Back pain is the most common type of musculoskeletal pain that affects over 80% of all people at least once during their life time. Many of these become recurrent and chronic problems, often negatively impacting the ability to be physically active, work, and enjoy life. The risk of other health problems increases as many back pain sufferers avoid physical activity.

Many people shy away from physical activity with back pain because it simply hurts too much.  Many "exercises" and "stretches" are sought, usually from uneducated (or partially educated) sources, only to provide temporary relief, or actually make the condition worse in the long run.  While many therapies exist, and many diagnostic names are given for various back conditions, back pain has remained a poorly understood entity for many years. Current back pain research and the leading experts in the field of back pain now agree that most back pain is "mechanical" in nature, however, the complexity of the mechanical streses that cause back pain often leaves doctors and their patients looking for lasting results that usually remain elusive.

Dr. Remy has enjoyed a 93% success rate in treating back pain for over 25 years in his clinical practice. This includes herniated discs, bulging discs, arthritis, stenosis, scoliosis, degenerative discs, sciatica, facet syndromes, strains, sprains,  mechanical back dysfunction, sacroiliac disorders, subluxations, and joint hyper and hypo mobility.  Patients often seek his advice and treatments after all the other "experts" have provided no lasting results. His approach targets the specific mechanical nature of physical stresses that cause back pain in the individual.  Through an analysis of each person's unique body mechanics, posture and movement tendencies, he is usually able to identify the underlying mechanical stresses that cause and perpetuate most back pain.  By learning how to correct the mechanical stresses, and then strengthening these corrections with healing conditioning exercises, most find significant lasting results by keeping their backs "in shape" for a lifetime. As opposed to most back exercises which usually strengthen back dysfunction and ultimately lead to more mechanical back stress, healing exercises which are custom designed  for the individual, support superior back healing, protection, and conditioning for a return to physical activities and fitness/ sports participation.

Dr. Remy has summed up all of his back healing exercise wisdom in our Low Back Pain Healing Exercise Program  TM.  We have included some sample exercises from the program here for you to try. Please remember that any of our Pain Free & Fit Healing Exercises TM are not intended to diagnose or treat your lower back pain, and that in some cases it may make your pain worse. Always consult with your own doctor before beginning this, or any exercise program.

Relief Exercise#1. Lay on the floor or on a firm mattress. Bend your hips and knees as shown above. Correct any posture or mechanical faults that you have identified in your body analysis with minimal muscular tension and position change. Any corrections MUST be comfortable and not aggravate your pain. There are three corrective maneuvers to this exercise. The first is finding the postion of greatest pain relief by either arching or flattening the lower back. You will find the right position by gently tilting your tailbone under to flatten, or up toward your lower back to arch the low back. Gently tilt back and forth until you feel the greatest position of relief. Next, without changing your low back arch, tilt your pelvis from side to side, as if trying to push one knee farther away from your hips than the other. Do not move the feet as you perform this second correction. Try pushing the right hip long first, then the left. Go back and forth until you feel the most comfortable position. It may be with the hips level, or with one side longer. Lastly, while holding the first two relief positions, gently twist your hips to the right, and then to the left to find the most comfortable position. This last correction will cause one side of your pelvis to be higher than the other. Hold the combined corrective position for 90 seconds before slowly relaxing back to the starting position. Repeat as necessary, and stand up slowly after the pain has abated.

Relief Exercise#2. While holding your analysis corrections with a comfortable amount of minimal muscular tension and position change, slowly tilt your tail bone up and hold for 2 seconds. Use a comfortable range of motion.  The reverse the direction and tilt your tail bone down and hold for 2 seconds. Repeat the tilts back and forth 4-15 times.  Do the same thing with tilting your pelvis side to side (as described in Relief Exercise 1 above), and then with a slight twist of your hips to the right and left. Hold each position for 2 seconds, repeat 4-15 times in each direction, and be sure to use a slight range of motion that is comfortable. These exercises can be done every hour if needed.

Sample Low Back Pain Relief Exercises

Sample Low Back Scar Tissue Stretch

Stretch 1. In the seated position, separate your feet as wide as comfortable on the floor. Place both hands on your left thigh and lean your torso forward and slightly to the left until a mild stretch is felt on the right side of your lower back.  Be sure that your entire upper body weight is supported by your hands, so that your back muscles can relax.  Hold the position for 15-60 seconds until the feeling of stretch resolves, and repeat to the other side. This stretch targets the erector spinae muscles which are often tight, and filled with scar/fibrosis as a result of overcompensating for weak multifidi and buttock (gluteus max) muscles. 

Stretch 2. From the "on hands and knees position", walk your hands off to the left side , allowing your spine to bend towards the left, as you keep your hips level and motionless.  Walk your hands to the left as far as it takes for you to feel a mild stretch in the right lower back. Hold the position for 15-60 seconds until the stretch resolves.  Repeat to the other side.  This stretch targets the lateral muscles of your spine and torso which are often tight and fibrotic due to hip hiking, external hip rotation, scoliosis, a short leg, and torso side leaning and translation posture tendencies.

