Back Clinic Mobility & Flexibility: The human body retains a natural level to ensure all its structures are functioning properly. The bones, muscles, ligaments, tendons, and other tissues work together to allow a range of movement and maintaining proper fitness and balanced nutrition can help keep the body functioning properly. Great mobility means executing functional movements with no restrictions in the range of motion (ROM).
Remember that flexibility is a mobility component, but extreme flexibility really is not required to perform functional movements. A flexible person can have core strength, balance, or coordination but cannot perform the same functional movements as a person with great mobility. According to Dr. Alex Jimenez’s compilation of articles on mobility and flexibility, individuals who don’t stretch their body often can experience shortened or stiffened muscles, decreasing their ability to move effectively.
Can stretching quadriceps help relieve stiffness and pain and improve flexibility for individuals with consistently tight quadriceps?
Quadriceps Stretches
Walking, running, biking, and other daily activities can tighten the quadriceps muscles. The quadriceps are four muscles in the front of the thigh that extend the leg and strengthen the knee. Stretching the quadriceps may be a part of a home or gym exercise program or physical therapy treatment to maintain quadricep flexibility. Resting the quadriceps with an exercise program can greatly maximize mobility and prevent injury.
Tight quadriceps may sometimes result from injuries such as patellofemoral stress syndrome or iliotibial band friction syndrome. The quads may also become tight for individuals with spinal stenosis or other related problems with the lower back. (International Sports Sciences Association, 2023) Ely’s test, also known as the Duncan-Ely test, is one way to determine whether your quadriceps are tight. It is a physical examination used to assess the flexibility and potential spasticity of the rectus femoris muscle (a quadriceps muscle) by passively flexing the patient’s knee. Lie on your stomach and try to touch your foot to your buttocks. If you can’t, the rectus femoris, one of the main muscles, may be tight and benefit from quadricep stretches. (Olivencia, O. et al., 2020)
Safety and Precautions
Before trying this or any other exercise program, consult a healthcare provider to ensure exercise is safe for you and your conditions. A professional can help diagnose any overuse injury that might be causing tight quadriceps. Quadriceps stretches will be a little more comfortable after warming up. A few minutes of walking or biking will warm the quadriceps muscles to stretch more easily.
Stretches
To stretch the quadriceps, try the standing, side-lying, and prone quadriceps stretch once fully warmed up and after a workout. Individuals who frequently experience quadriceps tightness should stretch them daily. Incorporate all or some of these stretches into a cool-down or off-day flexibility routine.
Standing Stretch
The standing quadriceps stretch can be done anywhere in the office, gym, or outside. All you need is a place to stand. Here is how:
While standing, hold onto a countertop or back of a chair to help with balance.
Bend your knee by grasping your ankle.
Move your foot toward your buttocks.
Gently pull on your ankle to bend your knee as far as possible.
Maintain position for 30 seconds.
Return to the standing position.
Repeat the exercise 3 to 5 times with each leg.
Stop stretching if there are any sharp pains.
Side-Lying Stretch
The side-lying quad stretch lengthens the quadriceps. On the floor in a supported position can help focus on the stretch. Here’s how:
Lie on your side.
Bend the knee of your top leg as far as you can, gently pulling with your hand.
Maintain position for 30 seconds.
Return to the starting position.
Repeat the exercise 3 to 5 more times with each leg.
Prone Stretch
Stretch the quadriceps while lying on your stomach. In this position, the floor helps to stabilize the pelvis, minimizing rocking and maximizing the stretch. To do the stretch:
Lie on your stomach.
Bend your knee back as far as you are able.
Grab your ankle to pull your foot toward your buttocks.
Maintain position for 30 seconds.
Return to the starting position.
Repeat the exercise 3 to 5 more times with each leg.
If you have difficulty reaching your ankle, pull the leg up, wrap a towel or strap around the ankle, and use it to pull. This can help stretch the quadriceps effectively even if you cannot reach the ankle easily.
