As Osteopaths, we regularly see people to help with the management of their back pain and spinal related annoyances such as stiffness and decreased range of motion. Since lockdowns started, we have collectively all been seeing much more back pain and stiffness related to immobility.
Within the clinic, there are many treatment styles that we use as part of our treatment including massage, dry needling, muscle and joint stretching as well as adjustments of the spine just to name a few. However as part of your ongoing management, or if you are unable to come to the clinic, we have put together a list of exercises that you can do at home to help alleviate and control your pain. Please remember there are lots of modifications that you can put in place that can make such a big difference. These can include postural changes with working from home, setting timers and reminders to get up and move, having more outdoor time, increasing your exercise, better lifting strategies, strengthening exercises for your back, glutes and core as well as stretches. In this article we have listed our top 10 stretches for back pain and stiffness that we regularly recommend as part of our management programs (we also do a lot of these ourselves!).
Please remember to ask us at your next appointment or feel free to give us a call to make sure these are safe for you to do, especially if you have or had back pain previously as we may need to tailor them individually for you. And most importantly, never force a stretch or exercise, and stop if there is any pain.
Thoracic Rotation Stretch
We regularly recommend stretches to the thoracic spine to help encourage range of motion in all of the spinal areas as well as to open up the chest and help with posture. The thoracic spine commonly becomes stiff due to our uniplanar motion with our lifestyles, especially in desk workers and the like. This is a great exercise that you can do at work or home, with or without equipment.
Start standing with your feet hip width apart. If you have a dowel, broomstick, golf club etc place it behind the back of your neck. Rotate the upper torso side to side, allowing the heel of the foot that you are going away from to lift slightly to allow you to move further, then go to the opposite side. Repeat this exercise for approximately 30 seconds.
Sidebending stretch (or QL stretch)
Side stretches are fantastic to allow for more sidebending and rotation in the spine.
Begin standing, placing your right leg behind your left. Bring your right arm up overhead and lean to the left side. You should feel a light stretch through the right flank region. After 30 seconds, direct your arm forwards and twist your trunk slightly to the left. This will allow you to feel a deeper stretch into the back. Repeat this sequence on the other side. This stretch can be repeated multiple times per side.
Knees to chest (with rotation variation)
This is aimed to stretch your spine into flexion to help alleviate stiffness and muscle tightness.
Start on your back with your knees bent. Begin with hugging one knee towards your chest. If this is comfortable and somewhat easy, repeat with both begs at the same time. This can be performed as a held stretch for 30 seconds, or more of an articulation exercise where you bring your knees to your chest, then come in and out of the stretch approximately 10 times.
Variation- If this is quite comfortable, have your knees bent and allow them to rock from side to side. It is ok if you allow the pelvis and back to lift. To feel a strong stretch, allow them to fall all the way over allowing the buttocks and pelvis to rotate also. You can stay in this position and take a few deep breaths in and out to encourage the stretch deeper again. As a held stretch hold for 30 seconds and repeat 3 times on each side, or until a release is felt.
Cat & Camel
This is a great exercise to promote mobility through the mid and lower back. It also creates activation through your core and pelvic floor as well as shoulder stabilizers.
Start on your hands and knees, with knees under hips and hands under shoulders.
Keeping the shoulders relaxed, push your hands into the mat, allowing the spine to lift towards the ceiling- arching up. Gently return to neutral. Then lower, inverting the Thoracic spine creating an arch in the back, feeling a stretch through the shoulder blades. Return to neutral. Only move in a range that is pain free and if you notice any pain during the exercise make sure you decrease the range and stick with what feels like a comfortable stretch. Complete this 10-15 times.
Child’s Pose
Child’s pose is great to encourage flexion and traction through your lower back. As Osteopaths we use techniques to encourage this motion all of the time as it can be extremely relieving for pain and compression.
Begin on your hands and knees with your knees slightly wider than your hips. Slowly reach your arms forwards while sitting back towards your heels. Once you are as close to the floor as comfortable see if you can reach a little further while dropping your head. Hold the stretch for 30 seconds before coming back onto your hands and knees. Repeat 5-6 times.
