I have covered the topic of back pain and in particular bulging disc injuries numerous times on my website as it is such a common injury that statistics show it is one of the most common injuries among people today. In 2009 1 in 7 Australians (13.6%) reported having serious back problems—that’s 3 million people! This injury can affect people of all ages and in recent times I have seen many teenagers suffering with this extremely painful and debilitating injury. The worst part about this is it can be prevented. If you are already suffering with this pain it can take considerable work to eliminate the pain for good and may require a multitude of exercises to find the right balance. Having said that for over 16 years of working with over a thousand different cases of bulging discs I have found I often resort to a few key exercises. The ones I use most can vary considerably from person to person in terms of which is more important and beneficial, but in most cases the following exercises I am about to explain in this article, are the ones that provide relief in the short term and get them out of chronic pain. There will be a stack of things to do as time goes on to eliminate the problem for good but these exercises provide the foundation to work upon without risk of more damage.

A bulging disc can commonly be referred to as a slipped disc or a protruding disc. However, when the disc bulge is significant enough for the disc nucleus to come out of the annulus, it is known as a herniated disc.

As I mentioned in the introduction there is no one size fits all approach to treating back pain or following a template of exercises that everyone should use. You have to use various exercises like tests to see if you have a dysfunction that needs to be addressed and use the results of your tests to determine where to start.

Just because the pain symptoms or MRI report of two people are identical, the reason for the injury could be completely different. Meaning the treatment will also be completely different.

Having said that there are some things you need to learn that are not exercises as such, they are movements we use in life. If you move poorly with these daily movements you will inevitably end up in pain. These movements are things like walking, bending over, how you sit in a chair. Funnily enough it is often within these movements that back injuries are created. Identifying dysfunction or finding the pain trigger as Dr Stuart McGill likes to call it is vital in the early stage to help you avoid using the very thing that created the problem.

Changing the dysfunction is another thing altogether and can be very difficult and time consuming to do. Often there is often considerable compensation, weakness, and pain within these movements limiting your ability to correct the problem. This is where you will need additional exercises to help you change the “big” problem that is too difficult to face head on.

The following exercises are a big part of my “go-to” exercises with most people I see with back pain. Once again I must state there are a lot more things I will need to do than these exercises but most of the time the other movements are built around these “go-to” exercises. These are listed in no specific order as most of the time I am trying to implement all of them as soon as possible.

Okay let’s get started.

1: Sit Correctly

You wouldn’t think that sitting is an exercise, but for many people I need to teach them how to sit correctly and in many cases this is a real game-changer. Obviously it is a good idea to limit how much you sit, but for some their job may require them to sit for long periods so it makes sense to know what good form with this is.

Sustaining a slouching or forward bending of your spine leads to overstretching and weakness of the posterior fibrocartilage (or annulus) of the spinal discs. Over time, this leads to poor disc integrity and displacement of the disc nucleus fluid posteriorly. This places your spinal joints and nerves under pain-causing pressure.

Take a look at the picture below. Click here to see the You Tube video explanation.

This chart demonstrates the spinal pressure from various positions in comparison to standing. Note the spinal disc pressures from sitting slouched are much greater than the spinal compression of bending with load otherwise known as a deadlift!

When we bend over to pick something up we do not stay in that position for hours at a time. It is more like a second or two before we pick the object up and stand up straight again. Yet when we sit we can easily be stuck in one position for hours at a time with no relief at all on the discs.

The biggest mistake I see is where people fall into a POSTERIOR TILT of the pelvis where the butt rolls underneath and they round out their spine. This leads to what is known as “BUTT GRIPPING” and can become a very serious chronic condition that can be very hard to get rid of.

The very first thing you need to do is move your butt back into the corner of the chair and gently roll your pelvis ANTERIORLY to allow you to maintain an optimal position of the spine and hip. Some people may find this very tiring as the muscles required to do this may be very weak. Using a lumbar roll to sit in the curve of your spine may be very useful here as well as taking breaks by standing up or even kneeling on the floor every 10 minutes to give your muscles a rest.

