Spine Precautions and Postural Training for your Back

Adopting a spine-friendly posture, combined with properly trained back and abdominal muscles, reduces the load on your spine which can help alleviate pain. Postural training can help prevent the progression specially with degenerative spine disorders.

  • Carrying heavy objects

    Never carry a heavy object on one side. Instead, distribute the weight evenly on both sides.

    Avoid carrying heavy weight for long periods.

    If you have back pain, avoid lifting or carrying heavy objects (more than 10-20 lbs)

  • Sitting

    Sit upright in a suitable chair with your knees bent at the same angle as your hips with the soles of the feet flat on the floor, or if necessary, on a footstool.

    Your pelvis should be right at the back of the chair, while your body from the waist upwards should be upright.

  • Activities on the floor

    It will be easier and more comfortable if you support yourself on your hands and knees rather than sitting on your legs and thighs.

    Try to maintain keeping your back straight.

  • Getting up from a chair

    Keep your back upright from the waist up.

    Bend from your hips and move your body forward from the chair.

    Push up and extend from your hips and knees at the same time.

  • Working in a standing position

    Ensure that your back is in an upright position.

    Aim to have an elbow height working surface by either raising the surface you stand on or increasing the working surface height.

  • Driving

    Sit in a relaxed position with your arms slightly bent.

    Sit back against the seat keeping your spine erect, and your pelvis at the back of the car seat.

    Your legs should be comfortably extended while using the pedals.

  • Sitting at a table or desk

    Sit close to the table.

    Ensure that the chair is not too high to avoid bending forwards.

    You may find it useful to have a surface that is inclined at a 15 degree angle.

    Get up regularly to stretch if you have to sit at prolonged periods.

  • Picking up objects

    When you have to pick up something up, do not bend over forwards.

    Bend your knees and hips while keeping your back straight, with your legs slightly apart.

    Hold the object close to your body and stand up by stretching and extending your knees and hips.

    Avoid picking up things suddenly or turning around while you do so.

  • Standing

    Stand in an active and erect position.

    Do not slouch, letting your weight hang on your joints and ligaments.

  • Getting up from a lying position

    Bend both legs, place both hands on your chest and raise your head.

    Then simultaneously turn your head, your shoulders, and your knees towards the edge of the bed, and use both arms to push yourself up in a sitting position.

  • Lying Down

    Lie on a flat surface that is not too soft. Your position should be comfortable and relaxing as much as possible.

    If possible, sleep with only a small pillow at the back of your head.

    To help relieve stress on the lumbar region, you place a cushion under your knees. It is not advisable to lie on your stomach.

  • Exercise

    Focus on core and abdominal exercises. Strengthening your core does not mean you have to perform abdominal crunches. Core exercises involves more hip movement, leg lifts, and tightening your abdominal muscles such as maintaining a plank position.

    Pool activities are highly recommended. There is less weight transmitted to your spine while in a pool. Simple activities such as walking while inside the pool will help you build muscle strength.

Exercises

Patients with back or neck pain or those who had a recent spine surgery are advised to participate in physical rehabilitation and therapy to allow for appropriate conditioning of the muscles surrounding your spine.

It is recommended that strengthening and stretching exercises be performed to help prevent the progression of degenerative back or neck pain or help relieve postoperative pain.

We recommend doing these simple exercises at home. If at any point these exercises worsen your back or neck pain, or if you notice any new weakness or numbness, stop immediately and notify your physician.

Reference

Armstrong AD, Hubbard C. Essentials of Musculoskeletal Care 5. 2016. Fifth edition. American Academy of Orthopaedic Surgeons, 9400 West Higgins Road, Rosemont, IL, USA.

Cervical Exercise: The Backbone of Spine Treatment. 2012. North American Spine Society.

  • Acute Back Pain
  • Low Back Strengthening
  • Low Back Stretching
  • Neck

Isometric Strengthening

Sit on a chair with your back supported and head placed on a neutral position.

Place you hand across your forehead. Push your head and neck forward as hard as you able while firmly resisting any head movement with your hand.

Push for 10 seconds. Repeat 3 times.

Place the hand at the back of your head and try to push against it with a backward motion of the head.

Push for 10 seconds, and repeat 3 times.

Bend your neck to your left side against a resisting hand that is placed on the left side of your head. Repeat on the right side.

Push for 10 seconds, and repeat 3 times each for the left and right side.

Do 1 set of the exercises twice a day continuing for 4-6 weeks.

Prone Head Lifts

Lie on your stomach with your face down on a firm surface.

Raise your chest, shoulders, and head up by resting on your elbows.

Let your head hang downward with your chin near your chest.

