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4 Exercises to Increase Low Back Strength | Image Courtesy of Anupam Mahaptra via Unsplash
4 Exercises to Increase Low Back Strength | Image Courtesy of Anupam Mahaptra via Unsplash

4 Exercises to Increase Low Back Strength

Julia Connolly, PT, DPT

Rest does not always = recovery. Strengthening the muscles of your lower back to increase low back strength, gain coordination, and increase aerobic endurance will improve your capacity to move throughout your day. Globally, low back pain is the leading cause for years lived with disability.1  Getting your body moving with better biomechanical strategies, and staying active are important ways to maintain your level of function.

Too much rest can deplete strength and cardiovascular fitness over time which may lead to more discomfort down the line. Finding the sweet spot where you are exercising vigorously enough to build muscles without straining or causing pain can be achieved with the guidance of a physical therapist. Increasing low back strength can help prevent injury, rehabilitate a current low back pain, and keep you moving without impedance in a more enduring way. The following 5 exercises are gentle movements to increase low back strength at home with minimal equipment required. 

Exercises to Increase Low Back Strength at Home: 

  

1. Bird dog

  1. The bird dog is performed on hands and knees with hands directly underneath shoulders and knees underneath hips in 90 degrees. You will raise the opposite arm and leg straight out while using your core to balance - hold 1 second at the top at a leg height that does not cause your spine to overly curve at your neck or low back. Then, gently lower in a controlled manner. Begin with a big diaphragmatic belly breath at rest, and as you begin to raise the right arm and left leg, exhale while drawing your belly button toward your spine to brace your core throughout the movement of the leg and arm. Inhale and relax when the arm and leg return to the floor. 
  2. This exercise conditions your deep, stabilizing abdominal muscle transversus abdominis when performed correctly. This muscle that attaches to your spine, pelvis, and rib cage holds your body stable against the perturbing forces of moving limbs in space as you perform the exercise. Your natural weightlifters’ belt is your transversus abdominis, and the cue to “draw the belly button in” is a good way to activate it without relying on superficial muscles that usually over-activate. The challenge lies with coordinating this deep core muscle with the breath throughout the movement to hold you steady.

 

2. Pallof Press

  1. The pallof press can be performed with a cable column or an exercise band secured in a doorway with a knot at the end. Begin facing perpendicular to the pull of the band or cable with your hands clasped around the handle at the level of the belly button. Inhale with a big belly breath, and exhale as you hold your spine in neutral and slowly punch the hands forward in a straight line in front of you, then back again.
  2. As you bring your hands further away from your belly button, this increases the rotational torque force on your spine, and the muscles of your core and low back work to maintain your spine, shoulders, and pelvis in a stable neutral position. Notice that the further the hands get from the belly button, the harder you have to work to keep your form. This works the muscles that control rotational forces that go through the body throughout the day.

 

3. Farmer’s carry

  1.  Begin with a kettlebell or dumbbell of a moderate weight comfortably in 1 hand. The weight should be high enough that it feels like work to keep your body upright, but not heavy for the strength of your hand grip (which tends to be a common limiting factor). Walk 10 steps forward and work to maintain your spine and ribcage upright as you weight shift with each stop. Hold the deep core activation described above, and breathe as you walk back and forth. Repeat 3x.
    1. Make sure to maintain your carrying shoulder level with the opposite, and prevent the scapula from being pulled downward with an active shoulder. 
  2. If you’ve ever been to a physical therapy appointment or ran into a DPT at a party and asked them for advice about your chronic shoulder injury, you know that physical therapy is all about achieving optimal function. Someone can give the fanciest and most challenging exercise, but I believe the best are the ones that look like the movements your body is required to go through every day. The farmer’s carry mimics the movement of carrying groceries, a heavy backpack on one shoulder, a laundry basket, and the shopping bag full of items to bring home after the errand run. This movement works the muscle stated above, in addition to a major bilateral and unilateral stabilizer of the trunk on pelvis – quadratus lumborum. This can be performed with weights in both hands as well. If you do not have access to equipment, using a bag with a handle and filling it with various items like shampoo bottles or jars of food are a good substitute. (we all learned how to improvise during the pandemic, right?).

 

4. Romanian Deadlift 

  1. Start in tall standing with your feet hips width apart. Lean forward into an L shape with your knees slightly bent and shift your hips backward until you feel your hamstrings get a stretch (this will be a different depth for everyone depending on your hip flexibility). Brace your core while you inhale on the way down, and exhale on the way up squeezing your glute muscle until you are in a full stand.. This works the stabilization strength of your lumbar spine since it is working in an isometric contraction to hold your trunk still while you move dynamically up and down.
    1. This can be regressed if it is too hard by starting on your knees in a tall kneel instead without weight.
    2. Make sure you are preventing your ribs from flaring outward and avoiding over- extending your low back into too much curvature. Maintain the exercise in a pain free- range and stop when form is compromised.
  2. Lumbar extension gets a bad rep in the exercise world. There is a lot of commentary on what the best form is while using harsh language to fear monger people into believing the way they exercise is causing pain, and preaching what they think is the best squat form and posture for your back. However, your low back extensors are postural muscles that need the strength to work all day long. There is a natural curve in your low back that helps your spine absorb shock as you take steps throughout the day, like a built-in spring in your anatomy. These muscles, like all other skeletal muscles, can get weak and tight, building up metabolites and getting sore, possibly compromising optimal blood flow to the area and causing pain. Training these muscles to have the endurance, strength, and coordination will improve their ability to work with you throughout your day. This may substantially help increase low back strength and subsequently ease low back pain. 

Not all back pain is created equal.  Often times, exercises to increase low back strength can increase aerobic endurance, gain stability, and help ease low back pain. See a licensed doctor of physical therapy to determine what exercises are right for you!  Contact us to find a physical therapist right for you.

References:

  1. Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, Smith E, Buchbinder R, Hoy D. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020 Mar;8(6):299. doi: 10.21037/atm.2020.02.175. PMID: 32355743; PMCID: PMC7186678.

Julia Connolly PT, DPT

Doctor of Physical Therapy

Specializing in Women's Health, Pelvic Floor, Orthopedic Rehabilitation

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Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

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Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
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Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

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Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

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Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

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