The title is misleading. For what? Because there is no “best” lower back stretch as such.
The same stretch could relieve a person who suffers from lumbago, while it could aggravate the symptoms oflumbar disc herniation in someone else.
How do we know if a stretch will reduce our lower back pain in the long term? We see so many stretches supposed to eliminate our lower back pain on Youtube, how can we be sure that they are adapted to our situation? (Don't worry, the answer is in the article).
Specifically, I will discuss the therapeutic effect of stretching on back pain. I will also share the situations when it is appropriate to stretch the lower back, and when it is better to choose other therapeutic options. Finally, I will show you 4 lumbar stretching exercises often prescribed to my patients to promote optimal back health.
The effects of stretching
A stretch is wrong replace a displaced vertebra. Neither correct your posture as such. Nor break muscle adhesions. Neither activate your circulation significantly. Or even prevent injuries with certainty!
Our understanding of stretching (and more specifically its effect on the body) changed a lot during the last years.
There was a time when stretching was thought to induce viscoelastic deformation, or a new plasticity (basically, the stretched muscle after a certain point cannot return to its original position). This would allow the muscles to be more flexible.
These theories, although possible, seem to have shown limitations in light of recent scientific research.
Today, the role of stretching is largely attributed to the nervous system (ie. the brain). This is called a neurophysiological effect. For example, stretching would induce a change at the sensory level, which would decrease the pain threshold at the level of the nervous system which in turn would allow better flexibility.
In summary, here are some potential effects of stretching:
- They improve suppleness and flexibility
- They increase range of motion
- In a framework of meditation, stretching can produce a relaxation effect and reduce stress
- When associated with a slow and deep breathing, they can help relax tense muscles.
The different types of stretching
There are several ways to stretch. The two most common types of stretching are static and dynamic stretching.
Static stretching refers to maintaining muscle elongation for an extended period of time (once the sensation of stretching is felt). You have probably already been prescribed a stretch where you are asked to hold the position 3 times for 30 seconds.
A dynamic stretch, on the other hand, consists of a back and forth movement that stretches the muscle, then returns to its normal position in a repetitive and progressive manner. This type of stretch is often used in athletes.
In general, dynamic stretching is recommended BEFORE a sports activity (much like a warm-up), while static stretching is recommended AFTER sports practice.
This is because static stretching could potentially weaken the muscle according to some studies, in addition to increasing the risk of muscle damage and affecting performance (especially when followed by explosive activity).
There are several other types of stretches that have not been mentioned here. Among them are the ballistic stretches, proprioceptive neuromuscular facilitator (PNF), etc. Talk to your healthcare professional to determine if these stretches are right for you.
In this article, we are going to present 4 static stretches that will need to be maintained for an extended period of time. (Coming)
When to stretch?
There are several contexts and situations where stretching is relevant for the back:
After sport
As mentioned in the previous section, static stretching after sport can notably allow muscle relaxation and increased flexibility.
Please note, however, that stretching has not been shown to allow more optimal recovery by reducing body aches, although many athletes seem to notice an improvement in their stiffness after stretching.
After surgery or injury
A stretch after a surgery could bring elasticity to the scar (especially in the subacute phase). The same principle applies after a sports injury to regain full amplitudes and optimal muscle function.
In the morning
I often suggest that my patients incorporate a morning routine consisting of active movements and stretching for their lower back. This will allow you to start the day on the right foot, in addition to activating the circulation, lubricating the joints, combating the stiffness that has set in during the night, etc.
When we are stiff
Stiffness is not always necessarily related to back pain. In some sports like weightlifting, some stiffness can even be protective and limit excessive movement of the spine and joints.
On the other hand, patients who feel stiff often note relief from their symptoms following stretching exercises. If you feel stiff, you should try stretching and reassess the impact on your lower back pain.
When practicing a sport that requires flexibility
We mentioned that stiffness was sometimes necessary in certain sports like weightlifting. Conversely, some sports require a high level of flexibility. Among these we count gymnastics, Brazilian Jiu-Jitsu, etc.
In these cases, stretching is indicated to reduce the risk of injury and perform optimally.
When muscle asymmetries and imbalances are observed
Imagine that the rotation of your trunk to the left is more limited than to the right. Or, that your right hip is stiffer than your left (you may notice this when crossing your legs while sitting).
Although studies are limited on this subject, we often find that a joint or muscle imbalance can contribute to your lower back pain (as in the case of a Scoliosis).
In this case, it is interesting to try exercises and stretches aimed at correcting the asymmetries, then evaluating the impact on the pain in the lower back.
To increase back confidence
By being able to move in all directions without pain, we increase the functional capabilities of our spine. In other words, our back is able to support us during our daily activities.
And above all, it comforts us in the idea that our back is solid. With this in mind, stretching allows you to explore new amplitudes, in addition to sending a comforting message to the brain:
"Dear Mr. Brain, you can trust Mr. Back, so no need to exaggerate the message of pain in the lumbar region!"
When we like it
Are stretches absolutely necessary to heal the back? Not according to scientific studies. If you hate the feeling of stretching, good for you: you can try something else.
