Category Archives for "back pain"

Low Back Strains – Advanced Strengthening Nordic Push Ups

You can perform this exercise with your ankles secured under a bar, on a squat rack or wall bar or have a partner hold your feet and ankles down.

Use a yoga mat to make it more comfortable for your knees. Start by pulling in your inner core and keep it engaged the entire time. With your hands out in front of you, then slowly lower yourself down to the ground in a controlled manner into a push up position.

Once you make contact with the ground, then push yourself back up. Repeat this for 10 repetitions, doing 3 sets daily.

This is an advanced level strengthening exercise for your low back that works on increasing your functional core stability strength. 

Low Back Strain Injuries – Big Ball Roll Outs

Kneel down with a big exercise ball in front of you. Keeping your back straight and your inner core muscles engaged, slowly roll down your forearms on the pinky finger side.

Straighten out your elbows and move slightly past them on the ball. Come back up with control to the start position. Repeat this for 10 repetitions, doing 3 sets per day.

This is a great exercise to strengthen your lower back after an injury and retrain your core stability muscles to help them work better.

If you’re unsure about the exercise or have uncertainty about where you’re at with your recovery book an appointment and have one of our Physiotherapists at either our North Burnaby or Vancouver locations to check things out.

Low Back Strain Injuries – Lateral Band Walks

Whether it’s returning to sport or just being physically active, part of the rehab for your low back strain injury is to regain the functional strength of your gluteus medium muscles with lateral movements.

Wrap a closed loop resistance band around the balls of your feet. Start with the feet about shoulder width apart. Keep your posture straight and tight and your core muscles engaged. Lift one foot up and out 3 inches to the side leading with the heels.

Resist the lateral movement of the foot with the opposite foot, leg and hip that’s on the ground. Make sure that the knees don’t buckle into each other, don’t bob your head up and down, and keep the toes pointing forward (Avoid having the toes pointing outward with the hips externally rotated).

Repeat these robotic type of lateral movements for 5-10 steps going right to left and then left to right for 3 sets on each side. 

Low Back Herniated Disc Injuries- Sloppy Push Ups

Start by lying flat on the ground, on a yoga mat or a firm bed. For the beginning stages of this exercise, lift your upper chest off the ground by supporting yourself on your forearms.

Take a deep breathe out to make sure your low back is relaxed in this position and your hips are on the ground. Stay here for 10 seconds, then lower and repeat.

To make this exercise harder, put your hands out in front of your head and push up from your hands instead of your forearms. This will help lift your chest even further off the ground and get more extension through the low back.

It’s still important that you are able to relax the back and glute muscles in this position. If you can’t do this, or if your hips come off the ground, you should revert back to the first stage of this exercise. Once again, stay here for 10 seconds & return to the ground. Do this for 30 repetitions, 3 times daily.

Low Back Sprain and Strain Injuries – Kneeling Thoracic Rotation

Start by kneeling on the ground with the leg closest to the wall up in a lunge position. You can kneel on a yoga mat or pillow to provide extra cushioning and support.

Bring your arms up to 90 degrees in front of you, maintaining the arm that’s closest to the wall right up tight against the wall. Open up your other arm, like you are opening up a book, and try to get it as close to the wall behind you as you can without bringing your other arm off the wall.

You should feel a stretch in your mid back area. Return to neutral and repeat 10 repetitions doing 3 sets on each side. Make sure to keep your neck neutral without straining it, and follow the movement of your arm with your head.

If you can’t get your other arm against the wall, that’s ok. Bring it to the end barrier of it’s movement but don’t force it. A stiff mid back or Thoracic spine can contribute to lower back strains and sprain injuries and it’s usually a good idea to incorporate this into your lower back rehab.

Low Back Strain: Running Rehab Knee Highs

Resisted knee highs strengthens the hip flexors in conjunction with your core and can help you rehab your functional running strength after a low back strain.