Injury Medical Chiropractic & Functional Medicine Clinic
Consult a healthcare provider or physical therapist to learn the recommended quadriceps stretches or other strengthening exercises. Keeping the quadriceps healthy will help keep the knees moving and maximize functional mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Olivencia, O., Godinez, G. M., Dages, J., Duda, C., Kaplan, K., Kolber, M. J., Kaplan, & Kolber (2020). THE RELIABILITY AND MINIMAL DETECTABLE CHANGE OF THE ELY AND ACTIVE KNEE EXTENSION TESTS. International journal of sports physical therapy, 15(5), 776–782. doi.org/10.26603/ijspt20200776
For individuals dealing with posture problems causing neck, back, and shoulder pain, can pectoralis minor stretches designed to work these areas be a part of physical therapy or as regular exercises at home?
Pectoralis Minor Muscle Stretches
The pectoralis minor is a small, triangular muscle situated deep to the pectoralis major in the anterior chest wall. It originates from the margins of the third to fifth ribs adjacent to the costochondral junction and connects to the coracoid process of the scapula. The pectoralis minor helps with posture, mobility, and shoulder stability and aids breathing. Muscle tightness can cause pain in the chest, shoulder, and neck and a restricted range of motion. Strain and injuries can occur during activities involving overhead movements or forceful pushing. Pectoralis minor stretches are designed to work these muscles that span the ribs and connect to the shoulder to help improve posture and relieve pain and chest weakness. They can help reduce muscle tightness and other conditions like thoracic outlet syndrome. (Kaur U. et al., 2023) (Wagner E. R. et al., 2023) Talk with a healthcare provider Before starting any exercise or stretching program.
Corner Pectoralis Stretch
A corner pec stretch is similar to a wall push-up, except the emphasis is on staying in a position that lengthens the chest muscles. It’s important to move the whole body as a unit and not bend.
Stand facing a corner with a relaxed, upright posture.
Place your feet so they are parallel, and bend your knees slightly.
Stay as relaxed as possible during the movement to protect your joints.
Keep your gaze forward.
Place your forearms and palms over the walls where two walls connect at a right angle.
With your elbows bent to 90 degrees, move forward into the corner of the wall until you feel a comfortable stretch in the pectorals.
The doorway stretch is similar to the corner stretch. It works the pectoralis major and the minor muscles and helps with mobility. To perform: (Maryland Pain & Wellness Center, 2025)
Stand in a doorway with your feet placed together.
Place the palms and forearms on either side of the doorway.
Your elbows should be even with your shoulders and bend at a 90-degree angle.
Keep your back straight.
Take a step forward, leaning into the doorway.
You should feel the stretch in the muscle.
Repeat the stretch with the other foot.
Exercise and ergonomic changes to your chair or desk height can help improve posture and relieve muscle tightness. (Kaur U. et al., 2023)
T Stretch
The T stretch stretches the front of the chest and is done on the floor, typically with a foam roller placed directly under the spine. To perform: (OrthoCarolina, N.D.)
Lie down on your back with the foam roller aligned to the spine.
Make sure your head and tailbone are supported.
Open your arms straight out like a T.
Hold the position while stretching.
Y Stretch
The Y stretch is similar to the T stretch; both reduce chest muscle tightness and discomfort. To perform: (OrthoCarolina, N.D.)
Use the same foam roll position, lying on your back with the head and tailbone supported and aligned.
Stretch the arms out above your head, placing them into the shape of a Y.
Allow the chest muscles that connect to the arms to relax.
Studies have examined how quickly a prone scapular retraction can help stretch the back and shoulders. Results suggest the exercises must be performed longer before the pectoralis minor is lengthened to improve symptoms. (Dye J., Allyn M., & Frank C. 2024) However, further research is needed.
Health Conditions
Pectoralis minor stretches may be part of a personalized therapy program to improve mobility, posture, and/or breathing and sleep quality with health conditions that include:
Stretching and strengthening exercises can help improve their flexibility and function. Exercises can improve strength and function by standing or lying down, depending on the stretch.