But if stretching soothes you, makes you feel good, or relieves pain, go ahead and stretch daily to treat yourself!
When to avoid stretching?
There are some situations where stretching is not indicated. Obviously, a health professional can tell you if this is your case. For example, a stretch could do you more harm than good in the following cases:
When we were diagnosed with lumbar instability
Instability refers to excessive joint movement. With this in mind, it doesn't make sense to stretch muscles, tendons or ligaments any further, as this will put additional stress on the joints and potentially irritate the nerve structures.
If you have been diagnosed with lumbar instability, it may be appropriate to limit and/or avoid stretching. Same thing if you are hyperlax in general, or if you suffer from Elher-Danhlos syndrome.
If you are ever too flexible, have pain in your lower back, and feel tension in your lumbar and gluteal muscles, here is an alternative to try:
The idea is to apply specific, sustained pressure with a tennis ball (or massage ball) to your tender points on either side of the spine or in the legs to induce relaxation.
Basically, just position the ball on the painful spot, and apply pressure using a wall. If that's not enough, you can also lie on your back and use the floor.
Remember that the sensation should be strong, but tolerable. If you're wincing in pain, you should definitely reduce the pressure.
When you have an injury or muscle tear (in the acute phase)
If you have severe back pain, it is likely to be a lumbago. This acute pain can for example come from a sudden twisting movement of the lower back which has caused muscle overstretching of the lumbar muscles, and created an inflammatory process.
In this case, it is preferable to avoid stretching for a few days, just to avoid accentuating the muscle tear and increasing inflammation. It is also the same concept that applies following a sprained ankle, or a breakdown.
When the pain gets worse
Stop stretching when the pain gets worse. Simple enough to understand, right?
Not always. Unfortunately, sometimes we have to go through trial and error to ensure that a stretch is suitable for our condition (you have certainly noticed this, sometimes to your cost!).
Here's a tip I often give to my patients when they want to know if a particular stretch is relevant to their lower back condition. I call this the traffic light analogy:
GREEN LIGHT: If the lower back stretch is well tolerated and feels good, continue!
YELLOW LIGHT: If stretching creates any discomfort, take a short break. If the lumbar symptoms fade within 30 seconds to 2 minutes, resume with a reduced intensity (for example, go less far!).
RED LIGHT: If stretching causes an increase in lower back pain that does not subside despite a short rest, we stop the exercise and aim to control the symptoms (heat, ice, medication, etc.).
4 stretches for the lower back
You are now familiar with the concept of stretching. You know the situations when it is appropriate to stretch, and when it is better to avoid them.
It's time to introduce you to 4 stretching exercises for the back. In all honesty, they're not necessarily superior to others in relieving your back pain.
Why then choose them? Simply because they make it possible to mobilize the spine in all its amplitude, that is to say in all directions. Some of these movements are inspired by yoga, and are practiced all over the world!
If you respect the principles stated above, these stretches will allow you to explore the movements of flexion, extension, lateral inclination and rotation. All these movements are necessary for the execution of everyday activities, and even more so if you are athletic.
1. Position of the child
- Kneel on a yoga mat.
- Extend your arms forward (as far as possible), and bring your buttocks toward your heels.
- You will then feel a general stretching of your back. Hold the position for 30 seconds and repeat 3 times.
2. snake
- Lie on your stomach.
- Pushing with your hands, arch your lower back until you feel a stretch in your lower back. (You may also feel a stretch in your abdominals).
- Hold the position for 20-30 seconds, and repeat 3 times.
Note: If the pain increases and/or if you feel radiating pain, stop exercising immediately. This means that extension is not your preferred direction (based on the McKenzie method).
3. Swiss ball flan stretch
- Lie on your right side on a Swiss ball. Make sure you have your legs fixed to the ground to avoid falling!
- Bring your left arm close to your ear, and extend your left leg back, making sure to keep it as stiff as possible.
- You will then feel a stretch in the left side. Hold the position for 30 seconds, and repeat 3 times.
- Do the same thing while lying on your left side on the Swiss ball.
4. Twisting stretch
- Lie on your back and bend your knees.
- Bring both knees towards one side to create a twist in your lower back.
- Once you reach the end of the movement, you can add light pressure with your hand to feel a light, comfortable stretch.
- Hold the stretch position for 30 seconds, then repeat 3 times.
Conclusion
So! You're now an expert at stretching (just kidding, of course!). But I hope at least you will stop blindly doing all the stretches offered on Youtube in the hope that they will relieve your lower back pain.
Now that you know the indications where it is best to stretch your lower back, and when to avoid them, you are in a better position to determine if the 4 stretches suggested above are justified in your case.
Also remember that flexibility is only one of the many pieces of the puzzle that make up a healthy back. In addition to stretching, it is important to incorporate cardiovascular exercises, strengthening, breathing, etc.
If in doubt, it is best to consult a health professional who will be able to choose stretches adapted to your condition, and integrate them into a complete therapeutic framework.
Good recovery!