When we talk about exercises for the herniated disc, recommendations often focus on thelumbar extension. You will find YouTube videos that offer exercises such as the Cobra, the Sphinx or even movements based on the McKenzie method, techniques that emphasize movements where we would arch the lower back.
These extension exercises are often prescribed because they can help bring the hernia back into a central position and reduce pressure on the nerves. But what is often overlooked is that there is an important piece missing from this therapeutic puzzle: la lumbar flexion at the end of treatment.
Important points to remember
- Lumbar extension exercises are often effective in the initial stages of disc herniation treatment.
- Long-term, avoid lumbar flexion is an error that can limit complete healing.
- The goal is to mobilize the column in all directions for optimal rehabilitation.
- Centralization of symptoms is an initial priority, but progressive flexion becomes crucial as healing progresses.
- An adapted and progressive program, like the one proposed in the 21 day program against back pain, includes movements in all amplitudes.
Why is lumbar extension prescribed for herniated disc?
La herniated disc is often the result of excessive or prolonged movements of lumbar flexion. For example, lifting a heavy load in a bent position or spending long hours sitting can cause a herniation. In these cases, repeated pressure on the intervertebral discs causes the nucleus of the disc to come out, creating a herniation.
THElumbar extension acts in counterbalancing this movement. By arching the lower back, it can be hoped to bring the displaced disc back to a more central position, thereby relieving pressure on the nerves and reducing symptoms such as sciatica (pain radiating down the leg) and numbness.
The goal of centralizing symptoms
Another great benefit of extension exercises is their ability to centralize symptoms. This means that the pain, which can extend from the spine to the leg, is referred to the lower back.
If sciatic pain is reduced, this often indicates an improvement in the condition of the disc and a reduction in nerve compression. For this reason, extension is often the first step in a treatment program for herniated disc.
Why lumbar flexion is crucial at the end of treatment
Once the pain is centralized and symptoms are under control, the common mistake is to continue to avoid bending movements. This seems counterintuitive, especially if flexion is the cause of the hernia. But in the long run, it is essential to remobilize the spine in all directions, including bending.
Why not avoid long-term bending?
Completely avoiding lumbar flexion after a herniated disc can lead to harmful consequences. This is because the spine is designed to move in all directions : forward (flexion), backward (extension), to the sides (lateral tilts) and rotation. If you continue to avoid lean forward, you limit the functional capacity of your spine, which can lead to muscle imbalances and additional tensions on other parts of your back.
For example, in the method McKenzie, which places a lot of emphasis on expansion in the initial phase, it is recommended to reintroduce the lumbar flexion at the end of treatment for complete rehabilitation. Exercises such as bringing the knees to the chest, child's pose, or leaning forward while seated are often added to restore balanced mobility.
The myth of “never bending over” after a herniated disc
A common myth is that you should not never leaning forward after a herniated disc. This is true in the short term, when bending could make things worse, but this idea is too restrictive in the long term. By reintroducing flexion in a progressive et controlled, you can regain full, healthy mobility, while avoiding future back problems.
When and how to reintroduce lumbar flexion?
The key is to do it at good time. Once your radiating pain is under control and the lower back pain is no longer constant, you can begin to explore flexion exercises under the supervision of a professional or by following a structured program. Flexion should be progressive and introduced into limited amplitudes before increasing the intensity.
Mobilize the column in all directions
Effective rehabilitation for herniated disc should include movements in all directions : forward, backward, sideways, and rotating. By ensuring that your spine can mobilize in all of these planes of motion, you reduce the risk of recidivism and improve the resilience of your back.
Regain control of your herniated disc with a tailored program
For those who want to take a comprehensive, step-by-step approach, I encourage you to try my 21 day program against back pain. This program includes extension and flexion exercises, adapted to your condition and designed to be safe and effective. You will also find tips for improving your mobility and returning to an active life.
👉 Sign up here for the 21 Day Back Pain Program
To go even further, you can access Lombafit Studio, a comprehensive platform that offers guided exercise sessions to improve your back health.
👉 Discover Lombafit Studio here
References
- McKenzie, R. A. (1981). “The Lumbar Spine: Mechanical Diagnosis & Therapy”. Spinal Publications Limited.
- Michel Benoist (2002). Natural history of lumbar disc herniation and radiculalgia. https://doi.org/10.1016/S1169-8330(02)00302-2
My name is Anas Boukas and I am a physiotherapist. My mission ? Helping people who are suffering before their pain worsens and becomes chronic. I am also of the opinion that an educated patient greatly increases their chances of recovery. This is why I created Healthforall Group, a network of medical sites, in association with several health professionals.
My journey:
Bachelor's and Master's degrees at the University of Montreal , Physiotherapist for CBI Health,
Physiotherapist for The International Physiotherapy Center