Injury Medical Chiropractic and Functional Medicine Clinic
The pectoralis minor muscles are often overlooked in clinical examinations but can contribute to musculoskeletal pain and dysfunction. A healthcare provider can teach about stretches, how they can help, and whether they are safe for the individual’s injury and/or condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Doorway Stretching Routine
References
Kaur, U., Shrestha, D., Hussain, M. A., Dalal, P., Kalita, M., Sharma, V., & Sharma, S. (2023). Prompt Impact of Muscle Energy Technique on Pectoralis Muscle Tightness in Computer Users: A Quasi-Experimental Study. Journal of Lifestyle Medicine, 13(2), 123–128. doi.org/10.15280/jlm.2023.13.2.123
Wagner, E. R., Gottschalk, M. B., Ahmed, A. S., Graf, A. R., & Karzon, A. L. (2023). Novel Diagnostic and Treatment Techniques for Neurogenic Thoracic Outlet Syndrome. Techniques in hand & upper extremity surgery, 27(2), 100–114. doi.org/10.1097/BTH.0000000000000419
Dye, J., Allyn, M., & Frank, C. (2024). Is there an immediate effect on pectoralis minor length after performing a prone scapular retraction exercise using typical sets and repetitions in pain-free participants? Journal of bodywork and movement therapies, 40, 1014–1019. doi.org/10.1016/j.jbmt.2024.07.026
Chankavee, N., Amatachaya, S., Hunsawong, T., Thaweewannakij, T., & Mato, L. (2023). Effects of modified long stick exercise on hyperkyphosis, muscle imbalance, and balance control in elderly community-dwelling women with hyperkyphosis. Journal of back and musculoskeletal rehabilitation, 36(5), 1151–1162. doi.org/10.3233/BMR-220350
Liao, Y. X., Saiken, A., Chang, X., Guo, Y. F., Tan, Z., Deng, F., Meng, Q. L., Zhen, H., Li, Y. M., & Fang, B. M. (2025). Associations of fat, bone, and muscle indices with disease severity in patients with obstructive sleep apnea-hypopnea syndrome. Sleep & breathing = Schlaf & Atmung, 29(1), 82. doi.org/10.1007/s11325-024-03241-8
Thongchote, K., Chinwaro, U., & Lapmanee, S. (2024). Effects of scapulothoracic exercises on chest mobility, respiratory muscle strength, and pulmonary function in male COPD patients with forward shoulder posture: A randomized controlled trial. F1000Research, 11, 1284. doi.org/10.12688/f1000research.126832.2
Can walking backward on a treadmill aid in treating conditions and injuries, improving strength, gait, and mobility in the lower extremities and knee, hip, and ankle range of motion (ROM)?
Walking Backward On A Treadmill
Walking backward is often used in physical therapy to treat multiple conditions and injuries and help improve strength, gait, balance, and mobility in the lower extremities. It is also used to improve knee, hip, and ankle range of motion and lower back pain and burn calories.
The Difference Backward vs. Forward
The difference from forward walking is that certain motions are normal gait characteristics.
First, the leg swings through the air, and the heel lands on the ground.
Then, the straight knee bends slightly as you roll from heel to toe.
As this occurs, the opposite leg rolls from the toes and up into the air.
This heel-to-toe motion repeats, and normal walking takes place.
Reverse walking creates the opposite gait process.
The leg swings through the air and reaches backward with a bent knee.
The toes contact the ground, and the bent knee straightens as you roll from toe to heel.
Then, the heel leaves the ground with the knee straight, repeating the process.
Reverse walking can help increase knee extension range of motion. (Zhang M. et al., 2022)
Individuals with knee injuries, surgeries, or arthritis may lose their knee extension or the knee’s ability to straighten.
The bent knee straightens fully when walking backward, moving from the toes onto the heel.
This helps to improve the range of motion into knee extension.
Quadriceps Function
Reverse walking can improve the function of the quadriceps muscles in the upper thighs. (Alghadir A. H. et al., 2019)
The quads are active when straightening the knee.
Exercises like quad sets, short arc quads, and straight leg raises increase quad strength.
Hamstring Flexibility
The hamstrings are located in the back of the upper thighs and work to bend the knees and extend the hips.
For individuals with tight hamstrings, a therapist may have you walk backward on the treadmill to improve the flexibility of the muscle group. (BBC, 2023)
When walking backward, the hamstring contracts to bend the knee as it swings through the air.
Then, the hamstring is stretched from the toe to heel movement, and the knee straightens.
Walking backward can help reset one’s gait and improve one’s ability to walk forward.
A study on stroke patients found that backward walking training was superior to standing balance training for improving balance and walking speed. (Rose, D. K. et al., 2018)
Burns Calories
Backward walking has been found to burn more calories than forward walking.
