Back Rehabilitation Exercises

Cervical (Upper Back and Neck)
These stretches and exercises are designed to improve the flexibility and strength of the spinal column. They should be performed in a smooth, controlled manner and not quickly so as not to cause increased spasm. Breathe into each exercise and perform them preferably after some form of warm-up (i.e. exercise or after work or working out).

Stretches 
Performed while standing, hold each for 5 seconds and repeat 5 - 10 times each:
- Rotate your head and look over your left shoulder until it is tight; repeat the same on the right side.
- Rotate your head and entire upper body and look over your left side; repeat the same on the right side.
- Tilt your head to the left side (without rotating) until tight; repeat the same on the right side.
- Tilt you head and entire upper body to the left side; repeat the same on the right side.
- Bring your chin towards your chest.

Exercises
Performed while sitting with a Theraband wrapped around something sturdy and with perfect posture. Repeat for 2 sets of 15 - 30 repetitions.
- Facing the band, grasp band with both hands and bring towards you as though you are rowing a boat--close grip.
- Same as above but with wide grip.
- Facing away from the band, grasp with both hands and push out away from you.
- Blade squeezes--standing or sitting-up straight, pinch shoulder blades together and hold for 5 seconds. Repeat 10 times.

* Maintain good posture regularly throughout the day. Sitting, standing, reaching, and lying down positions are equally important.

2 - 3 Times Daily
- Neck stretches-- standing or sitting-up straight bend neck side-to-side 5 - 10 times and hold for 3 seconds. Next, rotate the neck side-to-side 5 - 10 times and hold each for 3 seconds.
- Spine stretching--standing-up straight, side bend your whole body by sliding your hand down the side of your leg and then to the opposite side 5 - 10 times each. Next, rotate the whole body to one direction and then to the other 5 - 10 times.
- Chest stretching--standing with hand in a doorway, rotate the upper body away from your hand until it stretches in the chest. Hold 15 seconds and repeat 5 times.

*Make sure to maintain functional, neutral position of the back at all times during the daytime and especially when performing exercises.
*Abs, Abs, Abs--abdominal strength and regular recruitment of them during the day reduces strain on the spine. KEY: Try and actively exhale when performing any bending-over activity such as bending to pick up your keys, exhale while bending at the knees.
*Check your workstations at home and at work to make sure the keyboard, monitor, and chair are all well positioned.
*This program is designed for ongoing strengthening of the back stabilizers. Anytime the back feels weak, sore, susceptible, etc., return to performing the first stage exercises on the floor and on the half-roller until all symptoms are gone.

Lower Back
Perform this routine 3 days a week either coupled with your other workout routine or on alternate days for general maintenance.
- Hamstring stretching—standing or sitting with heel on a chair and leg and back straight, slowly lean forward pivoting at the hips until a stretch is felt in the hamstrings. Hold 20 seconds and repeat 3 times.
- Back extensions--lying on your stomach with your hands in push-up position and your lower body relaxed, press up through your hands until tension is felt in the low back while keeping lower body relaxed, then lower. Perform 10 repetitions.
- Knee bends/squats--feet shoulder distance apart, hands out in front of you, weight focused on the heels. Tighten abs to find neutral, then raise and lower yourself as if sitting down in a chair. Make sure to not let knees go forward of your toes. Go up and down smoothly without pausing for 1 - 2 minutes. 2 sets.
- Single leg step-ups--using an 8 - 10 inch step, place left foot on step, find neutral, step up through the heel focusing on lifting with the top leg. Use the same step height for the right if able to maintain good pelvis and leg position. 2 sets of 20 - 30 repetitions.
- Side steps--find neutral, step to the side into a semi-squat position, then to the opposite side. 2 sets of 20 -30 repetitions.
- Diagonal lunge steps--find neutral, then step, and gradually leap, at an angle onto one leg, then back, then onto the other. 2 sets of 20 - 30 repetitions.

NOTE: All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.