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TheBasicCoxLowBackExerciseProgram

toAccompanyChiropracticManagementofLowBackPain

GeneralInstructions:
Dotheseexercisesonafirmsurfacesuchasthefloorwithorwithoutamat.
Ifyouexperiencepainduringanyexercise,stopandconsultyourdoctorbeforecontinuing.
TheBasicCoxLowBackExerciseProgramisusedinconjunctionwithyourchiropracticcareandshouldbediscussed
withyourchiropracticphysicianbeforeuse.
Dotheexercisesmarked(x)innumericalorder____timesaday.

Exercise1.PelvicTilt(AbdominalTightening)

1. Whilestandingorlyingonyourback,tightentheabdominalandbuttock
musclessoastoflattenyourback.
NOTE:Iflying,flattenyourbackagainstthesurface.
2. Contractthemusclesforaslowcountof4.
3. Relaxthemusclesforaslowcountof4.
4. Repeat6timeseachsession.

Exercise2.PelvicLift

1. Lieonyourbackwithyourkneesflexedandyourfeetflatontheflooras
closetothebuttocksaspossible.
NOTE:Keepyourkneestogether.

2. Tightenthemusclesofthelowerabdomenandbuttockssoastoflatten
yourlowbackagainstthefloor.

3. Slowlyraiseyourhipsupoffthefloor,andholdforslowcountof4.
4. Repeatthisexercise6times.
NOTE:Ifyoucannotraiseyourhipsfromthefloor,merelytighten
thebelly,theabdominalandbuttockmuscles,andwaituntilyouare
strongenoughtoraisethehips.

Exercise3.KneeChest
1. Lieonyourback.
2. Drawyourrightkneeuptoyourchest,andpullthekneedownupon
yourchest.
3. Dothisforaslowcountof4.Repeatthisexercise6timeswiththeright
knee.Relaxbetweeneachkneechestexerciseforafewseconds.

4. Repeatthesameexercisewithleftkneebroughttothechest.
5. Dothisforaslowcountof4.Repeatthisexercise6timeswiththeright
knee.Relaxbetweeneachkneechestexerciseforafewseconds.

6. Repeatwithbothkneesbroughtuptothechest.
7. Dothisforaslowcountof4.Repeatthisexercise6timeswiththeright
knee.Relaxbetweeneachkneechestexerciseforafewseconds.
Disclaimer:Onlydotheseexercisesifyouarerecommendedtodosobyyourdoctor.Donotexercisewithouttherecommendationbyyourdoctor.Listencarefullyto
anymodificationsyourdoctorgivesyouforeachexercise.Onlydotheexercisestoyourtolerance.Ifyouexperienceanypain,stoptheexercises,anddiscusswith
yourdoctor.Ifyouhaveanyquestionsabouttheappropriatenessofanyexercise,askyourdoctorbeforeproceeding.

Ifacutebackpainispresent,performonlythefirstthreeexercises.Aftertheacutepaindiminishes,dothefollowing
exercisesifyoufeelnopaininyourlowbackuponcoughing,sneezing,orstrainingtomovethebowel.Followdoctors
ordersonincreasingexercises.

Exercise4.HamstringStretch

NOTE WHY: The hamstring stretch is a very important exercise as tight hamstrings limit flexion of the pelvis at the hip
jointsandforceyoutomoveyourbackmorethannecessaryforforwardbendingatthewaist.

NOTE HOW: Stretching hamstrings can be done in a number of ways. PNF (proprioceptive neuromuscular facilitation)
technique isthepreferredmethodtostretchhamstrings.Itisacombinationofcontractionagainstresistance,rest,and
stretching.PNFrequiresanassistantthough,soifyoudon'thaveanassistant,wepresentanalternativemethodforyou
tomakeyourownresistanceasdetailedbelow.

PNFMethodwithanAssistant:
1. Lieonyourback.
2. Haveyourassistantholdyourankle/foot,andholdyourkneestraight.
3. Theassistantliftsthelegashighasthehamstringmusclelengthwillallow.
4. Haveyourassistantholdthisposition.
5. Pushagainstyourassistant'sresistanceforacountof8.
6. Stoppushingandrelaxthehamstringmuscles.
NOTE:Youmaywanttorestyourfootagainstyourassistantsshoulderand
pushagainsttheshoulderifyoulike.Haveyourassistantpushyourleg
upwardtostretchyourhamstringmuscle.
7. Stretchthehamstringmusclebyslowlyandsteadilyflexingthehipbypushing
upwardonthepatientsankleandleg.Holdthisstretchforacountof8.
8. Repeat3timeswitheachleg.