Sample Low Back Corrective Exercises

Many cases of lower back pain are related to postural issues of the feet, hips, torso, shoulders and head.  They are almost always associated with weak or dysfunctional spinal stabilizing muscles. Many "core" exercises aimed at lower back pain health fail to address the individual's unique posture and stability corrections, and thus only strengthen the dysfunctional stress applied to the lower back. The following 2 exercise samples from our Low Back Healing Program target two of the most common stabilizing muscles- the multifidus and the transverse/internal oblique dysfunction.

1. Transverse Abdominus/ Internal Oblique Correction.  If you found that your lower abdomen bulges outwards while you pull it in on your analysis, it indicates that you have an overactive internal oblique muscle that is causing spinal stress.  To correct, simple palce your fingers on your lower abdomen about one inch inwards and downwards from the front prominences of your pelvic bone (ASIS bones). This is easier to do in the face up position with your hips and knees bent. Pull in SLOWER and DEEPER on the side that bulges out to master the inwards movement.  With practice you will feel your lower abdomen drawing in towards your spine equally on both sides, indicating normal transverse and internal oblique abdominal function, which will help you develop a properly functioning "core".

2. Multifidus Correction. This muscle is often either weak or inhibited in back pain. This is very important because it serves a protective stabilizing efffect on spinal joints and discs, as well as other muscles. To "wake it up" and strengthen it,  place your thumbs on the sides of your midline lower back vertebral bones.  Feel the outer, lower tip on both the right and left side.  Normally, when your lower abdomen draws inwards , you should feel a "bulging out" as the multifidus contracts under each thumb.  If you do not feel a bulge, or if you only feel a hollow at any vertebrae level in your lower back (there are 5 bones here to check), or on one side compared to another, you have an inhibited or weak multifidus, which is definitely involved in your back pain.  To correct this, focus on your lower abdomen pulling inwards as a "funnel shaped" force that narrows down to the point where your multifidus is weak or inhibited.  Do not move your spine, shoulder or hips as you do this.  The pressure of your lower abdomen will force the bulge outwards of the multifidus. With practice, the bulge will eventually be felt as you gain neurological control over this all too important spinal stabilizer.  Hold the bulge tension with your lower abdomen pulling inwards for 5-10 seconds at a time, breathing normally as you do so.

Sample Conditioning Exercises for Low Back Pain

While our Low Back Healing Program  includes over 130 exercises, we will share two sample conditioning exercises which are designed to strengthen your ability to "hold" your lower back stability while correcting hip motions.  The hips are often a root cause of lower back pain, as malposition tendencies, muscle imbalances, and altered hip joint stability often places injurious stress to the lower back.

Conditioning Exercise 1. Hip Re-alignment Squat. This exercise restores proper hip alignment and function, while training the lower back and abdominal muscles to properly stabilize the lower back.  It also allows the buttock muscles to become recruited.  These muscles are often weak as a result of external rotation hip malpositions, which in turn place an undue stress on the lower back as a result of over active erector spinae low back muscles.   Begin standing and correct any posture or mechanical dysfunctions that you have identified on your analysis.  This includes any corrections of the feet, knees, head and shoulders, as they all relate to lower back function.

Engage your multifidus and transverse abdominus by drawing in your lower abdomen, and brace your abdominal muscles as if you were protecting from a punch to your stomach. Position your foot on the same side as your externally rotated hip so that your foot faces 15 degrees inwards (pigeon toed) and one inch behind your normal stance. Tense, without moving, your tailbone slightly under, as this will release excess erector spinae tension and recruit your abdominals and buttock (gluteus max) muscles. Emphasize a backwards movement of your hip bones  (greater trochanters) in your hip sockets, especially on the side of any anterior hip malposition, or overactive hip flexors. Squat down and back with your hips by bending your hips and knees, allowing your upper body to follow the pelvic motion.  Avoid bending forward from your lower back, as it remains in the same position  (relative to the pelvis) as it did standing up straight.  Emphasize the motion in the hip socket, and tense the buttock on the same side as the external rotated hip to arise again to the standing position. Avoid hip hiking and torso side leaning on the external rotated hip side, and pelvic rotation to the opposite side.  Repeat for progressive repetitions over successive workouts. This exercise conditions your spinal stability and hip flexibility/strength, while re-aligning your hip joint, strengthening your resistance to hip hiking, torso side leaning, pelvic rotation, and anterior pelvic tilting.  This collectively normalizes the mechanics that affect low back stress, stimulates healing, and prepares you for the  physical demands of lifting and bending without back trauma. 

