Low Back Flexion Exercise Step-By-Step Progression

Performing lumbar flexion, or bending forward, may be the right exercises for your back pain or sciatica. But how do your properly progress with low back flexion exercises?

If you have low back pain, then exercise and postural correction are two simple things that you can do to help decrease your pain and improve your mobility. A visit to your physical therapist can help you determine the correct exercises to do and can help you perform the correct exercise progression.

Sometimes, low back extension exercises are warranted to treat your back pain. Extension of your spine occurs when you bend backward.

Occasionally lumbar flexion, or bending forward, is the best direction of motion to treat your back pain. People with conditions like degenerative disc disease and spinal stenosis typically, but not always, benefit from forward bending.

If you do require lumbar flexion to treat your low back pain, there is a safe and effective way to progress your bending exercises. Following the correct progression ensures that the forces you place on your back are safe and effective for your condition. This step-by-step exercise progression for your back focuses on how to properly progress your lumbar flexion and is typical of the way your PT may progress your back exercise program. This program is part of the McKenzie Method, a specialized method of treating back pain.

Remember to check with your healthcare provider or physical therapist before starting this, or any other exercise program, to ensure that it is safe for you to proceed.


Supine Lumbar Flexion

Young woman in Apanasana pose, white studio backgroun
fizkes / Getty Images

The low back flexion exercise while lying on your back is the safest of the back flexion exercises. This exercise bends your spine, but the amount of force and pressure on your back is minimal.

To do the exercise, lie on your back with your knees bent, and slowly bring your knees up towards your chest. Grab your knees with your hands, and give a gentle tug. Hold the position for a second or two, and then release your knees and return to the starting position.

This exercise can be done several times per day to manage acute back pain that responds positively to forward bending. It may also be done to maintain spinal health and prevent problems with back pain once your symptoms have resolved.


Seated Lumbar Flexion

Seated lumbar flexion.

 Verywell / Brett Sears

Once low back flexion has become easy while lying on your back, you can progress to seated lumbar flexion. In the seated position, gravity can add a bit of force to your spine, thus increasing the amount of flexion obtained.

Simply sit in a chair, and then bend forward as far as possible. When you perform this exercise, the stretch to your back can be increased by grabbing your ankles and giving a gentle pull.

Remember to monitor your pain when performing this exercise. An increase in back pain indicates that caution should be used and continuing with this exercise may cause worsening of your condition.


Standing Lumbar Flexion

Man doing standing forward bend, full length, side view

PhotoAlto / Eric Audras / Getty Images

When the lumbar flexion in lying and in sitting exercises become easy and painless, the standing lumbar flexion exercise should be performed.

Standing low back flexion is a great exercise to maximize your spine's ability to bend. In the standing position, gravity can really add quite a bit of extra force to increase the amount that your spine can flex. Simply stand up and bend forward as far as possible. Hold for a second or two, and then return to the starting position. Repeat about 10 times.

In the standing position of lumbar flexion, your hamstring muscles will also be elongated, and this exercise can be used as a method to improve your overall hamstring flexibility.

If you have back pain and require lumbar flexion to help manage your symptoms, you should follow the lumbar flexion progression. This may help ensure that your spine remains safe while you are improving your spinal mobility or restoring spinal motion after injury.

Visit your healthcare provider or physical therapist to see if progressing with lumbar flexion is the correct (and safe) way to improve your overall spinal health.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kim D, Cho M, Park Y, Yang Y. Effect of an exercise program for posture correction on musculoskeletal pain. J Phys Ther Sci. 2015;27(6):1791-1794. doi:10.1589/jpts.27.1791

  2. Matsudaira K, Hiroe M, Kikkawa M, et al. Can standing back extension exercise improve or prevent low back pain in Japanese care workers? Journal of Manual & Manipulative Therapy. 2015;23(4):205-209. doi:10.1179/2042618614Y.0000000100

  3. Ammendolia, C. Degenerative lumbar spinal stenosis and its imposters: three case studies. The Journal of the Canadian Chiropractic Association.

  4. Cleveland Clinic. Is your exercise causing good or bad pain? How to tell.

  5. U.S. National Library of Medicine. Taking care of your back at home.

Additional Reading

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.