Watch the video below to see more.

Another great way to combat this is to minimize how much you sit and use a stand-up desk! There has been several studies have been completed as to the effectiveness on these desks with back pain. One study participants have reported up to a 32% improvement in lower back pain after several weeks of using standing desks. Another study published by the CDC found that use of a sit-stand desk reduced upper back and neck pain by 54% after just 4 weeks. Additionally, removal of the sit-stand desks reversed some of those improvements within a 2-week period.

If you do need to sit down for work make sure you have a good workstation set-up. You will find a comprehensive workstation set up featured in this article - Move more and sit less

Other great articles I suggest to read with a ton of information relating to this are shown below.

• How much compression is placed on the spine during sitting?
• 5 daily habits that could be ruining your spinal alignment

2: Horse-stance (Bird-dog)

It is no surprise to see this is the first exercise as it is a perfect choice for a person suffering with any type of back pain.

Positioned in this prone (face down) allows the spine to lengthen and avoid being compressed, while at the same time maximising your stabilizing muscles of the core and shoulder. The hip extension part of the exercise allows you to improve your hip mobility in combination with activation of the important gluteal muscles. This exercise allows you to do work freely with little chance of aggravating the lower back muscles that often comes with other exercises using the legs.

The best part about this exercise with regards to a bulging disc injury is the prone position, for this position allows for gravity to drop the disc away from the sciatic nerve. For this reason it is usually my first choice as an exercise for anyone in pain, especially someone who I may have assessed is unstable with their joints. It is also a great exercise to do first thing in the morning when your hips and back are locked up.

This is the only exercise that I use that appears to be an abdominal strengthening type of movement. Many people think you need to use heaps of planks and specific abdominal exercises to strengthen the core. Not only is this a false myth, in many cases these exercises are part of the problem. The horse-stance exercise engages all parts of the core, not just the anterior abdominal wall which makes it superior to other forms of core work. The strength of the abdominal muscles is of no importance, the timing is.

You can read more about the horse-stance and why core training can be a real problem in the articles below.

• Is the horse-stance exercise the best for treating back pain?
• Why a strong core is not enough to prevent back pain

3: Romanian Deadlift

A real fear or re-injury is present with the bending movement as it closely mimics the action many people completed when they hurt their back. However, it is for this reason you MUST learn how to do this exercise correctly and so well that it can never hurt you again. This goes against the logic of most people, and even the instructions from therapists or doctors, who tell people never to do deadlifts or it will hurt their back.

It is important to understand that this is not an exercise, it is a pattern of movement we use in daily life all the time. Either you use a good pattern that is free of pain and limitation, or you use a poor one that destroys joints and creates pain. Many people hurt their back from something as simple as picking up a pen or tying their shoe laces. It was not that specific movement that was the problem it was the thousands of poor ones preceding it that was.

The picture below shows you the relevance of how this movement relates to so many real life movements.

Spending the time to improve your movement efficiency and then your strength and endurance to avoid fatigue is absolutely critical if you want to get rid of your pain for good. The earlier you start learning how to do this movement correctly the better as it stops you from continually aggravating the discs and the sciatic nerve giving the body a chance to heal itself.

Out of all the exercises I use this one is a constant from the first day of the program right up to the last day. It helps you to get out of pain in the short term, and also has a great influence of making sure it doesn’t return.

Great articles to read about this are in the links below

• Why the Romanian Deadlift is the key to treating hip and back injuries
• Which version of the deadlift is the best for your body?

Now the only problem with learning the deadlift is that some people have too much stiffness in their hips that does not allow them to get in the right position. This is where some people need to work on improving their hip mobility to give their body a chance at performing bending movements correctly. This brings us to the next exercise.

4: Hip & Thoracic Mobility

Some people have incredible strength in their glutes and their core, they even have great coordination and an understanding of how to move correctly. Unfortunately, they lack enough mobility to position their joints in safe and neutral positions and expose their body to damage.