As a result, it improves heart and lung health better.
Conditions That Benefit
Individuals with a lower extremity impairment that results in loss of normal walking mobility may benefit from reverse walking. Common conditions that may help include: (BBC, 2023) (DelMastro H. M. et al., 2023)
Hamstring strain
Sciatica with tightness in hamstrings
Hip, knee or ankle surgery
Lower extremity fracture
Cerebral palsy
Multiple sclerosis
Parkinson’s disease
Stroke
A physical therapist will decide if an individual’s condition warrants reverse walking as part of a rehabilitation program.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Control Foot Motion and Posture
References
Cha, H. G., Kim, T. H., & Kim, M. K. (2016). Therapeutic efficacy of walking backward and forward on a slope in normal adults. Journal of Physical Therapy Science, 28(6), 1901–1903. doi.org/10.1589/jpts.28.1901
Zhang, M., Pang, J., Lu, J., Kang, M., Chen, B., Jones, R. K., Zhan, H., & Liu, A. (2022). The Immediate Effect of Backward Walking on External Knee Adduction Moment in Healthy Individuals. Journal of Healthcare Engineering, 2022, 4232990. doi.org/10.1155/2022/4232990
Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial). BMC musculoskeletal disorders, 20(1), 159. doi.org/10.1186/s12891-019-2537-9
Balasukumaran, T., Olivier, B., & Ntsiea, M. V. (2019). The effectiveness of backward walking as a treatment for people with gait impairments: a systematic review and meta-analysis. Clinical Rehabilitation, 33(2), 171–182. doi.org/10.1177/0269215518801430
Rose, D. K., DeMark, L., Fox, E. J., Clark, D. J., & Wludyka, P. (2018). A Backward Walking Training Program to Improve Balance and Mobility in Acute Stroke: A Pilot Randomized Controlled Trial. Journal of Neurologic Physical Therapy: JNPT, 42(1), 12–21. doi.org/10.1097/NPT.0000000000000210
Thomas, K. S., Hammond, M., & Magal, M. (2018). Graded forward and backward walking at a matched intensity on cardiorespiratory responses and postural control. Gait & posture, 65, 20–25. doi.org/10.1016/j.gaitpost.2018.06.168
DelMastro, H. M., Ruiz, J. A., Simaitis, L. B., Gromisch, E. S., Neto, L. O., Cohen, E. T., Wong, E., Krug, R. J., & Lo, A. C. (2023). Effect of Backward and Forward Walking on Lower Limb Strength, Balance, and Gait in Multiple Sclerosis: A Randomized Feasibility Trial. International journal of MS care, 25(2), 45–50. doi.org/10.7224/1537-2073.2022-010
Could older individuals who do not have symptoms of shoulder pain or loss of shoulder and arm function have a rotator cuff tear?
Rotator Cuff Tear Physical Therapy
A rotator cuff tear is a common injury to the four muscles and tendons surrounding and stabilizing the shoulder joint. Studies have shown that (Geary M. B., & Elfar J. C. 2015)
30% of those under the age of 70
70% of those over age 80 have a rotator cuff tear.
Physical therapy is often recommended as a first-line initial treatment for rotator cuff pain. In most cases, a rotator cuff tear will not need surgical treatment. Determining when surgery is necessary depends on several factors a patient can discuss with their healthcare provider.
Causes
Overuse and repetitive motions
Trauma (e.g., falls, collisions)
Age-related degeneration
Symptoms
Shoulder pain, especially with overhead or rotational movements
Weakness and difficulty raising the arm
Clicking or grinding sounds in the shoulder
Limited range of motion
Treatment
The goal of physical therapy for a rotator cuff tear is not necessarily to heal the torn tendon but to relieve pain and improve strength by reducing inflammation and restoring shoulder joint mechanics. This is achieved through physical therapy, ice application, anti-inflammatory treatments like medications, and cortisone injections.
Physical Therapy
The goal of physical therapy is to improve the function of the muscles that surround the shoulder. Physical therapy targets the smaller muscles around the shoulder that are commonly neglected. By strengthening these muscles, the treatment can help compensate for damaged tendons and improve the mechanics of the shoulder joint. A chiropractic physical therapy team will develop a personalized exercise program. Generally, rehabilitation will start with gentle range of motion exercises that can be accomplished using the arms to lift a mobility stick/wand overhead.
