they are always in the shortened position. It is essential to stretch and strengthen these muscles to prevent imbalances and avoid back pain.

Single leg raises is one of my favourite exercises that I recommend every beginner. It strengthens hip flexors and quads (muscles in your thighs right above knees) while improving hamstring mobility. When performed correctly, this exercise strengthens and stabilises core muscles which can help alleviate low back pain. A strong core and hip flexors can improve your performance while running, cycling, squatting and numerous other activities. So, regardless of your activity of choice, this exercise can be an excellent addition to your warm-up routine.

Steps to perform Single Leg Raises:

• Lie down on your back with hands under your head or at your side
• Lock both your knees and ankles
• Keeping one leg in contact with the floor, lift the other leg as high as possible, while maintaining locked knee and ankle
• Keep ankle dorsiflexed, i.e. raising toes upwards towards the ceiling
• Feel the stretch in your hamstrings and calves; Feel your core and quads doing the work
• Ensure knees and ankles are locked at all times and aim to increase the angle between the raised leg and the floor
• Gradually bring the leg to the floor, ensuring slow and controlled movement; No jerks
• Inhale as you lift your leg and exhale while lowering it down.
• Repeat 10 times and switch to the other leg
• To ensure effectiveness, keep knees and ankles locked at all times

5. BIRD DOG POSE

This is one exercise I recommend to everyone regardless of their current level. Add this to your warm-up routine before strength training, and it will likely improve your spinal stability and ability to brace your core while performing deadlifts and back squats.

Steps to perform Bird Dog Pose:

• Start on all fours placing your knees under your hips and hands under your shoulders
• Raise your left arm and right leg, keeping your torso stable with shoulders and hips parallel to the floor
• Maintain neutral spine with neck, arm and leg in one straight line
• Keep core engaged and glutes activated while holding this position
• Make sure you are not tilting towards one side
• Breathe and hold this position for 10 secs, then lower back down to the starting position.
• Raise your right arm and left leg, holding this position for 10 secs and return to starting position; this completes one repetition
• Repeat fives times and perform up to 3 sets
• Keep the central body stable. Only the limbs should move when you are transitioning from one side to another

6. HIP FLEXOR STRETCH

A sedentary lifestyle with prolonged sitting can lead to tight hip flexors causing low back pain. As the name suggests, this exercise helps stretch the hip flexor muscles (namely Iliacus and Psoas Major) while improving mobility in the low back area, hips and hamstrings. This exercise works your core muscles, as you have to engage your abdominals to hold the partial high plank position. It also helps increase ankle mobility while stretching muscles around the inner thigh.

Steps to perform Hip Flexor Stretch:

• Start on all fours and step forward with your left leg inside of your left hand
• Keeping the right leg extended behind you, push the right knee backwards as far as comfortably possible
• Take support by pressing your palms down, lift your right knee from the floor and straighten your leg such that your hips and heels are in a straight line
• You should feel a stretch in your hip flexors, glutes and low back
• Turn your head towards the direction of your front foot, i.e. left side
• If the range of motion isn’t quite there and you can’t get the foot all the way to the hand, just go to where your body allows
• Hold this position for 10 secs and repeat for the other side.
• Repeat three times on each side and perform up to 3 sets

In the beginning, this position may feel awkward, so progress with this stretch at your own pace. In some cases, you may not be able to press your entire palm on the floor due to mobility restrictions. In that case, take support from just the fingers and aim to press the entire palm on to the floor, eventually.

DAILY ROUTINE TO AVOID BACK PAIN

The above set of six exercises can be incorporated, in your daily routine, as a quick 20 mins workout. Here is the sequence that I recommend performing at least five days a week.

• Glutes Bridge x 10 times
• Cobra Pose x 10 times
• Child’s Pose x 3 times (10 secs holds)
• Single Leg Rasies x 10 each side
• Bird Dog Pose x 5 each side (10 secs holds)
• Hip Flexor Stretch x 3 each side (10 secs holds)

Perform up to THREE sets of above with no rest between exercises and 30-60 secs rest between sets.

Check out below video to watch all six exercises together.

DEEP SQUAT EVERY DAY

Ditch the chair from time to time, and start resting in a deep squat position. Our body is not designed for sitting on a chair. We are supposed to rest in the deep squat position, also called Malasana in Yoga. If you notice the kids in the below photo, they are not exercising! They are relaxed in that position and playing effortlessly. With time, people lose the ability to sit in this position due to prolonged sitting on the chair and, never trying to squat.

