31 million Americans are experiencing lower back pain at any given time. (1)
That’s… a lot.
To take it even further, 80% of the population will experience back pain or stiffness at some point in their lives.
Chronic low back pain can happen from overuse, weak core strength, a sudden injury from lifting heavy objects, or a preexisting lower back condition.
So what is the anatomy of your back and what exercises should you do instead if you experience an ache?
Anatomy of the Back
Before we get into the low back pain exercises, let’s cover the structure of your back, starting with the spine.
Your vertebral column runs down the midline of your back and is made up of 33 spinal discs, your vertebrae.
These vertebrae are separated by intervertebral discs. (2)
The spine can be broken into 4 major regions. (3)
Your cervical spine, aka your neck, supports the weight of the head and protects the nerves that connect your brain to the rest of your body.
Next is your thoracic spine, aka your upper back.
The purpose of these 12 vertebrae is to protect your vital organs like your heart and lungs.
Your lumbar spine is your lower back.
This part of your spine carries the weight of the torso making it more prone to injury, specifically muscle strain.
Lastly is your sacral region.
This consists of a bone called the sacrum which is the back part of your pelvis. It’s shaped like a triangle and connects the spine to your lower half.
Ruptured disks, bulging disks, sciatica, arthritis, and osteoporosis are a few examples of structural problems that can cause back pain. (4)
Your back can be split into 2 muscle groups: extrinsic (superficial) and intrinsic (deep) muscles (5).
Your superficial back muscles include your trapezius, latissimus dorsi, levator scapulae, rhomboid muscles, and serratus posterior muscles.
Your intrinsic back muscles include your erector spinae, transversospinal, interspinales, and intertransversarii muscles.
Musculature back pain can be caused by pulled muscles, strained muscles, or even inflammation (6).
This occurs from overstretching and overusing the specific muscles and ligaments located in your back.
Inflammation occurs when a muscle is injured. This can feel like a spasm, tender to touch, or cramps.
Exercising with Back Pain
As with any injury, you need to be careful and know your limits.
If your back pain symptoms persist for a few weeks, are severe, and don’t improve with rest, the pain spreads down your legs, the pain causes weakness or numbness in your legs, or is accompanied with unexplained weight loss, contact your doctor (7).
That being said, a certain type of exercise is tougher on your back health than others.
They can cause more strain, tightness, create discomfort and lead to even more pain.
Naturally, this means if you are experiencing acute low back pain, you’ll want to avoid those kinds of exercises.
Here are 7 exercises to avoid and an alternative to try instead!
Exercises to Avoid With Lower Back Pain
Note that the physical activity described below are only suggestions for working out with lower back pain.
Consult a medical professional or physical therapist if you are experiencing severe back pain or your back injury gets worse.
1. Superman Back Extensions
The Superman exercise is a back extension move you perform while lying face down on the floor.
In this exercise, you begin by lying on your stomach and simultaneously alternating lifting the opposite arm and leg off of the ground.
This exercise can create discomfort from the stress in the joints in the low back.
TRY INSTEAD: Bird-dog
This exercise is great for strengthening and stabilizing your lower back and core without putting additional stress on your spine.
- Start in a tabletop position.
- Your wrists will be directly under your shoulders and your knees will be under your hips. Warm-up with the cat-cow stretch.
- Engage your abdominals for a stable core. Your hips won’t move the entire set.
- Extend your right arm and your left leg. Your thigh will be parallel to the ground. Hold for 3 breaths. Return to the starting position.
- Switch, extending your left arm and your right leg. Again, hold for 3 breaths. That is 1 rep.
- Repeat for your desired number of repetitions.
When trying for a strong core, crunches are probably the first exercise that comes to mind.
But! They are not the most back-friendly ab exercise.
Especially first thing in the morning. When you first wake up, your spinal discs are at their highest level of fluid retention.
This means you’re putting pressure on the discs when they are less tolerable to bending. (8)
Avoid them after sitting for prolonged periods of time like at your workstation or if you have herniated or bulging discs.
TRY INSTEAD: Planks
This yoga pose is a great exercise that works your core muscles.
- Start in the standard pushup position. Have your hands directly under your shoulders and tuck your toes.
- Pull your belly button towards your spine and engage your abdominals.
- There should be a straight line from the tip of your head to your heels. Keep that tailbone down. Hold.
- Take a child’s pose to rest.
The best thing about planks are the many variations!
A few options are dropping your forearms to the mat or trying the side plank.
Consider partial crunches as well!
3. High Impact Activities
High Impact Activities are defined as exercises that move both feet off of the ground at the same time. (9)
This includes but is certainly not limited to burpees, jumping jacks, and jumping rope. Essentially, any exercise that requires you to jump.
These exercises are typically used in High-Intensity Interval Training (HIIT).
TRY INSTEAD: Water Aerobics
Instead, try water aerobics!
The water will protect your joints and add resistance as you move. Plus, gravity is less in the water.
With less gravity, you’ll be able to move around more than if you were on land.