PNFMethodwithaTowel:
1. Lieonyourback.
2. Useatoweltopushagainstforacountof8.Rest.
3. Pullyourlegtowardsyoubypullingonthetowel.
4. Holdthisstretchforacountof8.
5. Repeat3timeswitheachleg.

PNFMethodAlone:
1. Lieonyourback.
2. Raiseonelegstraightupwardwithoutbendingtheknee.
3. Placeyourhandsbehindthekneewhilekeepingthekneestraight.
4. Raisethelegstraightupwardasfaraspossible
5. Pushagainstyourhandresistanceforaslowcountof8
6. Stoppushingagainstyourhandresistanceandpullthelegstraightupsoasto
stretchthehamstringmusclesbehindyourthigh.
7. Holdforacountof8.Repeatthis3timeswitheachleg.

Disclaimer:Onlydotheseexercisesifyouarerecommendedtodosobyyourdoctor.Donotexercisewithouttherecommendationbyyourdoctor.Listencarefullyto
anymodificationsyourdoctorgivesyouforeachexercise.Onlydotheexercisestoyourtolerance.Ifyouexperienceanypain,stoptheexercises,anddiscusswith
yourdoctor.Ifyouhaveanyquestionsabouttheappropriatenessofanyexercise,askyourdoctorbeforeproceeding.

Exercise5.AbdominalStrengtheningExercise

1. Lieonyourback.
2. Bendyourkneeswithyourfeetflatonthefloor.
3. Eithercrossyourarmsoveryourchestorplacehandsbehindtheheadtosupport
theheadandneck.
4. Flattenyourspineagainstthefloor.
5. Raisetheshouldersoffthefloorbycontractingtheabdominalmuscles.
NOTE:Feeltheabdominalmusclescontractandtighten.
6. Raisetheshouldersupwardslowlyuntilyoufeeltheabdominalmusclestighten.
7. Relaxtheabdominalmuscles.
8. Allowtheshoulderstoreturntothefloor.
9. Repeatthisexerciseasmanytimesaspossiblestartingwithasmanyrepetitionsas
youcandocomfortably.
NOTE:Make50to75repetitionsyourgoal.

or

Exercise6.ButtockMuscleStrengtheningExercise

1. Lieonyourstomach.Placeyourchinonyourhands.
2. Turnyourrightfootout.
3. Tightenthebuttockmuscle,andraisetherightlegoffthefloor
whilekeepingthekneestraight.
4. Holdthisforaslowcountof4.
5. Slowlyletthelegdown.
6. Repeatthis6timeswiththerightleg.
7. Repeatontheleft,6timesforaslowcountof4.

Exercise7.LowBackStrengthening*

1. Lieflatonstomachwitharmsalongsideyourbody,palmsup.
2. Slowlyraiseyourchestfromthefloor.
3. Feelthemusclesofthelowbacktighten.
4. Holdthechestupfromthefloorforaslowcountof4.
5. Slowlyletthechestdown.
6. Restafewsecondsbetweeneachsession.
7. Repeatthis6times.
*Onlydothisexerciseuponapprovalfromyourphysician.

Disclaimer:Onlydotheseexercisesifyouarerecommendedtodosobyyourdoctor.Donotexercisewithouttherecommendationbyyourdoctor.Listencarefullyto
anymodificationsyourdoctorgivesyouforeachexercise.Onlydotheexercisestoyourtolerance.Ifyouexperienceanypain,stoptheexercises,anddiscusswith
yourdoctor.Ifyouhaveanyquestionsabouttheappropriatenessofanyexercise,askyourdoctorbeforeproceeding.

Exercise8.OuterThighandHipStretch
StretchingthebuttockandhipmusclesisdonewithPNF(proprioceptiveneuromuscularfacilitation)techniqueaswell.

or

PNFAssistantMethod:
1. Lieonyourback.
2. Placeyourleftfootonoutsideofyourrightknee.
3. Pushtheleftkneetotheleftagainsttheassistantsresistance.
4. Holdforaslowcountof8.
5. Relax.
6. Haveyourassistantpulltheleftkneetotheright.
7. Thisstretchestheoutsidelefthipandbuttockmuscles.
8. Repeatwithyourrightfootontheoutsideofyourleftknee.
NOTE:Dothis6to8timesoneachside.

