The Best Ab Exercises for Low Back Pain
Dr Matisse Perks ChiropractorYour best ab workout at home – that won’t hurt your back!
Approaching an ab workout doesn’t have to make you nervous about experiencing low back pain. In fact, exercise therapy is recommended by many clinical guidelines for the treatment of low back pain, including a 2018 bulletin from the World Health Organisation.
The following exercises are specifically selected as our recommended best ab exercises for low back pain:
Abdominal breathing (Simple)
Stabilising the abdominal muscles is a challenge without proper breathing mechanics. By mastering this simple, low impact exercise, you can better control your diaphragm, abdominal muscles, and pelvic floor. Incorporating this breathing technique may allow you to perform other exercises with more control and less pain.
Starting position
- Lying on back, knees bent to 90 degrees with feet flat on floor.
- One hand on chest, one hand on belly.
Movement
- Breath in with the belly rising and out while the belly falls – keeping the chest still.
Abdominal breathing (90/90)
This simple exercise, adapted from the “Prague School” of Rehabilitation and Manual Medicine, is a progression from the previous abdominal breathing exercise. Ensure you are comfortable with abdominal breathing before starting this next step. With a little perseverance, this exercise forms a great foundation creating a strong abdominal region with more evenly distributed loads – great for those with strained and overactive lower backs!
Starting position
- Lying on back with feet supported on a chair, knees and hips at 90-degree angles.
Movement
- Abdominal breathing – belly rises during breath in and falls during breath out.
- Engage lower abdominal and pelvic floor muscles (hands may put pressure on lower abdominal muscles to help activate)
- Keep the breath into the belly – USE the breath to breathe and expand belly like a BEACHBALL (into floor as well as front)
- To progress from this exercise, try maintaining good breathing mechanics while slightly lifting the feet off the chair. You only need to lift up a centimetre or so to feel the added load on the abdominal muscles.
Avoid
- Arching the back
- Recruiting the chest when adding the lower abdominal muscles into the breath.
Supine dead bug
Starting position
- Lying on back with knees and hips raised to 90-degree angles.
- Maintain 90/90 breathing position foundations during movement
Movement
- While maintaining breathing position, straighten the right leg towards the floor with the left arm extending overhead.
- Continue straightening limbs until core is unable to maintain neutral position.
- Slow and controlled, return to neutral dead bug position
- Repeat with other side.
Avoid
- Allowing the back to arch to achieve full movement
- Breathing through the chest
Side plank
Starting position
- Side lying, knees at 90 degrees with knees, hips and shoulders in a straight line.
- Bottom arm with elbow on the floor underneath the shoulder and hand resting palm side down out in front.
- Top arm resting alongside body.
Movement
- Slowly lift hips up towards the ceiling. Slowly lower down and repeat.
- Control the movement and ensure the hips achieve a straight line in relation to the knees and shoulders.
- To advance the exercise, repeat with legs straight in line with the top leg slightly out in front of the lower leg. Lift from the ankles.
Avoid
- Keeping the hips curved when lifting up.
- Rolling forward or backwards.
- Putting unnecessary load or strain through the back or supporting arms and legs.
Side bridge with roll
Starting position
- Side lying, legs out straight in line with knees, hips and shoulders. The top leg should place the foot slightly in front of the lower leg, so each side of the foot is in contact with the ground.
- Bottom arm with elbow on the floor underneath the shoulder and hand resting palm side down out in front.
- Top arm resting alongside body.
Movement
- Slowly lift hips towards the ceiling, maintaining straight line through body.
- Maintaining this lifted position, slowly roll forward and lower the top arm towards the floor, into a plank position.
- Allow the shoulders, hips and feet to roll at the same time.
Avoid
- Twisting the body so the arms and shoulders reach the floor before the hips and feet.
Stuart McGill – ‘Sit Up’
Dr. Stuart McGill is a professor and researcher who has studied low back pain for over 30 years. As a published academic author with hundreds of peer-reviewed articles, he promotes this exercise as one of his three best ab exercises for low back pain – often referred to as “the McGill Big Three.” This exercise is great as it protects low back while working the abdominal muscles.
Starting position
- One leg bent with one leg straight
- Hands behind lower back
- Pelvis in neutral position – minimal gap between back and floor. (This is achieved by having one leg bent with the other straight – Before commencing the exercise for the first time, see yourself how having both legs straight or both legs bent changes the lumbar lordosis (curve) of your lower back)
- Elbows slightly lifted
- Chin tucked in slightly
Movement
Begin to perform a typical sit up movement – reverse the movement when you are about to lose control of lower back position and lifted elbows.
Avoid
- Sticking chin out
- Going beyond the point of shaking
- Flattening back into
- Performing the movement fast instead of controlled.
Getting started with exercise is often the most challenging part. If low back pain is holding you back from the lifestyle you deserve, the team here at Madison Healthstyle are here to support you. With services ranging from comprehensive, evidence-based assessment through to targeted remedial massage, chiropractic care and rehabilitative exercise programs, we are here to help you make your first step. Make an appointment with one of ours wellness directors to create a treatment program tailored to your needs.
References
Frank C, Kobesova A, Kolar P. Dynamic neuromuscular stabilization & sports rehabilitation. International journal of sports physical therapy.[internet]. 2013 [cited 2020]; 8(1):62-73. Available from: https://pubmed.ncbi.nlm.nih.gov/23439921
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578435/
Liebenson C. Rehabilitation of the Spine: A Practitioners Manual. Lippincott Williams & Wilkins; 2019.
Traeger AC, Buchbinder R, Elshaug AG, Croft PR, Maher CG. Care for low back pain: can health systems deliver? Bulletin of the World Health Organization.[internet]. 2019 [cited 2020]; 97(6):423-33. Available from: https://pubmed.ncbi.nlm.nih.gov/31210680