Water therapy is a great way to nurse injuries and improve blood circulation.
Swimming is another great aquatic exercise for a full-body cardio workout.
As you can imagine, running is jarring on your joints.
The repetitive stress and impact, especially when running for longer distances leads to more or even additional back pain (10).
To avoid agitation, be sure to warm up, cool down with gentle stretches and invest in a good pair of running shoes.
They’re worth it!
TRY INSTEAD: Walking
Start slow! Especially if you’re in a lot of pain.
- Begin at a moderate pace to get blood flow to your muscles.
- Slowly increase your pace as your body feels ready but don’t move faster than a jog.
- Feel free to add distance. Plus, it’s a great excuse to get outside!
5. Heavy Weight Lifting
Lifting free weights puts added pressure on your back.
That’s quite the opposite of what you want when experiencing low back pain (11).
Some people also have the tendency to take a deep breath and hold while lifting.
This can increase the pressure in your abdomen and lead to even more back pain or poor posture.
It’s always a good idea to focus on proper form and breathing when exercising. If you’re unsure, ask a personal trainer!
TRY INSTEAD: Light resistance machines
Use resistance machines instead. You will have more control of the weight.
Use a lighter weight for more reps. And of course, don’t forget to breathe!
Bodyweight exercises are another great alternative.
6. Double Leg Raises
Double leg raises are a popular move that puts a lot of strain on your lower back.
You’ll start off by laying on your back and simultaneously lifting both legs.
While this move mainly targets your abdominal muscles, your lower back compensates for weak muscles.
TRY INSTEAD: Single Leg Raises
Instead, leg lifts one at a time.
- You can plant the opposite foot on the ground for stability or slide your hands or a cushion under your sacrum or buttocks for additional back support.
- The key here is control. Slowly lift and lower each leg engaging your glutes and stomach muscles for your desired number of reps and sets.
7. Standing Toe Touches
Stretching is vital for any modality of movement you choose. It can help you avoid soreness and injury.
But bending over to touch your toes can aggravate your back even more.
Especially if your low back pain is stemming from tight hamstrings or your gluteus maximus.
So what can you do?
TRY INSTEAD: Hamstring stretches with a towel
Flip it around by laying on your back for this stretch!
- You can have your right knee bent or keep a straight leg. Pull your left knee into your chest.
- Use a towel or yoga strap around your quad or left foot depending on the length.
- Maintain a neutral position in your pelvis.
- Straighten your leg. Control the depth of the gentle stretch by bending at the elbows while holding the towel. Hold.
- You also have the option of taking small pulses to get deeper into the hamstrings.
- Repeat on the opposite side.
There’s a good chance you’re going to experience back pain at some point in your life.
Knowing the anatomy of the back, both structurally and the musculature is a great way to figure out your movement plan if you happen to experience low back pain.
Use these 7 alternatives if you’re experiencing any sort of pain symptoms in your back such as tightness, mild discomfort, or aches.
Remember to consult a medical professional, physiotherapist, or physical therapist if the back pain symptoms persist or worsen.
- “Back Pain Facts and Statistics”. American Chiropractic Association. 2021. https://www.acatoday.org/Patients/What-is-Chiropractic/Back-Pain-Facts-and-Statistics.
- O. Jones. “The Vertebral Column”. Teach Me Anatomy. September 23, 2020. https://teachmeanatomy.info/back/bones/vertebral-column/.
- T. Scioscia. “Spinal Anatomy and Back Pain”. Spine-health. August 24, 2017. https://www.spine-health.com/conditions/spine-anatomy/spinal-anatomy-and-back-pain.
- J. McIntosh. “What is causing this pain in my back?” Medical News Today. February 23, 2017. https://www.medicalnewstoday.com/articles/172943.
- J. Vaskovic. “Overview of the back muscles”. Ken Hub. June 17, 2021. . https://www.kenhub.com/en/library/anatomy/overview-of-back-muscles.
- K. Hamilton. “Pulled Back Muscle and Lower Back Strain”. Spine Health. September 8, 2017. https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-and-lower-back-strain.
- Mayo Clinic Staff. “Back pain”. Mayo Clinic. August 21, 2020. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906.
- E. Ryan. “Are Abdominal Crunches Contraindicated for Spinal Health?” Chron. https://livehealthy.chron.com/abdominal-crunches-contraindicated-spinal-health-6936.html.
- “High Impact Exercise – Good or Bad for your Body?”. Dr. Gena Chiropractic. December 17, 2019. https://www.drgenachiropractic.com/blog/161045-high-impact-exercise-good-or-bad-for-your-body.
- S. McCance. “Running and Lower Back Pain”. Spine-health. February 27, 2008. https://www.spine-health.com/conditions/sports-and-spine-injuries/running-and-lower-back-pain.
- A. Lopez. “The Worst Exercises for Back Pain”. Share Care. 2019. https://www.sharecare.com/health/back-pain/slideshow/worst-exercise-for-back-pain.