Shoulder Pulleys
These improve shoulder range of motion and flexibility.
Isometric Exercises
These exercises are for the rotator cuff muscles and may then be started.
This exercise can improve the contracting of the muscles around the shoulder and offer more support to the shoulder joint.
Scapular Stabilization Exercises
These can also be done to improve the muscles surrounding the shoulder blade’s function.
This can help improve how the shoulder joint, arm, and scapulae move together when using the arm.
Advanced Strengthening
Advanced exercises can be done with a dumbbell or resistance band.
Consult your healthcare provider or physical therapist before starting these or any other exercises for a rotator cuff tear. Doing exercises correctly prevents further pain, injury, or shoulder problems. Specific, focused exercises can help expedite and regain normal shoulder function.
Injury Medical Chiropractic and Functional Medicine Clinic
The prognosis for rotator cuff tears depends on the severity of the tear and the individual’s overall health. With proper treatment, most people can regain the full function of their shoulders. However, some may experience ongoing pain or limitations in severe cases. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Shoulder Pain Chiropractic Treatment
References
Geary, M. B., & Elfar, J. C. (2015). Rotator Cuff Tears in the Elderly Patients. Geriatric orthopaedic surgery & rehabilitation, 6(3), 220–224. doi.org/10.1177/2151458515583895
Should individuals wanting to engage in the exercise start with a warm-up and end with a cooldown to prepare the muscles for optimal performance and post-workout recovery?
Warming Up, Cooling Down
Warming up 5 to 10 minutes before exercise is beneficial for pumping blood to the muscles and preparing them for a run. Dynamic or active stretching and light aerobic activity are a few ways to warm up. This could be active stretching, such as walking lunges, brisk walking, or riding a stationary bike for a few minutes before running. However, individuals should avoid static stretches before running, as they can increase the risk of injury. The minimum length of time for an effective cooldown session is five minutes. Depending on the intensity of the workout, individuals may choose to extend that to 10 minutes.
Steps for a Running Warmup
Do five to 10 minutes of light aerobic exercise to loosen up muscles.
Walk briskly, march, jog slowly, or cycle on a stationary bike.
Don’t rush.
Perform dynamic stretches and movements during the warmup, including walking lunges, jumping jacks, or toe touches.
Begin the run with a slow jog and gradually increase speed.
Slow down if you run out of breath.
This is part of knowing how fast you should run; starting too fast is a common mistake.
Pay attention to posture and form.
Ensure you are using the best technique before speeding up.
Warm Up Benefits
When warming up, the blood vessels dilate. The increased blood flow primes the muscles with oxygen and prepares them to perform at their best. Blood flow also increases the temperature in the muscles for enhanced flexibility. Allowing the heart rate to increase gradually is beneficial, instead of going full max heart output by jumping full speed into the running. (The American Heart Association, 2024)
Properly Cooling Down
At the end of the run:
Cool down by walking or slowly jogging for five to 10 minutes.
Breathing and heart rate should gradually return to normal.
Drink water or an electrolyte-infused drink to rehydrate the body.
Benefits of a Cooldown
The cool-down keeps blood flowing throughout the body at a consistent level. Stopping immediately can cause light-headedness because heart rate and blood pressure can drop rapidly. Winding down slowly allows heart rate and blood pressure to fall gradually. The cooldown is also a good mental transition from the intensity and accomplishing the workout.
Before or After Stretching
Stretching evidence shows it doesn’t have the benefits once thought. Static stretching before, during, or after exercise has not been shown to prevent injury or delayed onset muscle soreness. (Herbert R. D., de Noronha M., & Kamper S. J. 2011) Stretching cold muscles is not recommended. However, there is some evidence that dynamic or active stretching after a warmup can benefit performance. Active stretching is done with exercises that take the muscles through their full range of motion and mimic the actions that will be done during the workout. (Van Hooren B., & Peake J. M. 2018)
Stretching After Running
Standard stretching includes the hamstring stretch, quad stretch, calf stretch, low lunge stretch, IT band stretch, butterfly stretch, hip and backstretch, arms and abs stretch, and triceps stretch. Tips for proper stretching:
Don’t Bounce
Avoid bouncing, as this mimics pulling a rubber band back and forth. You want the muscle to stay stretched.