I know for myself that the 2 times I hurt my back it was due to poor hip mobility that forced me to move in a compensatory way. My strength was great, the problem was I was unable to use it effectively for I could not position myself correctly to move.

The hip and thoracic mobility have a big influence over the stability of the lumbar spine. Both of these areas of the body are primarily concerned with providing you with the ability to extend and rotate. Unfortunately, our modern lifestyle of sitting too often tends to stiffen and lock these joints up. If you are not paying attention to this stiffness the body is forced to find another way and this is when it starts flexing, over-extending, and even twisting the lumbar spine to find the lost range of motion from the stiffness at the hips or thoracic region.

How do you fix this?

Well it is not quite as simple as do this one stretch and you are done. Once again the types of exercises you may need to use will vary from person to person so I found it good to have a series of different stretches and drills to see what works best. Below are two videos to watch that show you some ways to do this.

I also suggest to read these two articles for more detail about each joint.

• Top 10 hip mobility drills to improve movement
• 10 ways to improve thoracic mobility

5: Single Leg Stability & Strength

This particular movement can be very difficult to do early on and might be the one I save for last. We know that with most cases of back pain the glutes are very weak and there is poor stabilization of the pelvis in a single leg stance that creates all types of compensation as the body flexes laterally on itself. Why is single leg stance so important?

This is important for we use it all the time when we walk. If we are unable to stabilize the pelvis during walking, the walking action will create compensation that leads to hip stiffness, gluteal weakness, and ultimately an unstable lumbar spine. This is where we can see back pain from a lateral pelvic tilt creating havoc on multiple joints on the body and even causing scoliosis in the spine.

At first single leg exercises are not about strength, they are more to do with joint alignment and control. This is where I love to use exercises like the Toe Touch Drill that are very simple and risk-free, yet extremely effective at restoring stability to the stance leg during walking.

As time goes by and the person improves their joint stability and control of this movement I progress to more strengthening based exercises like the single leg deadlift and single leg squat. It is in these movements that they can build incredible strength into areas that may have been weak for a long time. By addressing this weakness you go a long way to preventing the problem from returning. In addition to the Romanian Deadlift the single leg exercises are a crucial part of the long term recovery and movements that a back pain sufferer will need to work on for some time.

Below are two videos to watch that feature these single leg movements and explain the skills you need to have to improve your ability to execute this stance effectively.

You will also find great information in the articles below relating to these two exercises.

• Why the Toe Touch Drill is my favourite stability exercise
• How to use the single leg squat as an assessment tool

6: Walking

From a fundamental stand point walking is the most basic of adult daily movements and is something we really don’t think about, simply because we are usually so efficient at using it. Many people would not think the simple act of walking can be a critical part of their rehabilitation program. With every step you take, your arms, hips, and surrounding muscles activate in perfect harmony to complete their role in the movement.

"Each step is a series of small muscle contractions that work to keep the pelvis from sinking down on one side and bending the spine". - Dr Stuart McGill

I remember a few years ago reading a book called the "Gift of Injury" written by Brian Carroll and Dr Stuart McGill. This is a book written like a case study that talks about Brian Carroll who was an elite power-lifter who suffered a severe back injury that almost crippled him. It explains how he rebuilt his body through corrective exercise with the help and guidance of world renowned back pain researcher and scientist Dr Stuart McGill. 

There is a part in the book where he refers to the use of an interval walking program during his early stages of rehab that made a big difference to his treatment. Dr McGill prescribed him to walk 15 minutes at a brisk pace with swinging arms 3 times per day. Here is Dr McGill's reasoning for this.

