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Kapandji described the role of the spinal column as providing rigid support of the trunk on the pelvis, while allowing freedom of motion during a tremendous variety of movements and positions. He made the comparison between the spinal column and the mast of a ship which draws stability from the hull, while providing support for the rigging of the sails which in turn impart motion to the ship. In a similar fashion, the spine relies on the supporting structures of the trunk (muscles, ligaments, disks, and spinal joints) for stability, while accommodating movements of the head, arms, and legs. When all these elements of movement and support are functioning in a coordinated manner the spine will be able to maintain an ideal alignment throughout the day. An individual in ideal alignment has the best capability to deal with the wear and tear of everyday life without suffering injury to the spine. The exercises depicted below are utilized by our physical therapists to assist some individuals who enters our spine center to restore and maintain optimal spinal health and overall wellness.Flexibility of the neck, legs and back is instrumental to good spinal health. Stretches held for 30 seconds and performed 2-3 times over the course of the day can help improve flexibility. The levator scapulae and upper trapezius muscles are often tight in people whose work involves long hours on the computer or telephone. You can stretch these muscles and help alleviate tension while sitting at your workstation.
Spending time sitting in a slouched posture causes some of the muscles in the front of the neck to become weak and some of the muscles in the back of the neck to become tight. Tucking the chin in towards the throat while keeping the jaw relaxed can help improve muscle balance in the neck. This exercise can be performed either lying on your back or sitting up. We recommend starting with a 10-second hold and working your way up to 10 repetitions.
Leg Stretch – Calf | Leg Stretch - Hamstrings with Knee Bent | Leg Stretch – Piriformis
- Calf Stretch
Stand with one foot in front and one foot in back. Place your hands on something secure, like a table or wall. Make sure the toes of the back foot are facing straight ahead, not turned out to the side. Keep the heel of the back foot touching the floor and the back knee straight. Lean forward slightly, allowing the front knee to bend. Feel a stretch in the calf of the back leg. - Hamstrings Stretch
Lie on your back. Bring one knee close to your chest, wrapping your hands around the back of the thigh. Keeping the thigh close to you, slowly straighten the knee a bit, feeling a stretch in the back of the thigh. - Piriformis Stretch
Lie on your back. Bend one leg, placing the foot flat on the table. Cross the opposite ankle over the knee. Lift the flat foot off the table, using your hands wrapped around the thigh of this leg to help you. Feel a stretch in the buttock of the crossed leg.
The muscles in the back of the legs, such as the calves, hamstrings and piriformis are often tight. Flexibility of these muscles is instrumental to good spinal health. Some of the stretches can be performed while standing, while others are accomplished more safely while lying down.
Back Stretch - Lumbar Extension in Prone Prop | Back Stretch - Lumbar Extension in Prone Press Up | Back Stretch - Spinal Rotation
- Lumbar Extension in Prone Prop
Lie on your stomach. Prop yourself up on your forearms, with your elbows directly beneath your shoulders. Let your arms support you and let your back and stomach relax and sink towards the floor.
Note: Do not maintain this position if you feel increased symptoms further down your buttock or leg. - Lumbar Extension in Prone Press Up
If you tolerate the prone prop position described in the previous exercise, and find that your back, buttock, or leg symptoms improve, you may want to try prone press up.
Lie on your stomach with your hands by your shoulders. Use your hands to press up until your elbows are straight. Let your arms support you and let your back and stomach relax and sink towards the floor. If you are unable to straighten your arms, try starting with your hands a bit further away from you, instead of directly under your shoulders.
Note: Do not maintain this position if you feel increased symptoms further down your buttock or leg. - Spinal Rotation Stretch
Lie on your back with your knees bent, your feet flat, and your arms outstretched in a T position. Keeping the inside of your legs touching each other, let your knees gently fall out to the side. Feel a stretch in your back.
Note: Starting with your knees bent more will move the stretch higher up your back.
Having good spinal mobility is important.
Many patients find it helpful to reverse the flexed posture of the spine associated with sitting and bending. This exercise helps by relieving tension on the disks in the lumbar region of the spine. Some individuals benefit from increasing rotation of the spine as well.
Slumped Spine - Lumbar Flexion | Arched Spine - Lumbar Extension | Neutral Spine
- Neutral Spine
Sit at the very front of your chair, with your feet resting flat on the floor. Notice the contact that your pelvis makes with the seat. You may feel two bones on either side of your buttocks where most of the weight is distributed. In anatomical jargon, these bones are called your ischial tuberosities, but for simplicity, we often call them the sits bones. Slowly slump, letting your back round and your pelvis rock back towards your tail. Now slowly arch your back, sticking out your tummy. Continue moving back and forth slowly between a slump and an arch, feeling the full range of your lower spinal mobility. As you continue moving between these ends of your range of motion, begin to make each movement a little smaller. Making the movement smaller each time you do it, eventually you will come to a stop. This is your neutral spine position. In this position, you should feel the weight of your body resting comfortably on your sits bones and minimal to no pain in your back.
Learning proper neutral spinal alignment is also important.Neutral spinal alignment is a place somewhere between the extremes of your available motion where there is the least amount of strain on your spinal structures.This position should be comfortable and pain-free. Developing your awareness of what positions, movements or activities aggravate your symptoms, and noticing when you may be arching or slumping can help you refine you ability to attain a neutral spine.
Spinal Stabilization – Marching | Spinal Stabilization – Bridging | Spinal Stabilization - Bridging with Leg Lift
- Marching
Lie on your back with your knees bent and your feet flat. Find your neutral spine. You can find instructions for finding neutral spine in the lumbar spine stabilization videos. Next, engage your abdominal muscles by: 1) pulling up the muscles of the pelvic floor (these are the muscles that stop the flow of pee when you are urinating), 2) drawing in your navel and lower abdomen, and 3) bracing your abdomen gently, as if preparing to protect yourself from a punch in the tummy. Slowly lift one foot off the table, into the air. Keep your pelvis and back stable and your breath moving easily. Replace the foot on to the table, and repeat on the other side. - Bridging
Lie on your back with your knees bent and your feet flat. Find your neutral spine, engage your abdominal muscles and tighten your buttocks. Slowly lift your pelvis off the table. Lower your pelvis, returning to the starting position. - Bridging with Leg Lift
Lie on your back with your knees bent and your feet flat. Find your neutral spine, engage your abdominal muscles and tighten your buttocks. Slowly lift your pelvis off the table. Keeping your pelvis level, lift one foot a few inches off the table do not let your hip drop towards the table. Replace your foot. Repeat on the other side, lifting and replacing your foot. Lower your pelvis.
Lumbar stabilization exercises are designed to teach you how to build a dynamic corset, using your trunk muscles to support your spine in neutral alignment even while you are moving.
