Simple Steps to Strengthen Your Core

A physical therapist offers tips and exercises to strengthen your core and prevent back pain.

About 20% of adults in the U.S. experience chronic back pain, according to the Centers for Disease Control and Prevention, and around 80% of adults will experience an episode of low back pain at some point in their life.

While back pain is the third most common reason people see a doctor in the U.S., there are a lot of simple activities people can do to keep their back healthy and strong, says Evan Johnson, D.P.T., director of clinical outreach and physical therapy at NewYork-Presbyterian Och Spine Care in Midtown Manhattan.

“Motion is lotion,” says Dr. Johnson. “Our best advice is to keep fit, change postures often and make regular exercise a part of everyday life.” Dr. Johnson adds that having a strong core — which comprises the muscles of your lower spine, abdomen, pelvis, and hips — is almost like wearing a corset or a girdle around your abdominals and back. A strong core, he says, will protect your spine during all kinds of activities.

Dr. Johnson shared with Health Matters simple exercises you can do at home or even at work to strengthen your core and support your lower back and spine. Follow along with the video and read on for detailed instructions on how to do each exercise, and discover other tips for keeping your back healthy.

Heel Walkout

The heel walkout is easy to do at home on a yoga mat on the floor, or on a very firm bed surface if it’s difficult for you to get on and off the floor. Start by lying on your back with your knees bent and feet flat on the surface. Tilt your pelvis up toward the ceiling then tilt it back down. Stop when you find a pain-free posture, what’s called your neutral spine. Once you find your neutral spine, bring in your navel to engage your abdominal muscles and slowly move your feet away from your body by taking small steps, while keeping your spine stable. Then slowly move your feet back toward your body. This helps you develop a stronger core in a pain-free posture.

Hamstring Stretch

Many people with low back pain have hamstring tightness on the back side of their thigh. This happens because the muscles on the back of the thigh tend to pull on the pelvis and spine if they are tight. One safe way to stretch the hamstring is, while you’re on your back, find your neutral spine position. Pull one leg up, bending it at the hip and knee to 90 degrees. Use two hands to hold up your thigh just above the knee and then straighten your leg until you feel a stretch in your hamstring muscles along the back of your thigh. Hold for 15 to 30 seconds while keeping your neutral spine position, then repeat with the other leg.

Prone Press-Up

This is an exercise to get your back to move in a direction in which it typically doesn’t bend, called backward bending. This exercise has a pumping effect, where it pumps spinal fluid away from the nerve roots in the back. For people who have disc issues, such as bulging or herniated discs, this is a very useful exercise. To start, lie on your stomach or put your hands on the floor. Push yourself up so you are bending your spine backward. You can push yourself all the way up or make this a small exercise and go halfway. A note of caution if you’re arthritic or have spine mobility issues: This might not be the right exercise for you, so consult with your physician or physical therapist first.

Plank

Planks are exercises that strengthen your abdominals and back muscles. Start by coming down on your knees, leaning forward on your forearms. Find a position where your spine is comfortable, then straighten out your legs. Keep your head facing down, your behind up with a slight curve in your spine, and hold this position for 15 to 30 seconds.

Door Frame

This exercise is easy to do while sitting, and it’s good for opening up the chest and the midback. Start with a good sitting posture. Now imagine you’re sitting in a door frame. Bring your hands together in front of you, then bring them overhead, turning your palms toward the ceiling with your fingertips touching. Move your palms along the top of the “door frame,” then down the side of the door frame. When your hands come down to your side, bring them back together again in front of your chest.

Dr. Evan Johnson headshot.

Dr. Evan Johnson

In addition to these exercises, Dr. Johnson also offered some general tips for everyday activities that can impact your spine:

How You Sleep

Many people find it difficult to sleep soundly as a result of back pain due to their sleeping posture. If you are a side sleeper, try placing a pillow between your knees or a small towel roll under your waist. This will help you maintain a straight spine while you sleep. If you sleep on your back, try placing a small pillow or rolled towel under your knees. This allows your back muscles to relax as you sleep. Sleeping on your belly can place undue stress on your neck and lower back and is not recommended.

Good Posture

Standing bent forward at the waist can double the load placed on your spine, and even sneezing can triple the pressure placed on the discs of your spine. A relaxed, upright posture will ease back strain. In addition to good posture, regular exercise can help prevent back injury.

Sitting for Long Periods

If you work at your desk all day, your chair should be set so your hips are level with or slightly higher than your knees. This allows you to sit upright with a slight forward curve in your spine, your shoulders placed over your hips, and your head placed over your shoulder. A balanced posture minimizes the stress placed on your back while you sit.

What you really want to do during the day is have a lot of variety of motion. If you have a standing desk, alternate throughout the day from standing to sitting postures. Many people also benefit from standing and bending backward after sitting for long periods.

Evan Johnson, D.P.T., is the director of clinical outreach and physical therapy at NewYork-Presbyterian Och Spine Care in Midtown Manhattan. He is also an assistant professor of clinical rehabilitative medicine (physical therapy) at Columbia University Vagelos College of Physicians and Surgeons and holds appointments in the departments of Rehabilitation and Regenerative Medicine; Neurosurgery; and Orthopedic Surgery. Dr. Johnson has numerous peer-reviewed publications related to the biomechanics of manual therapy, nervous system mobility, physical examination techniques, and spinal stabilization in athletes.

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