By: DiAnna Grimm
Description of Motion1
Lumbar extension is the movement of backward bending. To perform lumbar extension start in a standing position and place your hands on the back of your thighs, proceed to bend backwards letting your hands move down the back of your thighs.
Primary Muscles
Erector Spinae (iliocostalis, longissimus, spinalis) - innervated by dorsal rami of spinal nerves
Transversospinalis (semispinalis, multifidus, rotatores) - innervated by dorsal rami of spinal nerves
Mobilizing - Increasing Range of Motion
Kneeling Back Extension2
Begin on your hands and knees with your shoulders positioned over your hands. Rock backwards and sit your buttocks as close to your heels as possible. Extend your arms and hold for 30 seconds. Repeat 3 times.
Tip: Look down on the floor to keep your neck in alignment with your spine.
Bilateral Knees to Chest2
Lie on your back with your knees bent. Bring both knees into your hands and let your arms pull your knees toward your chest. Hold for 30 seconds and then lower your bent legs. Repeat 3 times.
Tip: Tighten your abdominals to maintain your back to the floor throughout the entire sequence
Cat Cow Stretch3
Start on your hands and knees with your wrists directly under your shoulders, and your knees directly under your hips. Center your head in a neutral position. Breathe in as you drop your belly towards the mat. Lift your chin and chest, and gaze up toward the ceiling. Broaden across your shoulder blades and draw your shoulders away from your ears. Hold for about 2 seconds. As you breathe out, draw your belly to your spine and round your back toward the ceiling. Release the your head toward the floor, but don't force your chin to your chest. Hold for about 2 seconds. Repeat 10 times, and then rest by sitting back on your heels with your torso upright.
Tip: Take your time going through each movement of this stretch.
Indications for Stretching
Tight erector spinae muscles
Low back pain especially in runners - tight hip flexors can lead to an anterior pelvic tilt, forward body lean
Posture - anterior pelvic tilt
Strengthening
Prone Lower Back Extension
Lie down on your stomach. Place your hands by your shoulders, palms down. Keep your neck in alignment with your spine. Exhale and use the strength of your lower back muscles to lift your shoulders 8 – 12 inches off of the floor. Pause briefly. Inhale and slowly return back to the starting position. Perform 12-15 reps and 3 sets.
To progress this exercise, cross your arms underneath your chin instead of placing them by your side.
Hip Bridge2
Lie on your back on the floor with your arms at your sides, your knees bent, and your feet flat on the floor. Tighten your abdominal and buttock muscles as you lift your hips so that your body is in a straight line from your shoulders to your knees. Hold this position for 15 seconds. Slowly return to the start position and repeat 3-5 times.
Tip: Center your weight over your shoulder blades. Do not tense up in your neck.
To progress this exercise, lift one leg off the floor, but make sure to keep your hips level.
Bird Dog2
Begin on your hands and knees with your shoulders positioned over your hands and your hips directly over your knees. Tighten your abdominal muscles and raise one arm straight out to shoulder-height and level with your body. Hold until you feel balanced. Slowly lift and extend the opposite leg straight out from your hip. Tighten the muscles in your buttocks and thigh, and hold this position for 5 seconds. Slowly return to the start position and repeat with the opposite arm and leg. Repeat on each side 12-15 times.
Tip: Keep your stomach muscles tight and your back flat to stay balanced.
To progress this exercise you can try adding resistance by wearing ankle weights.
Potential Clinical Syndromes or Etiologies
Disc Herniation - http://www.southshoreorthopedics.com/downloads/Lumbar_Disc_Herniation.pdf
http://orthoinfo.aaos.org/topic.cfm?topic=a00534
Lumbar Spinal Conditions - http://downloads.lww.com/wolterskluwer_vitalstream_com/sample-content/9780781784450_Anderson/samples/98853.Ch11.pdf
Additional Resources
Proper Body Mechanics for Activities of Daily Living (ADLs) - http://www.aurorahealthcare.org/fywb_pdfs/x18808.pdf
http://www.orthonc.com/forms/physical_therapy/homeex/Lumbar_Extension_Exercises.pdf
Common Postural Deviations - http://synergyptpilates.com/wp-content/uploads/2009/08/ideal-posture-and-postural-types.pdf
References
1. Marshall University. Available at https://musom.marshall.edu/anatomy/grosshom/allppt/pdf/Muscles%20of%20Back%20Lectureff.pdf. Accessed on November 10, 2014.
2. American Academy of Orthopedic Surgeons. Available at http://orthoinfo.aaos.org/PDFs/Rehab_Spine_5.pdf. Accessed on November 10, 2014.
3. YogaOutlet.com. Available at http://www.yogaoutlet.com/guides/how-to-do-cat-cow-pose-in-yoga. Accessed on November 10, 2014.
