Early Low Back Rehab

Presented bu WIMB’s Dr. Brandon Carlucci

McKenzie Method

McGill Curl-Up

Steps: lie down with your head flat on the floor and one leg bent with the foot on the floor. Place hands under the lower back, palms down. With the head remaining in line with the spine, come up so the top of the shoulder blades comes off the floor. Pause at the top, then return to the starting position.

Goals:/tips: picture a scale under your head and make the scale weigh zero. Make sure the low back does not flatten into your hands and keep the elbows off the floor.

Timing: pause at the top and perform for 6-20 repetitions.


Seated Repeated Flexion

Steps: sit in a chair with erect posture. Slowly flex forward moving your chest toward your knees. Reverse to the starting position.

Goals/tips:  if there is pain within a portion of the range of motion, slightly tap the pain and come back to the starting position.

Timing: Tempo is individualized, but in general perform the movement in a slow and controlled manner for the prescribed sets and repetitions.


Supine Repeated Hip Flexion

Steps:  lie on your back with your head on the surface. Flex your affected side hip so that your hip is at a 90 degree angle.  Grab your knee with both hands as you pull your knee to your chest, providing slight overpressure at the end range of motion. Return to the starting position with your hip flexed to 90 degrees.

Goals/tips:  if there is pain within the range of motion, slight tap the pain and return to the starting position.

Timing:  tempo is individualized, but in general, perform in a slow and controlled manner for the prescribed sets and repetitions.  


Repeated Standing Hip Extension

Steps: stand with your knee of the affected side on a stable surface, or get into the bottom of a split squat position. Opposite leg should be out in front. Place the affected side hand on the glute region of the affected side. Glide the hips forward while leaning back as far as you can. Provide slight overpressure with the hand at the end range of motion as you exhale and lean the head back. Return to the starting position.

Goals/tips:  if there is pain within the range of motion, slightly tap the pain then return to the starting position.

Timing:  Tempo is individualized, but in general perform in a slow and controlled manner for the prescribed sets and repetitions.


Extension in Standing

Steps:  start in a standing position with an upright posture.  Put the hands in the middle of the lower back, using either open palms or closed fists.  Glide the hips forward as you lean  back as far as you can, and provide slight pressure with the hands at the end range of motion. Give an exhale at the end range of motion as you lean the head back. Come back to the starting position.

Goals/tips:  if when performing the movement, there is pain, go back, slightly tap the pain while giving an exhale, and come back to the starting position.

Timing:  Tempo should be individualized, but in general, perform the movement in a controlled fashion for the prescribed number of sets and repetitions.


Standing Repeated Flexion

Steps:  start in a standing position. Flex forward and try to touch your toes while running your hands down the front of your legs. Reverse the direction and come back up to an erect posture.

Goals/tips: if there is pain in a portion of the range of motion, go down, slightly tap the pain and come back up to an erect posture.

Timing:  Tempo will be individualized, but in general, maintain control through the range of motion.  Repeat for prescribed number of repetitions.


Skywalker with Heels on Floor

Steps: Lie on your back with hips and knees bent 90 degrees and heels placed on the floor.  Tilt the pelvis in a slight backward direction to flatten your back to the floor and raise your tailbone slightly.  Pull into the floor with your heels to engage your hamstrings.  shift your right knee forward ahead of your left and then straighten your right knee. Reach upward toward your right toes with your left hand without lifting the head.

Goals/tips:  Maintain the slight backward tilt of the pelvis and hamstrings working throughout the exercise. Keep your straight knee higher than your bent knee. Try to reach farther each exhale without lifting the head. 

Timing: Hold this position and perform 3-5 full breaths in through the nose and out through the mouth.  Repeat on the other side. Perform 3-5 repetitions on each side.


Skywalker w/ Heels on Bench

Steps: Lie on your back with hips and knees bent 90 degrees and heels placed on a bench. Tilt the pelvis in a slight backward direction to flatten your back to the floor and raise your tailbone slightly. Pull down on the bench with your heels to engage your hamstrings. Shift your right knee higher than your left and then straighten your right knee. Reach upward toward your right toes with your left hand without lifting the head. Hold this position and perform 3-5 full breaths in through the nose and out through the mouth.

Goals/tips: Maintain the slight backward tilt of the pelvis and hamstrings working throughout the exercise.Keep your straight knee higher than your left.Try to reach farther each exhale without lifting the head.

Timing: Repeat the same directions for the other side. Perform 3-5 repetitions on each side.


Toe Touch w/Adductor and Exhalation

Steps: stand with the toes elevated more than the heels and something to squeeze between the knees lightly. Inhale at the top and give an exhale as you descend into the toe touch. Cycle a breath at the bottom and exhale as you return to the starting position.