PNFMethodWithoutAssistant:
5. Whilesitting,placeyourleftfootontheoutsideofyourrightknee.
6. Resistyouroutwardpushoftheleftkneebyplacingyourhandon
theoutsideoftheleftkneeandpushingagainstthehandresistance.
7. Holdthispressureforaslowcountof8.
8. Relax.
9. Pushtheleftkneetotherighttostretchthelefthipandbuttock
muscles.
6. Repeatwithyourrightfootontheoutsideofyourleftknee.
NOTE:Dothis6to8timesoneachside.

Exercise9.Innerthighstretch
StretchingtheinnerthighmusclesisdonewithPNF(proprioceptiveneuromuscularfacilitation)techniqueaswell.

PNFAssistantMethod:
1. Lieonyourback.Placeyourleftfoot/ankleonyourrightkneewith
thekneelyingasfardownaspossible.
2. Haveyourassistantpushagainst/downontheleftkneeasyoupush
up.

NOTE:Thisforcestheleftinnerthighmusclestocontract.
3. Holdthispressureforaslowcountof8.
4. Haveyourassistantstoppushing,andrelaxthemusclecontraction
oftheinnerthighmuscles.
5. Forcethekneedownwardtostretchtheinnerthighmuscles.
6. Stretchlikethisforaslowcountof4oruntilastretchoftheinner
or
thighmusclesisfelt.
7. Repeatwithyourrightfoot/ankleonyourleftknee.
NOTE:Repeat6to8timesoneachside.

PNFAloneMethod:
1. Situpright.Placeyourleftfoot/ankleonyourrightknee.
2. Letthekneefalldownward.
3. Useyourhandtoresistasyoupushyourleftkneeup.
NOTE:Thisforcestheleftinnerthighmusclestocontract.
5. Holdthispressureforaslowcountof8.
6. Relaxthemusclecontraction.
7. Forcethekneedownbyusingyourhandpressuretopush.
8. Stretchlikethisforaslowcountof4oruntilastretchoftheinner
thighmusclesisfelt.
9. Repeatwiththerightfoot/ankleonyourleftknee.
NOTE:Repeat6to8timesoneachside.
Disclaimer:Onlydotheseexercisesifyouarerecommendedtodosobyyourdoctor.Donotexercisewithouttherecommendationbyyourdoctor.Listencarefullyto
anymodificationsyourdoctorgivesyouforeachexercise.Onlydotheexercisestoyourtolerance.Ifyouexperienceanypain,stoptheexercises,anddiscusswith
yourdoctor.Ifyouhaveanyquestionsabouttheappropriatenessofanyexercise,askyourdoctorbeforeproceeding.

Exercise10."Exercisebeforearisinginmorning"

Beforegettingoutofbedinthemorning,dothecombinationofexercises3&4whilelyinginbed.
ThiseliminatestheexcuseofIdonthavetimetoexercise!andbenefitsyourspinebywarmingupyourmusclesbefore
youhavetousethem.

Dothisroutineslowly.Itwillstretchyourlowbackandthighmusclestoallowgreatercomfortonarisingtoweight
bearingposture.

1. Pullyourkneestoyourchest.
2. Holdforaslowcountof4.
3. Repeat6times.
4. Holdyourrightlegbehindthekneetostretchthehamstring.
5. Keepyourrightkneestraight.
6. Holdforaslowcountof4.
7. Repeat6times.
8. Holdyourleftlegbehindthekneetostretchthehamstring.
9. Keepyourleftlegstraight.
10. Holdforaslowcountof4.
11. Repeat6times.
AND
12. Slowlygetoutofbed.
Rolltoyourside.
Riseupononeelbow
Swingyourlegsoffthesideofthebed.
Pushuptoasittingposition.
Slowlyrise,usingyourlegmusclestostand.
Moveslowlyandpurposelyinthemorning.

Disclaimer:Onlydotheseexercisesifyouarerecommendedtodosobyyourdoctor.Donotexercisewithouttherecommendationbyyourdoctor.Listencarefullyto
anymodificationsyourdoctorgivesyouforeachexercise.Onlydotheexercisestoyourtolerance.Ifyouexperienceanypain,stoptheexercises,anddiscusswith
yourdoctor.Ifyouhaveanyquestionsabouttheappropriatenessofanyexercise,askyourdoctorbeforeproceeding.