Loop a resistance band around your ankle. Step the opposite foot forward while having the opposite arm also forward and position yourself in a running stance with your core muscles engaged below the belly button.

Bring the knee up towards the chest matching the motion with the opposite arm and then bring the foot back down with control.

A few things to look out for when you’re doing this exercise is to control the motion of the foot so the resistance band doesn’t uncontrollably pull your foot back and also keep the arms and knees from crossing the mid line of the body and prevent the low back from flexing or extending backwards too much by keeping it in neutral.

Repeat this for one minute on each side doing 3 sets 2x/day.

Resisted knee highs strengthens the hip flexors in conjunction with your core and can help you rehab your functional running strength after a low back strain. 

Sleeping Tips for Back Pain

Back pain can make it tough to sit and/or lie down for extended periods of time. Here are some tips that can help improve your sleep quality over time, while suffering with back pain.  

Stretching Before Going To Bed
Research has shown that intensive stretching or yoga and help reduce low back pain. Stretching before bed can also reduce stress and help improve sleep quality. Check out for additional benefits yoga can provide for you.  
Exercise Your Core
Getting regular physical activity can improve the quality of your sleep. Building flexibility and strength in your core muscles can reduce the chances of back strains and muscle spasms throughout the night. Check out to learn more about core stability and ways to improve it. 

Get A Good Pillow And Mattress
Studies show a medium-firm mattress is the most beneficial to most people. A mattress too soft can cause you to sink too deep into the mattress, thus causing joint pain. Test out different types of pillows and mattresses and find the correct one for you.  

Find The Right Sleeping Position
Try not to sleep on your stomach, as this can cause you to arch your back. For most people, the best position is to lie on your side in a fetal position. Another popular position is to lie on your back, but place a pillow under your knees to help maintain the natural curve of your spine. If you are unable to find a good sleeping position, you may want to refer to a specialist or physiotherapist for further help. 

Good Sleep Hygiene
Back pain can disrupt sleep, but many other factors can add to the poor sleep routine, such as bad habits. Try avoiding stimulants in the evening, and avoid heavy exercise right before going to bed. Take time to wind down by relaxing, taking a warm bath, or reading before going to sleep. Removing distractions such as computers and TV’s can also aid in good sleep hygiene. 

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Stretches to do while on an Airplane

Extended durations on cramped, uncomfortable seats for hours can cause your body to become stiff and sore. These discrete simple stretches and exercises can help travellers reach their destination pain-free, while encouraging blood circulation throughout the body. 

Seated Spinal Twists – Sitting tall, grab onto the arm rests of your seat and twist your torso from one side to the other.

Neck Rolls – slowly twist your neck from side to side, and up and down. Then bring your left ear to your left shoulder, and repeat on the other side. Finally, tuck your chin down to your chest and repeat the steps until you feel the tension release from your neck. 

Shoulder Rolls – sit in a relaxed position with your arms by your sides. Roll your shoulders both forward and backwards.

Ankle Circles – lift your feet off the ground and roll your ankles in a circle.

Calf Raises – stand with your feet a couple inches apart and raise your heels so you’re on your toes. Hold this position for a few seconds before lowering back down. You should focus on stretching out your calves. 

Quad Stretches – In a standing position, bend your knee, grab your ankle and pull it behind your back. 

Pec Stretch – place your hand on a wall with your elbow at chest height. Rotate your body away to stretch out your shoulder. Repeat on the other side. 

In addition to these stretches, don’t forget to take the opportunity to walk around every few hours to get your blood circulating throughout your body. 

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Addressing Low Back Pain while Performing a Squat (Weighted or Unweighted)

Athletes around the world regularly perform weighted squats. Research has shown that squatting has a direct impact on your body’s power, which is the ability to overcome a resistance with speed (Loxtercamp, 2018). Therefore, squatting can result in great power and an increase in sprint speed. General benefits include increased flexibility, greater core strength, as well as protection from injury as a result of better coordination of the body. 