Hold the stretch for 15 to 30 seconds.
Don’t Stretch Through Pain
Don’t stretch beyond the point where tightness is felt in the muscle.
Do not push through muscle resistance.
Never stretch to the point of pain.
Stretch Whole Body
Don’t just stretch the areas with tightness and/or soreness.
Stretch the whole body equally to prevent injury.
Don’t Hold Your Breath
Take deep breaths during the stretch.
Stay relaxed and breathe in and out slowly.
If starting a new fitness routine, consult your healthcare provider to determine the optimal running warmups and stretching exercises.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Herbert, R. D., de Noronha, M., & Kamper, S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane database of systematic reviews, (7), CD004577. doi.org/10.1002/14651858.CD004577.pub3
Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. doi.org/10.1007/s40279-018-0916-2
Can individuals incorporate these simple but effective exercise routines to reduce pain and discomfort in their spine and back?
Why It’s Important To Keep The Back Mobile
When many individuals are dealing with back pain from their upper, middle, and lower portions, it can put a halt to a person’s routine. When back pain becomes present, it causes the person to find a comfortable place like a couch or a bed and lie down. However, this can cause more issues than the original one, affecting the individual. Back pain is a common worldwide problem and is the leading issue of disability associated with a high socio-economic cost. (Chou, 2021) Additionally, when a person is dealing with back pain, they are also dealing with degenerative issues that are also affecting their spines, thus causing problems to their joints, discs, and bones. (Hauser et al., 2022) This is because back pain is a multifactorial musculoskeletal disorder that can cause referred pain to different body locations. So when a person dealing with back pain rests, it can become an issue as inflammation builds up and swelling in the affected areas. Hence, many doctors, chiropractors, physical therapists, and spine specialists recommend keeping mobile to allow blood flow and the body’s natural healing response to reduce pain and speed up recovery. Since back pain relief is challenging through visceral-somatic disturbances, it is important to find various treatment options to aid the person’s specific condition. As a person goes to get treatment for their back pain, it is important to note that the causes of their back pain can help determine which exercises can be most effective within their treatment plan. We associate with certified medical providers who inform our patients of the benefits of incorporating simple but effective exercises for their back pain. While asking important questions to our associated medical providers, we advise patients to integrate an exercise routine to reduce the chances of environmental factors causing back pain to return. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
Understanding Academic Low Back Pain- Video
Effective But Simple Exercises For The Back
Many people often wonder, “If I am dealing with back pain, why should I exercise to reduce this pain?” The answer is simple: since the affected back muscles are tight and weakened, simple but effective exercises can help recover. Exercise therapy can help increase muscle-joint strength in the body while improving muscle function and increasing range of motion. This boosts a speedy recovery and allows the individual to return to their usual activities. (Hayden et al., 2021) At the same time, with a customized treatment plan, exercise therapy can incorporate other non-surgical treatments with one goal: to restore normal musculoskeletal function and reduce the pain caused by environmental factors, diseases, or injuries. (Karlsson et al., 2020) Now, depending on the severity of the back pain, there are simple but effective exercises below to help reduce the pain and restore mobility to the back.
Physical Therapy & At-Home Workouts
Physical therapy and at-home exercises can help many individuals with back pain. They can help figure out which position can help centralize the pain and correct any restricted motions. Many physical therapists incorporate the McKenzie method to strengthen and support the spine while decreasing pain and inflammation. At-home exercises can be combined with a series designed to be practical, assessable, and feasible for therapeutic gain or even to improve physical capacity to maximum effort. (Quentin et al., 2021)
Water Exercises
Water exercises are amazing exercises that can help lessen the body’s weight to take pressure and stress off the spine. This is because water is supposed to help cleanse and rejuvenate the body. When individuals are experiencing chronic back pain, aquatic physical therapy can help relieve pain intensity, relax the aching muscles, and even promote a positive workout experience for the individual. (Ma et al., 2022) After a few consecutive sessions, many individuals can see improvement in pain intensity and restored mobility function in their routines.