Goals/tips: perform 3-5 repetitions.

Timing: breath through the whole rib cage.


Modified Camporini Dead Lift

Steps: stand with the left foot elevated more than the heel. Place the right foot slightly in front of the left on the ground. Hold a weight in the right hand. Maintain most of weight on left heel. Hinge at the hips and lower the weight to the inside front of the right foot. Return to the starting position.

Goals/tips:  stay left heel heavy and sit into the left hip as you descend.

Timing:  perform between 5-10 repetitions.


Heels Elevated Goblet Squat

Steps:  stand with a narrow stance with the heels elevated.  Tuck the pelvis under slightly. Hold a weight and slightly open up the area between the shoulder blades by pushing the elbows forward. Maintain that position, drive the knees forward and perform a squat.

Goals/tips: exhale as you ascend out of the squat.

Timing:  maintain control as you squat.


Pullover With Hamstrings

Steps: Lie on your back with hips and knees bent 90 degrees and heels placed on a bench. Grasp a kettlebell or dumbbell with both hands and press it directly above the chest with arms straight.  Pull down with the heels and tilt your pelvis backward to flatten the back to the floor. Exhale fully as you reach toward the ceiling with the weight. Reach back overhead until the arms are at a 45-degree angle from the floor. Hold this position as you take 3-5 full breaths in through the nose and out through the mouth.  Return to the starting position.

Goals/tips: Attempt to extend your reach upward with each exhale. After the first exhale, maintain the ribs in the exhaled position and breathe against the active abdominal muscles”

Timing:  Perform 3-5 repetitions while maintain the pelvic tuck and arm reach.


Kneeling Side Plank

Steps:  maintain a side plank position with your elbow below your shoulder and your top foot in front of your bottom foot. Keep a straight line from your head to your feet with your hips extended. Place your top hand on your bottom shoulder for support or on your hip to decrease stability.

Goals/tips: do not allow your shoulder to approximate your ear as you fatigue. Maintain hip extension throughout the time.

Timing:  maintain a static position for between 30-90 seconds and repeat on the other side.


Side Plank

Steps:  maintain a side plank position with your elbow below your shoulder and your top foot in front of your bottom foot. Keep a straight line from your head to your feet with your hips extended. Place your top hand on your bottom shoulder for support or on your hip to decrease stability.

Goals/tips: do not allow your shoulder to approximate your ear as you fatigue. Maintain hip extension throughout the time.

Timing:  maintain a static position for between 30-90 seconds and repeat on the other side.


Partial Suitcase Deadlift

Step:  place a weight on a surface that is about knee height. Stand beside the weight, push the hips back while maintaining a neutral spine and grab the weight. Stand up with the weight while pushing the hips forward.

Goals/tips: push the hips back like you are trying to touch the wall with your butt behind you. Do not side-bend or rotate as you perform any of the movement.

Timing: control the movement and give a slight butt squeeze at the top of the movement. Control the lowering phase as you keep the chest up.


Suitcase Deadlift

Steps: grab a weight with one hand and stand straight up. While pushing the hips back, lower the weight beside the thigh. As the weight clears the knee, give a slight knee bend. Reverse the movement and stand straight up.

Goals/tips:  keep the chest up and a neutral spine as you perform the movement. Do not rotate or side-bend the torso as you perform the movement.

Timing:  perform with a controlled tempo, while keeping the torso braced. Repeat for the prescribed number of repetitions.


Suitcase Romanian Deadlift

Steps: the difference between this and the suitcase deadlift from the top, is the lack of knee bend with this movement. Grab a weight with one hand and stand straight up. While pushing the hips back, lower the weight beside the thigh.Reverse the movement and stand straight up.

Goals/tips: keep a soft knee bend as you lower the weight down.  keep the chest up and a neutral spine as you perform the movement. Do not rotate or side-bend the torso as you perform the movement.

Timing:  perform with a controlled tempo, while keeping the torso braced. Repeat for the prescribed number of repetitions.


Belly Lift Bear

Steps: Get on your hands and knees with your hands under shoulders and knees under hips. Tuck the butt slightly under. Push the ground away with your elbows locked, creating space between the shoulder blades. Move the body slightly forward so the shoulders are now in front of the hands. Lift your knees slightly off the ground and take 3-5 breaths in through your nose, out through your mouth.

Goals/tips: maintain the butt tuck and the hands driving into the floor through out the movement. Get all the air out on the exhale.

Timing:  this should be an isometric hold so no movement should occur. Perform 3-5 breaths.