Low Back/Core Rehabilitation

Strengthening

Pelvic Tilt- Lie on your back with knees bent and feet on the floor. While maintaining this position, engage the core by flattening the low back (patient should focus on rotating hips backwards) and hold for 2-3 seconds. Relax and return to starting position. Complete this 15 times. 

Pelvic Tilt with March- Lie on your back with knees bent and feet on the floor. While maintaining this position, engage the core by flattening the low back (patient should focus on rotating hips backwards). While the back is flattened, the patient will raise their leg in a "march" position. Return to the starting position, while still maintaining a flattened back. Switch sides. Complete this 15 times. 

Cat-Cow Exercise- Get in four-point position on hands and knees, shoulder width apart. Hips should be bent at 90 degrees and back should be in neutral spine. Cat: tuck chin to your chest and arch your back. Hold for 5 seconds. Cow: Raise chin, look up and dip the back. Hold for 5 seconds. Alternate between "cat" and "cow" positions (Cat- Caw is 1 rep). Repeat 30 times. 

Bird- Dog Exercise- Kneel in four point position on hands and knees. Tighten core (Neutral Spine and Flat Back). Raise left arm and right leg up to a table top position. Slowly lower to four point position. Repeat with opposite side. Try not to rock the hips. The hips should stay stable throughout the entire exercise. Repeat 10 times, 3 sets. 

Lumbar Bridging- Lie on back with knees bent, shoulder width apart. Lift hips up, squeeze glutes and hold for 5 seconds. Slowly lower to starting position. Repeat 10 times, 3 sets. 

Clamshells- Lie on your side with knees bent and Theraband looped around thighs, just above the knees. Keeping the heels together and lift top knee upward while squeezing glutes. Do not rock the hips backwards. Slowly return to starting position. Repeat 10 times, 3 sets on both sides. 

Stretching

Lumbar Rotation Stretch- Lie on back with legs straight. Bend one knee up to chest and grasp outside of the knee with opposite hand. Twist trunk to one side while shoulders maintain contact with the ground. Hold for 10-15 seconds., then switch to the other side. Repeat 10 reps. 

Figure 4 Glute Stretch- Sitting on a chair, cross opposite ankle over bent knee. Sitting up straight, gently put pressure on the bent knee and lead forward with a straight back. Hold for 30 seconds, repeat 3 times. Repeat on opposite side. 

Hip Flexor Stretch- Take big step into a forward lunge. Back leg is kneeling on ground. Front leg is positioned with knee over ankle. Do not allow knee to push past toes. Push hips forward while raising arms up and over head. Hold for 30 seconds, repeat 3 times. Repeat on opposite side. NOTE: this can also be done on a stool for increase range of motion. 

Hamstring Stretch-Lie flat on the ground or table with legs fully stretched out. Wrap the stretching strap (Black) around the foot of the leg. Pull the leg up towards the chest, and slowly straighten the knee until it feels as though it is stretching. Hold for 30 seconds. Repeat 3 times on both sides. ​

Soft Tissue Mobilization

Foam Roll Hamstring- Sit on the ground, place roller under legs just above the knee and balance on hands behind you. Slowly roll from just above the knee up to glutes, scannng for tender areas. Rotate foot in and out to isolate areas of the hamstring. Cross over leg to emphasize pressure on one leg. Complete for 3 minutes on each side. 

Foam Roll Hip Flexor-Lie on stomach on the ground, place roller halfway between belly button and hip. Support upper body on elbows directly under shoulders at 90 degrees. Slowly roll from top of thigh to hip bone, scanning for tender areas. Complete for 3 minutes. 

Foam Roll Piriformis- Sit on the ground, place roller under your left sit bone and place left ankle over the right knee. Tilt to left side, focusing on one glute at a time. Balance with hands behind you and right foot flat on the ground. Slowly roll from top to bottom of glutes, scanning for tender areas. Complete for 3 minutes. Repeat on the other side. 

Foam Roll Low Back-Lie on back on the ground, place roller in the arch of your lower back. Place feet on the ground with knees bent and arms across the chest. Slowly roll along the arch of the back, scanning for tender areas. Rotate to the right or left, supporting yourself with your forearm. Complete for 3 minutes.