Lift your head upward to the head-neutral position (back and neck aligned) and then continue to extend your neck by looking toward the ceiling.

Hold that position for 5 seconds.

Bring back to the head neutral position and then return to the chin tuck head hanging position.

Do this 5 times, twice a day, continuing for 4-6 weeks.

Supine Head Lifts

Lay flat on your back on a firm surface.

Raise your head fully off the surface and bring your chin to your chest.

Hold for 5 seconds. Then return to starting position.

Repeat 10 times per day, twice a day, continuing for 4-6 weeks.

Scapular Retraction

Stand with your arms on the side, while keeping your head and neck in neutral position (head – neck – back aligned).

Gently pull both shoulders backward trying to squeeze both shoulder blades backward and downward.

Hold for 10 seconds. You may increase to 30 seconds.

Do this 5 times, twice a day, continuing for 4-6 weeks.

Neck Rotation

While sitting or standing, keep your head in a neutral position (head – neck and back aligned).

Slowly turn your head to the left as far as you can hold comfortably. Maintain for 5 seconds.

Slowly turn the head to the right and hold for 5 seconds.

Do this 5x per day, twice a day, continuing for 4-6weeks.

Head Rolls

Sitting or standing, begin by gently bringing your chin to your chest.

Flex your head by bringing the right ear to the right shoulder and then left ear towards your left shoulder.

Gently roll your head in a clockwise circle 3 times. Then turn your head counterclockwise 3 times.

Do 3 sets, twice a day for 4-6 weeks.

Cat Back Stretch

Kneel on your hands and knee in a relaxed position.

Raise your back up like a cat and hold for 5 seconds.

Repeat 10 times, twice a day, continuing for 4-6 weeks.

Cat Back Stretch / Like a Cat

Kneel on your hands and knees in a relaxed position.

Raise your back up like a cat and hold for 30 seconds. Then relax for 30 seconds.

Repeat 5 times per day, continuing for 4-6 weeks.

Low Back Extension and Flexion Stretch

Lie on a firm surface, face down, and press up with your arms; hold for 5 seconds.

Extend your arms, rock back and sit on your bent knees, and tuck your head until you feel a stretch in your back; hold for another 5 seconds.

Repeat 5 times per day, continuing for 4 to 6 weeks.

Seat Side Straddle

Sit on the floor with your legs spread apart.

Place both hands on the same ankle and bring your chin as close to your knee as possible.

Hold the maximum stretch for 30 seconds and the relax for 30 seconds.

Repeat on the other side. Repeat the sequence 5 times per day, continuing for 4-6 weeks.

Sitting Rotation Stretch

Sit on the floor with both legs straight out in front of you.

Cross one leg over the other, place the elbow of the opposite arm on the outside of the thigh and support yourself with your other arm behind you.

Rotate your head and body in the direction of the supporting arm.

Hold the maximum stretch for 30 seconds and then relax for 30 seconds.

Reverse positions and repeat the stretch on the other side.

Repeat the sequence 5 times per day, continuing for 4-6 weeks.

Leg Crossover

Lie on the floor with your legs spread apart and your arms at the sides.

Keeping the leg straight, bring your right foot to your left hand.

Try to keep the other leg on flat on the floor, but you may bend it slightly if needed for comfort.

Hold the maximum stretch for 30 seconds and then relax for 30 seconds.

Repeat with the left leg and right hand.

Repeat the sequence 5 times per day, continuing for 4-6 weeks.

Wall Squats

Stand straight with your back and feet against the wall.

Place hands on top of abdomen and tighten abdominal muscles so your stomach is tucked in.

Squat in place keeping your back against the wall, until your knees and hips are level, then stand back up.

Perform 10 repetitions 1-3x per day continuing for 3-4 weeks.

Abdominal Bracing / Pelvic Tilt

Lie on your back on the floor with your arms at your sides, your knees bent and your feet flat on the floor.

Contract your abdominal muscles so that your stomach is pulled away from your waistband.

Hold for 15 seconds while breathing normally. Do not hold your breath.

Perform 5 repetitions once per day continuing for 3-4 weeks.

Draw-in Double Leg Lift

Begin in the supine position with your back flat on the floor.

Start on the abdominal bracing / pelvic tilt starting position.

Slowly flex both legs to 90 degrees of knee flexion.

Lift both legs off the mat to achieve 90 degrees of hip flexion and hold for 10 seconds.

Slowly lower legs until heels hit the ground.

Extend legs straight by sliding heels on the ground.

Slowly lift straight legs together to 45 degrees and hold for 10 seconds.

Repeat 10 times once a day continuing for 3-4 weeks.