Once completed, thread one arm under the opposite side of the torso and through. This allows the upper body to rotate. Rest the arm on the floor and breathe. You should feel a nice gentle stretch through the body.
Glute Stretches x 2 plus Piriformis
Glute stretches are necessary to help bring the gluteal muscle to a better resting length position so they are then able to work to help support the lower back. The glute muscles can become tight for a variety of reasons such as overuse with exercise or spasm from protecting an injury.
To start this stretch lay on your back. Slowly bring one knee up towards the opposite shoulder with the knee bent. Hold for 30 seconds. If there is any pinching in the front of the hip try and change the angle to relieve it. Once completed, direct the knee down and across slightly and repeat these variations 2-3 times. This ensures that you are stretching the whole glute complex and not just one of the muscles.
To get a deeper stretch in the piriformis, bend one leg and place the ankle on the top of the opposite knee, allowing the hip to open out. Then place your hands behind the leg that has the ankle resting and pull it towards your chest. You should feel a deep stretch through the hip that has the ankle resting. Hold for 30 seconds and repeat on both sides.
These stretches can be completed multiple times on each side, multiple times per day if wanted.
Prone extension
This is designed to create more movement into spinal extension (bending backwards) and to help stretch through the chest. It is great for desk workers, teachers and people that spend a lot of time bending or slumping forwards.
Lay on your stomach with your legs straight. Bend your arms, placing your hands underneath your shoulders. Draw your stomach into your spine and slowly press through the hands, bringing back your head, neck and shoulders to feel a back stretch. Slowly return down, focusing on moving one segment of your spine at a time. Repeat 10 times.
Quadricep/Hip flexor stretch
Your quadricep and hip flexors attach to the front part of your lower back and when tight can pull the back and cause pain. They can also get overly tight with prolonged sitting and aggravation with exercises. You will be surprised how much stretching these muscles can help relieve tension in your lower back!
Quadricep stretch- lay on your side. Bend one knee, directing your heel to your buttocks region. You should feel a light stretch through the front of the thigh. Hold for 30 seconds and repeat on the opposite side.
Hip flexor stretch- Start in a kneeling lunge position. Slowly shift your body weight onto your front leg. This will allow you to feel a stretch through the back thigh and hip flexor. Hold for 30 seconds and repeat on the opposite side. If this felt quite comfortable for you then take a hand and place it on your ankle. Gently pull the lower leg towards your buttocks, which should create a stronger stretch through the front of the thigh.
Hamstring Stretch
Your hamstring muscle attaches up around your ischial tuberosity (your bum bone) and tightness can pull the pelvis downwards, creating pressure on the back and glute muscles. Tight hamstrings can also cause biomechanical pressures on other regions to allow you to get the movements that you require in everyday life. They can also become extremely tight with prolonged sitting!
This stretch can be performed sitting or standing. If standing, place one leg on something elevated at approximately knee height. Make a small bend in the knee, have your toes facing up to the ceiling and stand up tall. Slowly tip forwards from the hip (you don’t need to lean and reach your toes). You should feel a stretch down the back of the leg and hold for 30 seconds. Return to standing, rotate the hip so the toes are pointing inwards and repeat the stretch. Return to standing and rotate the hip so toes are outwards and repeat. This stretch can be repeated multiple times on each side.
Bridging
This is great for strengthening your glutes, legs and back while feeling a stretch of your spine into flexion and extension. You may also feel a stretch through the fronts of the thighs at the top of the bridge.
Lie on your back with your arms straight, knees bent and feet on the floor. By pushing through the heels, slowly peel up your sacrum and lower back, one segment at a time until you are resting on your shoulder blades. Then slowly curl back down from the upper back and return to the start position.
We hope you find this list beneficial the next time you are stiff or experiencing back pain or just to incorporate into your regular stretching routine. Please remember to ask us if you have any questions about these at your next appointment.