Tai Chi & Stabalizing Exercises
Now, another simple and effective exercise routine can help stabilize the surrounding muscles in the back and spine and become effective as part of a health and well-being routine. Tai chi and Qigong practices can help the individual emphasize stillness and controlled movements to promote calmness, resilience, body awareness, and relaxation for proper body alignment. (Yang et al., 2024) Tai chi and Qigong can also help support immune function in the body while regulating inflammation, which can help reduce and prevent diseases. (Oh et al., 2020) At the same time, yoga can help improve flexibility, mobility, and stability within the muscles and joints while also improving spinal alignment, which can help many individuals have proper posture. (Zhu et al., 2020) Depending on which exercise a person prefers for their treatment plan and to reduce their back pain; it is important to make these small changes to achieve optimal results. Making these small changes can help many individuals reduce the chances of their back pain returning and help them along with their health and wellness journey.
Hauser, R. A., Matias, D., Woznica, D., Rawlings, B., & Woldin, B. A. (2022). Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil, 35(4), 701-712. doi.org/10.3233/BMR-210097
Hayden, J. A., Ellis, J., Ogilvie, R., Malmivaara, A., & van Tulder, M. W. (2021). Exercise therapy for chronic low back pain. Cochrane Database Syst Rev, 9(9), CD009790. doi.org/10.1002/14651858.CD009790.pub2
Karlsson, M., Bergenheim, A., Larsson, M. E. H., Nordeman, L., van Tulder, M., & Bernhardsson, S. (2020). Effects of exercise therapy in patients with acute low back pain: a systematic review of systematic reviews. Syst Rev, 9(1), 182. doi.org/10.1186/s13643-020-01412-8
Ma, J., Zhang, T., He, Y., Li, X., Chen, H., & Zhao, Q. (2022). Effect of aquatic physical therapy on chronic low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord, 23(1), 1050. doi.org/10.1186/s12891-022-05981-8
Oh, B., Bae, K., Lamoury, G., Eade, T., Boyle, F., Corless, B., Clarke, S., Yeung, A., Rosenthal, D., Schapira, L., & Back, M. (2020). The Effects of Tai Chi and Qigong on Immune Responses: A Systematic Review and Meta-Analysis. Medicines (Basel), 7(7). doi.org/10.3390/medicines7070039
Quentin, C., Bagheri, R., Ugbolue, U. C., Coudeyre, E., Pelissier, C., Descatha, A., Menini, T., Bouillon-Minois, J. B., & Dutheil, F. (2021). Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health, 18(16). doi.org/10.3390/ijerph18168430
Yang, Y., McCluskey, S., Bydon, M., Singh, J. R., Sheeler, R. D., Nathani, K. R., Krieger, A. C., Mehta, N. D., Weaver, J., Jia, L., DeCelle, S., Schlagal, R. C., Ayar, J., Abduljawad, S., Stovitz, S. D., Ganesh, R., Verkuilen, J., Knapp, K. A., Yang, L., & Hartl, R. (2024). A Tai chi and qigong mind-body program for low back pain: A virtually delivered randomized control trial. N Am Spine Soc J, 20, 100557. doi.org/10.1016/j.xnsj.2024.100557
Zhu, F., Zhang, M., Wang, D., Hong, Q., Zeng, C., & Chen, W. (2020). Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 15(9), e0238544. doi.org/10.1371/journal.pone.0238544
Can performing the hip hinge exercise movement help individuals with lower back pain?
Hip Hinge Exercise
A hip hinge is a controlled movement that involves bending forward from the hips while keeping the spine neutral. The thoracic, lumbar, and pelvis stay neutral while bending forward. The movement comes from the hips, preventing the thoracic and lumbar spine from flexing or rounding. It is a fundamental movement that helps prevent back injuries and strengthens the glutes. It’s used in everyday activities, like picking up objects and sitting down.
The hip hinge exercise targets the posterior chain or back muscles, including the lower back, the glutes, and the hamstrings. It also strengthens the core or abdominal muscles to assist in the movement. When the body hinges at the hips, the bend occurs at the hips, and the spine stays neutral. When the lower back hinges or bends, this causes pain and reduces the range of motion.
