This series of exercises is closed chain and helps to take stress off the lower back. The key is to bend from the hips and isolate hip motion from spine motion. It may seem like a simple concept, but is very challenging for many people to do.
When the hips are bending and low back is stable, we refer to this as dissociating movement at the hip. This is a huge factor in decreasing and eliminating low back pain.
When an injury occurs, we tend to over recruit certain muscles to protect ourselves. (i.e. gluteus in buttocks area & hip with the abductors). By teaching dissociation/stabilization, we facilitate movement in our hips and movement & control in the abdominal and trunk area.
What if the client experiences pain during the series?
If someone experiences pain and after 3 reps the pain is tolerable, continue with the series. If by the 5th or 6th rep the pain increases, the client is not. Use ice or heat, depending on which gives the best result and rest. The client may respond better to a Mat Work or Springboard series which can be tried another day
Reformer sequence for low back pain
Note, it’s important to know the type of back pain your client is experiencing. If they have a certain condition, you may need to modify this series to avoid contraindications.
- Free the c-spine: Paint the ceiling with your nose, vertical nod and horizontal turn.
- Pelvic motions with feet together on footbar
This teaches dissociation at the hip. Move like a bicycle with flow (lateral translations in closed chain)
- Footwork – many variations (2.5 red springs + 10 reps recommended)
More dissociation/stabilization. Think of space gravity provides. Drop neck, shoulders wide, lumbar longer. Don’t tuck or tilt pelvis posteriorly.
On heels in parallel
Medially rotated (great one to focus on sitting bones coming together in “out” position and widening as they come in)
Medially rotated – legs wide (opens pelvis and hips)
Parallel on balls of feet
Parallel heel lift and lower
Laterally rotated – legs wide
Keep movement fluid for all variations
- Articulating bridge (3 reds recommended + head rest in lowest position)
This exercise is great for spinal articulation. If your client should not articulate their spine, do this in a neutral position.
Do this with legs in a wide position. Start with anterior and posterior pelvic tilting.
The teacher can hold each knee and lengthen it away from the body to help distribute the force.
Exhale coming down & create an axial elongation as you lower down
Move half way up: do some lateral translation side to side
Lower down 1 cm – 2 more times and do more lateral translations
*NOTE: This wakes up local stabilizing muscles: Multifidus, rotators & even segments of transverses abs. If you can get 5 segments sliding: 150% more movement
- Knee Stretch (1 red recommended)
This exercise challenge dissociation/stabilization concept. By being in Quadruped with lower springs: difficulty is increased with Anterior abs A) Short hinge first from hips dissociating pressing out B) More challenging without contact from lying on back
If the basic knee stretch is successful, dissociate the arms by pushing further out into plank position.
- Legs in straps variations
- Parallel: lift legs up and down
- Medial rotation: hip circles
- Parallel: open & close at 45 degrees
- Bend and extend (legs 10” apart.) Close eyes to correct discrepancies in your head. This is great proprioceptive work
- Arm arcs without lifting shoulder
Transition to seated: Arms reaching from the ceiling to the things, then roll up to T8 (if this is contraindicated for the client, eliminate it)
- Quadruped to kneeling plank
Kneel in quadruped with hands on frame under foot bar or lowered bar on Allegro2. Crown of head & tail bone reaching away from each other.
Push legs out to kneeling plank position and reach tail bone long on the way in. Repeat several times.
Can progress to plank with knees lifted if client is strong enough.
- Knee Stretch
With Round Back (if not contraindicated for the client) with high foot bar
With Flat Back
Arms fixed, only legs move focusing on creasing at the hips
Keep knees bent or prop up heels if backs of legs are too tight
- Heels up – Plank High bar
- Jack rabbit (bend knees)
- Down stretch
Keep ribs forward & down
- Leg press seated on foot bar
Keep heels off carriage.
Add arm arcs + spinal rotation while pressing legs.
- Carriage pull
Kneel facing tower end with knees at shoulder rests. Hands on rails. Draw knees towards hands
This balances hip flexors & anterior wall. Be careful not to overuse hip flexors
- Chest Expansion
Looking L & R
Take full breaths and feel thoracic spine
- Scooter (1 red recommended)
Watch posture and ensure alignment is square
- End with arm arcs and full breaths