Clamshell exercise start

As a fitness professional, I’ve encountered many clients who have either suffered from or are suffering from low back pain. This is one of the most common musculoskeletal disorders that plagues the population and is said to be the second most common complaint doctors hear from patients. When it comes to low back pain, whether it is acute or chronic, or a result of a strain, sprain or disc degeneration, it can be extremely debilitating and can limit one’s ability to function in daily life.

Before establishing an exercise program with your personal trainer or Corrective Exercise Specialist, it is important to understand the nature, duration and severity of your low back pain. It is essential for you to get clearance from a physician or physical therapist.

It is important to note that pain reduction and improved function may not be immediate and may take several months to become evident.
Avoid the following movements so as not to exacerbate pain in the low back:

• Rapid twisting, forward flexion or hyperextension
• Unsupported forward flexion
• Simultaneously lifting legs while lying prone or supine
• Twisting at the waist with feet turned

Determine which movements create discomfort or pain for yourself. You should inform your personal trainer or Corrective Exercise Specialist of any postures, movements or positions that produce pain. The major focus in programming for low back pain is on improving muscular endurance, which means improving the function of the muscles supporting the spine.

In programming and training:
• Be aware of your posture and alignment
• Know how to adopt and maintain a neutral spine
• Be aware of your lumbar spine, abdominal bracing and glute activation

Listed below are five exercises, from St. Louis, Brentwood, and Clayton, MO personal trainers, of varying difficulty to help improve function and relieve low back pain. As function improves and pain diminishes, you can incorporate more challenging exercises to improve strength.

Start with one set and increase to two to three sets as tolerated and as function improves. The recommended range for muscular endurance is 12-16 reps depending on the your fitness level and low back pain. You may start with fewer repetitions if you are a beginner until you are able to work up to the muscular endurance repetition range.


Wall roll start

Wall roll end

Improves torsional control and encourages abdominal bracing through co-contraction
• Assume plank position with both elbows planted on a wall
• Abdominals are braced
• While on the balls of the feet, pivot, pulling one elbow off the wall
• Avoid any motion at the spine while the movement occurs
• Work up to approximately 10 repetitions 


Clamshell exercise start

Clamshell exercise end

Retrains the gluteals, which is important for improving back health
• Lie on the side, and anchor the thumb on the anterior superior iliac spine
• Reach around with the fingertips and position them to land on the gluteus medius
• Keeping the heels together, open the knees like a clamshell
• The position of the fingertips on the gluteus medius should allow your personal trainer or Corrective Exercise Specialist to feel glute activation


Side Bridge start

Side Bridge end

Targets lateral muscles, which are important for optimum spinal stability
• On the side of the body, place elbows under the shoulder
• Elevate hips and knees off the ground
• Perform regression with knees on the ground if this is too much for you
• Hold for 20 seconds


Bird Dog

Safely and effectively develops spinal extensors
• Begin on all fours, hands under shoulders and knees under hips
• Extend opposite arm and leg (hold position as tolerated)
• Work up to holding extended position for seven to eight seconds on each side


Hip bridge end

Improves core stability via glute activation
• Lie supine, elevate hips off the ground
• Activate glutes as hips are elevated
• Hold for three to five seconds

For more information on how to combat low back pain, contact Maurie Cofman, CMES, CES, TBMM-CES, Personal Trainer, Certified Medical Exercise Specialist, Health Coach and Corrective Exercise Specialist in the St. Louis, Brentwood, and Clayton, MO area.