Sitting in deep squat allows the force of gravity to act on the body and gives a natural stretch to the tight muscles around your low back, opening up the hips and producing a traction effect that may decompress your spine. Over time, it will have a positive impact on your spine health. Bending your legs fully, stretches the tight muscles in the legs and helps restore ankle mobility. This can also be beneficial for your knees.

Here are some guidelines you can follow while resting in the deep squat position:

• Keep spine relaxed, no need to try and keep erect – It is a RESTING pose
• Ideally, keep feet around shoulder-width apart with toes pointing forward. However, one needs to experiment and adjust so that you are comfortable in that pose
• If unable to balance, elevate your heels by putting something underneath your heels such as a rolled-up towel, yoga block, stack of cardboards, books etc. Alternatively, you can hold onto something sturdy such as bench, bed, desk or pole and then try to get in the deep squat position.
• If you are at home, best to do it barefoot
• How low should you squat? As low as you comfortably can!

Start with sitting in the deep squat position (or Malasana) for 30 secs throughout the day split into three sets of 10 secs each. It may be uncomfortable for some initially, but keep trying, and the body will adapt eventually. Gradually get to a level where you can sit for up to 30 mins throughout the day. Yes, 30 mins! Sit for 5 mins in the morning, then 5 mins at noon and so on! Sit in deep squat position whenever you get bored from sitting on chair or standing. Squat everywhere, every day!

START STRENGTH TRAINING

If I were to recommend one strength exercise for beginners, it would surely be Bear Crawl. It is a simple but brutally effective way to improve strength and work a variety of muscles all over the body, with the upper arms, shoulders and quadriceps bearing the brunt of the action. It is essentially a full-body workout that places a low load on your spine and challenges various muscle groups to keep your body stable as you move. That said, as you get stronger, you must advance to other compound movements such as squats, lunge variations, pushups, pullups, deadlift variations etc.

When it comes to fitness, there is no finish line! It is a life long journey of learning and exceeding your capabilities.

Another great thing about bear crawls is that they provide a great mental challenge, as your brain focuses on maintaining proper coordination while moving opposite limbs together. E.g. right hand and left leg. Don’t be surprised if you struggle to do this movement gracefully, at first. It happens with everyone. Prioritise technique over speed, and it will get better with consistent practice. There should not be any joint pains (knee, hips, shoulders etc.) while performing this exercise. Take it slow and be patient. Here is a tutorial to perform bear crawl.

IMPROVE POSTURE AND INCREASE DAILY MOVEMENT

While regular stretching and strength training will allow you to build the core strength and stability required for a healthy spine, simple changes at your workplace can go a long way in avoiding back pain.

It is essential that you change your position every 30-45 mins – from sitting TO standing, standing TO walking, walking TO resting and resting TO moving

Here are some tips to improve your posture and incorporate more movement while at work and otherwise:

• Use this workplace ergonomics guide to improve your posture while sitting.
• Take stairs to climb 2-3 floors instead of using an elevator
• Conduct walking meetings at work
• Drink more water, so you have to get up often for restroom breaks
• Keep a glass (instead of a bottle) to drink water. Walk over to fill it up every hour
• Go for leisurely walks while talking on the phone or listening to podcasts
• When working from home, take voice calls while walking whenever possible
• Walk to the grocery store instead of driving
• Change positions often and stretch while watching TV or Netflix

THE MOST IMPORTANT ASPECT

The exercises explained above are highly effective, no doubt. But at the end of the day, there is no magic pill that will solve all your problems. If you want to be strong and avoid back pain for the rest of your life, you have to work at it regularly over a long period. It takes time, and anything that offers quick results, often, does not provide long term sustainable outcomes.

I started doing these exercises in 2017, and I still do them regularly despite reaching an advanced level of fitness. Why? Because I tend to sit for long periods throughout the day. These exercises have excellent carry over to the other day-to-day movements and allow me to stay pain-free.

SEEK PROFESSIONAL HELP

While these exercises are highly effective and have helped me during my injury and beyond, they may not be well suited for those with pre-existing conditions or injuries. If you experience any pain or discomfort while performing these exercises, please consult an appropriate professional. If you are pregnant, please consult your doctor or physio before undertaking any exercise program. You should always feel a slight pull when stretching but not a burning pain or tear like sensation. Stretching should NEVER be painful.

Wrapping up

A sedentary lifestyle with long periods of continuous sitting can lead to weak core muscles and a stiff low back. Changing your position every 30-45 mins by making simple changes in your lifestyle can go a long way in preventing injuries and back pain. If you are a beginner and have limited time, follow the simple daily exercise routine, detailed in this article, to build core strength and stability that will allow you to stay pain-free for life.