Draw-in Single Leg Lift (Easier Method is to do Lying March / Supine Bicycles)

Begin in the supine position and start on the abdominal bracing / pelvic tilt starting position.

Slowly flex both legs to 90 degrees of knee flexion

Slowly flex the right leg to 90 degree of hip flexion

Extend the left leg, and slowly raise it 4 to 5 inches off of the ground.

Hold his position for 30 seconds and perform on the opposite leg to complete one set.

Repeat 10 times daily continuing for 3-4 weeks.

If you are having difficulty with the exercise, you could do the Lying March / Supine Bicycles. Lie on the back with bent knees. Lift alternating legs off the ground several inches in a marching motion and remember to keep the pelvis stationary. March for 30 seconds three times a day continuing for 3-4 weeks.

Hip Bridges

Lie on your back on the floor with your arms at the sides, your knees bent, and your feet flat on the floor.

Lift your pelvis so that your body is in a straight line from your shoulders to your knees.

Hold this position for 5 seconds.

Perform 10 to 20 repetitions per day for 4-6 weeks.

Modified Side Bridges

Lie on your side on the floor with your knees bent.

With your elbow bent at 90 degrees, lift your body off the floor as shown. Remember to keep your body straight.

Hold this position for 5 seconds and repeat on the other side.

Do 10 to 20 repetitions per day completing 4 to 6 weeks.

Bird Dog / Opposite Limb Raise

Kneel on the floor on your hands and knees.

Lift your RIGHT arm straight out from the shoulder, level with your body, at the same time lift your LEFT leg straight out from the hip.

Start by holding this position for 15 seconds and gradually increase the hold time with the goal of 150 seconds total.

Repeat with the opposite arm and leg.

Perform 5 repetitions per day, continuing for 4 to 6 weeks.

Prone Superman (easier Method is doing prone hip extension)

Start in the prone position, with your stomach on the floor, and your arms extended overhead.

Slowly lift legs, arms and head off the ground simultaneously.

Continue to lift extremities until you are at the point of maximum spinal arch.

Hold position for 10 seconds, return to starting position for 30 seconds and repeat for a total for 10 sets, continuing for 4 – 6 weeks.

If you are having difficulty doing this exercise, you can opt to the Prone Hip Extension. Lie on your stomach, raise one heel toward the ceiling and keep the other leg on the ground. Alternate legs 5 to 10 times, continuing for 4 – 6 weeks.

Prone Lying

Lie on a firm surface, face down for 5-10 minutes. If lying flat on your stomach in not comforable, place a folded pillow under your stomach. As you become more comfortable, remove the pillow and try lying flat.

Use this position several times per day as needed to keep pain minimize. Continue for 3-4 weeks.

Prone Press Up

Lie on a firm surface, face down, and press up with your arms until a gentle stretch/pressure is felt in the lower back.

Hold this position for 3 seconds and repeat 10 times.

Perform 1-3 sets per day for 3-4 weeks.

Single Knee to Chest

Only perform this exercise if the first two exercises are not effective at decreasing your pain.

Lie on your back on a firm surface and bring one knee up to your chest.

Pull on the knee with your hands until a gentle stretch is felt in the buttok/lower back region.

Hold this position for 3 seconds and repeat 10 times.

Perform 1-3 sets per day for 3-4 weeks

Double Knee to Chest

Only perform this exercise if the first three exercises in this program are not effective at decreasing your pain.

Lie on your back on a firm surface and bring both knees up to your chest.

Pull on your knees with your hands.

Schedule an Appointment

Patients can consult with Dr. Mario and Dr. Miko at their clinic, or via online video calls. Online consultations are done using Facebook, WhatsApp, Viber, Telegram, Google Meet, or Zoom.

Our Clinics

Set an Appointment
St. Luke’s Medical Center - Quezon City Room N-802, North Tower Cathedral Heights Building
Tel. No. (+63917) 629.3669

Available for both walk-in and appointment patient

Monday 2pm - 5pmTuesday Wednesday Thursday Friday 2pm - 5pmSaturday 9am - 12nn
Monday Tuesday 2pm - 6pmWednesday 2pm - 6pmThursday 2pm - 6pmFriday Saturday 1pm - 4pm
St. Luke’s Medical Center - Bonifacio Global City Suite 506 Medical Arts Building
Tel. No. (+63917) 810.0897

Available for both walk-in and appointment patient

Monday Tuesday 2pm - 5pmWednesday Thursday 2pm - 5pmFriday Saturday 2pm - 5pm
Monday 12nn - 4pmTuesday Wednesday Thursday Friday 9am - 11amSaturday