Chiropractors, belts, shoe inserts, hanging upside down on inversion tables... these days, people will try just about anything to prevent and treat lower back pain. But it turns out that the magic elixir may actually be quite simple: exercise. In a recent review of medical literature published online by JAMA Internal Medicine, researchers combed through studies, trials, and reports to determine what really works when it comes to warding off the debilitating issue. The consensus: regular exercise. Regular is a keyword here: "for exercise to remain protective against future [lower back pain], it is likely that ongoing exercise is required," the study states. Good news for fit guys already hitting the gym pretty regularly. But even if that's you, you can decrease your odds of pain even further by focusing on specific moves that really shore up your back. Click through for the best exercises for preventing and alleviating lower back pain, courtesy of Joey Percia, MS, CPPS, CSCS, Weside Barbell Coach and a Lifestyle and Performance Coach at Soho Strength Lab in New York City.
You can work these moves in to your regular workouts or complete them all together as one workout. Here's a sample workout you could try:
Dynamic Warm-up concluded with hip thrust with band around the knees 3x15 reps
1a) Goblet Squat 3 x 8 reps
1b) Half kneeling hip flexor stretch 3 x 30 seconds/side
2a) Kettlebell RDL 3 x 8 reps
2b) Lying straight leg iron cross 3 x 12 /side
2c) Anti Rotation press 3 x 12 reps /side
3a) Goblet Bulgarian Split Squat 3 x 12 reps/side
3b) Plank with reach 3 x 6 /side
4a) Suitcase deadlift 3 x 8 reps/side
4b) Prisoner back extension 3 x 10 reps
Lying Straight Leg Iron Cross
Why It Helps: "The straight leg iron cross is a great mobility exercise to release tension in the legs, back, and glutes," says Percia. "A lot of lower back pain can stem from these muscles being weak or tight. The straight leg iron cross will help relieve that."
Directions: Start lying flat on your back with both legs straight. Lift one leg back towards you and making sure to keep the knee straight. From this position, bring the leg that is in the air, across your body and down towards the ground. You will most likely feel the stretch along the outer side of your leg and possibly behind the knee. In this position take a deep breathe and try to relax. Keeping the knee straight bring your leg back across your body and straight up to the ceiling.
Prescription: 3x12 reps each side every day.
Half Kneeling Hip Flexor Stretch
Why It Helps: "The half kneeling hip flexor stretch is one of the keys to unlocking a tight lower back," explains Percia. "The hip flexor become tight from being in a constant shortening position from sitting."
Directions: Start with one knee down on a pad and other leg bent with the foot flat on the floor. Stay in a tall position with your back straight. From here squeeze the butt cheek of the knee that is down and try to push your hip to the wall in front of you. You should feel a stretch in the front of your hip and maybe even down your quad depending how tight you are. Be sure to keep your back straight and DO NOT arch from your lower back when pushing your hip forward. It may help if you think of performing a mini crunch when you do this to bring your ribs down and make the exercise even more effective.
Prescription: 3 x 30 second holds on each side every day.
Anti-Rotation Press aka Pallof Press
Why It Helps: "The anti-rotation press or ‘pallof press’ is an exercise which will strengthen the key players and bulletproof your core," says Percia. "The weight will try and twist your body but you will use your legs, butt, oblique, abs and back to resist."
Directions: Start in an ‘athletic stance’ like a linebacker, with your feet about shoulder-width apart. Grab the cable or band and position yourself at a 90 degree angle. From here you will brace your core and bring the cable to your chest. Keeping your core tight, reach the cable straight away from your body until your arms are fully extended. Pause for 1-2 seconds and return back under control. At no point in the movement should the weight be pulling you off balance or move you at all. Your core should be braced tight and strong the entire time.
Prescription: 3 x 12 reps on each side.
Why It Helps: "The Kettlebell RDL deadlift is a safer way to train the traditional deadlift but with less stress your lower back," says Percia. "This version with keep the majority of the weight closer to your body which is a safer position. This will also strengthen the lower back, hamstrings, glutes and abs which are all major players to a healthy back."