However, squats have been known to cause unwanted low back soreness. Although squatting will work the muscles of the lower back, if the low back becomes the most targeted region during the squat, chronic soreness and overuse injury can occur. Previous injury to the lower back, poor technique, as well as weakness of the core or surrounding muscles can contribute to this overuse of the back muscles (Gordon & Bloxham, 2016). Barbell back squats are also the most common for causing back pain as the weight is loaded across the back (Loxtercamp, 2018). If you find this movement difficult, but still want to add weight to your squats, you may want to opt for goblet squats or front squats. 

Goblet Squats

Front Squats


  • Proper footwear
  • Progressing weight/load too quickly when squatting
  • Correct stance and posture
  • Spinal alignment
    • Ensure you’re looking straight ahead or an upward gaze 
  • Joint mobility 

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Gordon, R., & Bloxham, S. (2016). A systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Healthcare. 4(2). doi:10.3390/healthcare4020022

Loxtercamp, B. (2018). Influence of attentional focus on a weighted barbell back squat among experienced performers. Medicine and Science in Sports and Exercise. 50(1). doi:10.1248/01.mss.0000536504.18312.43

Mobilizing the Thoracic Spine

A tight upper back may be attributed to stiffness in the shoulder, neck, or back muscles surrounding the thoracic spine. Rounded or slump shoulders, having sway in the lower back, or a forward head position due to weak back extensor muscles, short and tight chest muscles, or weak abdominal muscles may result in an individual having poor posture. Poor posture can place tension in the upper back and may result in irritation or pain. Sports, weightlifting, irregular sleeping positions, or car accidents may also cause tightness in the upper neck and back region. Mobilizing and strengthening the muscles surrounding the thoracic spine may relieve an individual of stiffness or pain, while improving an individual’s range of motion and functioning. Remember to have a balanced, upright posture by standing tall, bringing the shoulders down and back, tuck your chin, and keep a neutral spine to work on better posture.


1) Thoracic Rotations: 

Lie sideways on a mat or on the floor with both arms extended to one side and hands together. Bend the knee of the top leg to form a 90 degree angle. Place a long foam roller underneath the bent knee if you are unable to touch the ground with this top knee. Keeping your lower body in this position, twist your upper back by bringing the top arm over your body to the other side to touch the floor. Repeat 10-12 times, then lie on the other side and complete the same movement.

2) Cat-Cow: 

Begin in a table-top position with your knees hip-width apart and wrists shoulder-width apart on a mat or on the floor. Keep a neutral spine and head position. Move into the “cow” pose by inhaling as you drop your belly down towards the mat as you lift your chin and chest up to gaze toward the ceiling. Then move into the “cat” pose by exhaling as you draw your belly into your spine and round your back toward the ceiling. Repeat 10-15 times.

3) Seated Lateral Flexion: 

Begin seated in a chair with both feet planted on the floor or seated on the floor. Raise one arm up towards the ceiling. With your arm raised above your head, slowly bend to the opposite side. Return to the start position and lower your arm. Then raise the other arm and slowly bend to the opposite side. Repeat 5-10 times on each side.

4) Thoracic Extension with a Foam Roller: 

Place a long foam roller perpendicular to your spine on a mat or on the floor underneath your shoulder blades. Interlace your fingers and place your hands behind your head to support the weight of your head. Slowly push with your feet to roll the foam roller up and down the thoracic region. Maintain a neutral spine and engage your abs.

5) 4-Point Walk-Out: 

This exercise helps to re-train muscle activation in the shoulder blades and mobilizes the muscles surrounding the thoracic spine for a better functional recovery. Place your hands and knees in a four point or table-top position with a neutral spine. Engage the inner core and start by walking one hand out to one side, then back to the centre, and then to the other side, then back to the centre again. Put full equal weight each time you place your hand down. Maintain a neutral spine throughout the exercise. Repeat for 30 seconds for 3 sets.

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.