Performing the Movement
A wooden dowel, broom handle, or PVC pipe can be used as a guide to help achieve the proper positioning and learn the correct form. Place the dowel or pipe vertically on your back, anchoring it to the head, shoulder blades, and tailbone.
Grasp one end with your right hand in the natural curve of your neck and the other with your left hand in the small of your back. Ensure the dowel touches the back of your head, upper back, and the area where the lower back meets the sacrum. To perform the hip hinge:
Stand with your feet shoulder-width apart
Shift your weight to your heels and
Push your hips back while hinging your torso forward
Keep your chest open and back flat
Slightly bend your knees
Visualize sticking the butt out
The dowel should not lose contact with the three points as you hinge. If it does, the movement is incorrect.
Lower your torso until it’s midway between vertical and parallel to the floor.
Pause when your torso is about 45 degrees
Keep a slight bend in your knees during the downward and upward phases.
Reverse the movement by contracting your glutes and pushing your hips forward and upward to return to the starting position.
Repeat
Benefits
The hip hinge is a fundamental movement pattern that helps the body perform essential tasks such as bending over and picking things up without worry of pain or injury. It’s also required in strength training exercises like the deadlift, kettlebell swing, power clean, and more. The exercise can help strengthen the core, reduce back pain, improve balance, and improve flexion, extension, and trunk rotation. (Michaud F. et al., 2021) Stronger core muscles can increase fitness and athletic performance. (Clark D. R. et al., 2018)
Variations
It is a challenging movement that requires plenty of practice. Individuals who can’t perform it correctly after a few tries may need to modify the movement.
Wall Variation
Using a wall as a guide is an easy way to make the movement easier.
To do this, stand with your back to a wall, about three inches away.
Start hinging at the hips by sticking your butt out touching the wall.
Keep a neutral spine and a flat back.
Once you can do this several times, try stepping out another inch or two and perform the same modified motion. Stick with this until you are away from the wall and can do a full hinge without the wall.
With A Kettlebell
Once you master the basic hinge, you can elevate it using a kettlebell to make this move more difficult.
Start with the kettlebell swing exercise and progress to more challenging moves with the kettlebell.
Common Mistakes
Be aware of common mistakes to keep the move effective and reduce the risk of injury.
Treating the Move Like a Squat
The hip hinge is not the same as a squat.
This is a common misconception. When squatting, the knee joint determines the movement pattern.
But when hip hinging, the movement starts at the hips.
Not Engaging the Core Muscles
This exercise requires core engagement throughout the entire movement.
If these muscles relax, there is an increased risk of dipping the hips during the hinge, which can cause the lower back to dip and cause pain.
Using the Lower Back
Bending or hinging with the lower back rather than letting the hips generate the movement.
Using the wall as a guide can help reduce and eliminate excessive bending at the waist.
Lost Dowel Contact
If the dowel loses contact with one or more set-up positions on the back, the hinge is not being executed correctly.
If your head loses contact with the dowel, the neck is flexing too far forward.
If you lose contact with the sacrum or lower back area, the spine is flexing too much.
If you lose contact with the mid-back, the knees are bending rather than the hips.
Safety
Stop and check your form if you feel back pain during any part of the movement. The movement may need to be modified further or decrease how far the hinge is at the hips. If the pain continues, discontinue the exercise and talk with a doctor or a physical therapist before reattempting the exercise. The dowel is a great tool to help maintain a neutral spine. If you cannot perform the hip hinge while keeping the dowel in contact with the body, you might benefit from working with a personal trainer or physical therapist who can walk you through the steps with the correct form.
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Chiropractic: The Secret to Unlocking Mobility
References
Michaud, F., Pérez Soto, M., Lugrís, U., & Cuadrado, J. (2021). Lower Back Injury Prevention and Sensitization of Hip Hinge with Neutral Spine Using Wearable Sensors during Lifting Exercises. Sensors (Basel, Switzerland), 21(16), 5487. doi.org/10.3390/s21165487
Clark, D. R., Lambert, M. I., & Hunter, A. M. (2018). Contemporary perspectives of core stability training for dynamic athletic performance: a survey of athletes, coaches, sports science and sports medicine practitioners. Sports medicine – open, 4(1), 32. doi.org/10.1186/s40798-018-0150-3
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