Directions: Set up with the kettlebell directly under you and take a wide stance with your toes slightly pointing out. While keeping your back straight and core tight, lower yourself down to the kettle bell and grab it with a tight grip. Keeping your abs and back tight, smoothly lift the weight off the floor by ‘leg pressing’ the floor away from you. Finish the movement by squeezing your butt at the top not leaning back and arching your lower back. Return to the floor under control and make sure to keep your back straight.
Prescription: 3 x 8 reps.
Why It Helps: "The goblet squat is a squat variation that will really strengthen your upper back and core while keeping your back safe," says Percia.
Directions: Set up with you feet around hip- to shoulder-width apart with your toes pointed slightly out. With a straight back crouch down to pick up the weight. Hold the dumbbell or kettlebell at chest height with your elbows pointing down towards the ground (not out to the sides). You should really feel your upper back working. Start the movement by pushing your hips behind you and bending your knees at the same time. Go as low as your body will allow as long as you keep a straight back. Reverse the movement by pushing your feet through the floor.
Prescription: 3 x 8 reps.
Prisoner Back Extensions
Why It Helps: "The prisoner back extension is a back exercise that strengthens the entire back," says Percia.
Directions: Set up in a glute ham developer or regular back extension machine and place your hands in prisoner position (behind your head). It is important to squeeze your shoulder blades together and pull your elbows back when you are in this position to really fire up your upper back. From the hanging position squeeze your glutes and push your hips against the pad. This should pull your body up so you are parallel with the ground. You want to try to do the majority of the exercise with your glutes and not your lower back.
Prescription: 3 x 10 reps.
Plank with Reach
Why It Helps: "The plank with reach is a great plank variation to really challenge your core," says Percia.
Directions: Set up in a regular plank position with your forearms directly under your shoulders and your entire body braced too, so are in a nice straight line. From here, reach one arm out in front of you and fully extend the arm, then bring back under control. Then repeat on the other side. The key to this exercise is to prevent any swaying from side to side when you reach the arm out.
Prescription: 3 x 6 reaches per side.
Why It Helps: "The suitcase deadlift is a deadlift variation that will really challenge your core and fire up your obliques," says Percia.
Directions: Start with your feet about hip-width apart and a kettlebell right to the outside of your foot. With a straight back, hinge at the hips and lower yourself towards the ground to the kettlebell. When you reach the kettlebell make sure to keep your abs squeezed tight. From here, deadlift the kettlebell off the floor. At the top, remember to finish the movement by squeezing your butt and not arching your lower back. Return the kettlebell towards the floor under control by pushing the hips back and keeping your back straight. Remember to keep your abs braced strong and stand tall and DO NOT let the weight pull you to the side.
Prescription: 3 x 8 reps per side.
Hip Thrust with Band Around the Knees
Why It Helps: "The bodyweight hip thrust with a band around your knees is a great way to build strong hips which will carry over to a stronger back," says Percia. "The hip thrust is a great glute exercise but the added band around the knees makes the exercise even more effective."
Directions: Position yourself against a bench so your shoulder blades are on the edge of the bench. Place your feet on the ground and tuck your feet in towards your butt. Start the movement by driving through your heels and finish the movement with a strong butt squeeze. Try not to use your lower back; your butt should be doing most of the work. Make sure to push out against the band the whole time and you will feel your hips fire up. You want to make sure your knees are in line with your toes or slightly outside of them. DO NOT let the band putt your knees in.
Prescription: 3 x 15 reps.
Goblet Bulgarian Split Squat
Why It Helps: "The Bulgarian split squat is a very physically demanding single leg exercise which also strengthens the core," says Percia. "Standing on one leg allows you to train stability and strength of the core while working the legs too."
Directions: You will be holding a dumbbell or kettlebell at chest high during the exercise. Start with your back foot on a bench or single leg squat stand. Place you foot flat/laces down, do not try to stay on the ball of your foot. From the top of the movement, begin to lower yourself under control by bending the front knee. Keep the majority of your weight on the heel and middle of your front foot, the back leg (the one on the bench) should just be keeping you stable. Stop right before your back knee touches the ground and then reverse the movement by standing up. Be sure to keep your knee in line with your toes during the exercise and don't let it drift side to side.
Prescription: 3 x 12 reps per leg.