Hip Re-Alignment Squat for
Right Hip External Rotation

Conditioning Exercise 2. Standing Bird Dog.  While the Bird Dog is a common rehab exercise performed from the "on hands and knees" position, it is often used as a generic isometric core strengthening exercise with little or no attention given to unique posture and mechanical tendency corrections.   This unfortunately only serves to strengthen lower back mechanical dysfunction and stress. By incorporating an individual's posture and mechanical corrections from the feet through the shoulder and head, the multiple fascial planes of spinal stability are properly recruited in an integrated function. By performing this in the standing position, greater corrective and conditioning effect is applied to the hip, abdominal and gluteal  muscles, as hip hiking and pelvic/torso rotational tendencies are held stable, and the one legged stance supercharges the neurologic sensory feedback and resultant reflexes from the corrected mechanics into the spinal cord.  Thus, balance training that includes mechanical and postural corrections, helps train these corrections to become more automatic by encouraging corrective reflexes.

Standing on one leg with all of your posture and mechanical corrections engaged, tense the buttock of your non- weight bearing leg as you position that straight leg slightly behind you.  Raise your opposite arm overhead, avoiding shrugging your shoulder upwards.  You may "tap" with either hand onto a wall for balance.  You should not sway more than a quarter of an inch as you maintain balance for 10 seconds.  The switch sides. Build up over progressive workouts to a 3 minute hold time.  Avoid pelvic rotation away from, and hip hiking and torso side tilting on the same side as the standing leg. Avoid anterior pelvic tilting and increased arching of the lower back with tail under abdominal tension.


Pain Free & Fit TM

Low Back Pain Healing Exercise Program NOW !

Learn how to analyze and correct the posture and mechanical flaws that commonly cause lower back pain, along with the special exercises that will strengthen and condition your back against pain and inury. Written by Dr. Michael C Remy, a chiropractic sports orthopedist with over 25 years of experience in successfully treating chronic and complicated cases of lower back pain with healing exercises. Almost every case of lower back pain ever treated by Dr. Remy had "some key posture or mechanical issue that was at the root of the problem". The Pain Free & Fit TM Low Back Pain Healing Exercise Program teaches you self-analysis and all the corrective exercises you will need. Specific pain relief exercise techniques, targeted stability, stretching, coordination, posture, mechanical corrections, nutrition and conditioning programs are all explained in detail. Over 130 exercises are carefully presented, all being customized for your unique posture, mechanics and pain. A simplistic, yet comprehensive approach is given for you to begin the healing stimulus your lower back needs today. There is simply no other book or program on the market today which is as cutting-edge and comprehensive when it comes to learning how to use exercise to support pain relief and healing, while providing the specific strength and conditioning required for a pain free and fit lower back. 

Pain Free & Fit TM Low Back Pain Healing Exercise Program
(Part of the Pain Free & Fit TM Self-Help Series)


Format: PDF Digital ebook, 160 pages
Publisher: North Shore Health & Fitness Associates, Inc.
Publication Date: 2017
Author: Dr. Michael C Remy, DABCO, CCSP

 Chapters and Content:
1- Understanding Pain and Injury, How  Injury Occurs, The Body's Response to Injury,  The Inflammatory    Cycle and What Goes Wrong,  Dysfunctional Healing, The Root Causes of Injury,  Your Unique Lower Back Pain, Traditional and Alternative Treatments,  What You Can Do To Help Your Body Heal  

2- Low Back Functional Anatomy,  The Anatomy of Discs, Joints, Muscles and Function, Local vs. Global Muscles, Diagnostic Conditions, Importance of Asymmetry and Posture, 

3- Self-Analysis of Posture and Body Mechanics for Low Back Pain, Your General Body Posture, Posture and Lower Back Pain, Analysis of Posture and Alignment, Analysis of Body Mechanics, Stability and Coordination,  Global Analysis, Local Analysis

4- Correcting Posture, Mechanics, and Stability (RPI), How to Customize Your Lower Back Stability, Local Corrections, Global Corrections, Abdominal Bracing, 5X5 Posturcise TM Correction, 

5- Dangerous Movements for Lower Back Pain, How To Modify Dangerous Movements for Pain-Free Function, Asymmetrical Posture, Foot Pronation, Sitting, Twisting, Carrying Loads, Bending and Lifting, Walking, Common Fitness Workout Mistakes

6- Pain Relief Exercises and Techniques, Mechanisms for Pain Relief, The 7 Low Back Pain Relief Exercises

7- Flexibility and Scar Tissue, How to Resolve Scar Tissue and Fibrosis, Professional Health Care and Techniques, 4 Self-Methods, Hip and Back Stretches, 2nd Method of Stretching

8- Corrective Conditioning Exercises for Body Mechanics, Posture, and Back Stability, Application and Progression of Exercises, Techniques to Ensure Pain Free Conditioning, Beginnner through Advanced Exercises, Specific Conditioning Exercises for Sports, Fitness, Home & Work Activities

9- Putting It All Together, Review of Program, Beginner, Intermediate and Advanced Workouts



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Healing Exercise for Back Pain

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