top of page

Why Exercise Helps Back Pain

Why Exercise Helps Back Pain

Consistent, high quality research says that movement, exercise or physical activity is best for back pain. So lets explore this a little further.

At Sydney Muscle & Joint Clinic our approach is high quality, that is care that is effective, efficient, safe, patient-centred, timely, equitable, and delivered by practitioners who are respectful, communicate clearly, and involve patients in decision-making. High quality is care that is supported by research, is evidence-based, strives to be guideline-based and ultimately results in the better outcomes for patients.

For low back pain this means active interventions whereby you move, perform exercise and avoid rest. Heat, massage, dry needling, stretching, foam rolling and taping are all not supported by the evidence and therefore have proven to be useless for low back pain and shouldn't be used by evidence-based physiotherapists.

3. You haven’t been educated in the directional preference of your spine

When your spine is painful, stiff and irritable it will always have a directional preference- this means it will prefer to move in one direction opposed to the other. In most cases of low back pain when the diagnosis is disc-related the spine does not like to flex, this means it does not like to bend forward, sit for prolonged periods, do hamstring or glut stretches and does not like deadlifts, squats, crunches or sit ups. In this case your back will love to extend back and should be encouraged to do so as often as positive.


If your diagnosis is unilateral or one sided low back pain with sciatica or radicular leg pain down one leg the spine will not like to flex or shift away from the affected side. In this case your back should be desensitised with contralateral lateral shift and when your leg pain has resolved, progressed to back extensions. These directions and movements should be assessed in the initial assessment and be the cornerstone of your treatment plan. Our physiotherapists and exercise physiologists make a good habit of knowing the directional preference of your low back when painful, stiff and irritable.

Back Pain Penrith Physiotherapy.jpg

4. The treatment you have received or the relief strategies you employ are in direction contradiction to the directional preference of your spine

When your spine is painful and irritable and doesn't like flexing or bending, then don't do hamstring stretches, glut stretches or try to strengthen your trunk (abs) with leg lifts, crunches or sit ups. Use directional preferenced movements to reduce pain and irritability.

McKenzie Method Physio Penrith.jpg

5. Stretching does not help back pain and possibly makes it worse

The majority of low back pain that our physiotherapists see is mechanical disc-related low back pain and as such 95% of the time these spines or backs don't like to bend or flex or sit. Stretching your leg muscles has no effect on your back pain and if these stretches are bending your back then you'll be making it worse.

9. You haven’t been given cutting edge anti-movement trunk strengthening exercises

Our physios and exercise physiologists prescribe anti-movement exercises when treating low back pain. These exercises target muscles that restrict or control movemnt and examples are anti-rotation, anti-lateral flexion and anti-flexion or extension. They target trunk and back muscles and create stability and stiffness all whilst reducing the irritable movement that is contributing to the back pain.

bottom of page