"Walking is the best tool we have in the essential early training of the muscles in the frontal plane. This simple movement engages and exercises the core muscles required to counterbalance a recovering back, and takes some of the load off the rear muscles. Pained individuals tend to carry an unnatural tension in their shoulders. Laxity is required in the shoulders to reduce spine load while walking which is why we encourage a jaunty arm swing to loosen those shoulder muscles as you stride." - Dr Stuart McGill

Brian Carroll also explains in the book himself how this strategy along with several basic exercises were pivotal to his recovery in the stage where his pain was at its worst. This really struck a chord with me at the time, and it was something I put in my memory bank as I was constantly working with people suffering similar symptoms and could see this being a valuable tool to use.

Now before you start pounding the pavement you need to be aware that HOW YOU WALK is of great importance.

In Dr McGill’s book he provides 5 ways to build a pain free walking posture. These are listed below for you to follow.

1. Maintain an upright posture which embraces a pain free stance. This can be achieved by proper “stacking” of your spine over your hips. Adjusting the tilt of your hips either forward or back should give you a sweet spot you can resort back to if you feel you posture gets out of line. Your chest should be high and your head and neck should be straight over your shoulders and not leaning forward.
2. Gently engage your abdominals without gripping excessively. DO NOT hold your abdominal muscles stiff like you would with a plank or you will risk ruining the movement. See the article on gripping for detail on this.
3. Start in one spot doing “marching steps”. With this you’re establishing a strong walking movement with your knees coming up slightly higher than they would if you were walking normal.
4. Start walking with your arms swinging at the shoulders not just the elbows.
5. Progress with larger and faster steps until you can maintain a pace that looks like you are trying to get somewhere in a hurry. You still want to maintain good posture and control. Controlled yet aggressive.

Watch the video below for a good explanation of how this works and the important technique tips you need to be aware of.

You will also find this article a great resource – Why walking is so good for treating back pain

Do you Need More Help?

Before jumping straight into a corrective program make sure you have seen a qualified Health professional for an accurate diagnosis and assessment of your condition. I cannot stress this enough as self-diagnosing can potentially lead to more problems. We often refer out to Doctors, Chiropractors, and Physiotherapists before implementing our program to know exactly what we are dealing with. Being certain on where to start is crucial to the success of the program.

If you have seen a health professional and are now looking at implementing a series of exercises and stretches this article will provide you with many great ideas on how to do this. As many people struggle to implement this into a gradual progression I created a detailed step by step program called Back Pain Secrets that includes a 85 page Ebook and 90 minute video with exercises, stretches, mobilizations and in an easy to follow format. This can be done at home or in the gym and we cover everything about your condition in great detail from eliminating the cause to best strength exercises, even nutrition to speed up the healing process! For more information you can watch a quick trailer video of what is included. Click here or on the image below to get a copy.

Summary

Well I hope I have been able to simplify what exercises to use if you currently have back pain. As mentioned several times during the article there is a lot more to do than just these movements, but if you spend the time to get these right there is a good chance you will not be suffering with pain anymore. They set a great foundation for you to build upon other exercises and movements that come with less risk as your body will be more mobile, stable, and strong enough to handle the stress. As you continue to develop your ability to move with more efficiency your body heals the damaged tissues more effectively.

Back pain can be very debilitating and change your entire life so spending the time to do these key movements is everything.

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 300 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily. You can also subscribe to our FREE fortnightly newsletter to stay up to date with all of our latest tips and training methods by clicking here.

If you live in Melbourne and feel you need specific help with your exercise program please feel free to reach out to me for help and we can set you up with your individualised program.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 15 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

• The Vital Glutes - By John Gibbons
• Movement - By Gray Cook
• Corrective Exercise Solutions - by Evan Osar
• Back Pain Mechanic - by Dr Stuart McGill
• Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
• Low Back Disorders - by Dr Stuart McGill
• Ultimate Back Fitness & Performance - by Dr Stuart McGill
• Core Stability - by Peak Performance
• Athletic Body in Balance - by Gray Cook
• Anatomy Trains - by Thomas Meyers
• Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
• Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
• How To Eat, Move & Be Healthy by Paul Chek
• Scientific Core Conditioning Correspondence Course - By Paul Chek
• Advanced Program Design - By Paul Chek