Exercises for Back Pain

1. Warm-Up Stretches – mobilise and open the joints

Arms Over Head

Interlock the fingers and stretch arms above head. Loosen up the shoulders, then twist the body left and right. Finish by stretching the arms backwards.

Shoulder Rolls

Rotate the shoulders forwards, then backwards. Make the movement as large as is comfortable. It is important to finish by rotating backwards to leave the chest open and shoulders back.

Hip Rotations

Start with small circles and gradually increase the size of the movement. Eventually you want to be stretching the front, back and sides of the torso as you rotate (but only when you can do the smaller movements comfortably and smoothly).

Focus on stretching gently and keeping the movements smooth.

2. Spinal Wave – create movement and flexibility in the spine.

Make a circle with the pelvis, starting by dropping the pelvis and bending the legs, then bring the pelvis forward and up, then backward and down. As the pelvis moves forwards and up, this generates a wave of forward movement through the spine all the way up to the head. Initially this will feel very awkward, but with time and practice you want to begin to feel each vertebra moving independently one after another.

Focus on creating a smooth wave through the whole spine.

3. ‘Upholding the Moon’ – create space between the vertebrae.

Bring your arms out to your sides (level with your shoulders), then bend forward (also bending your legs) and scoop down with both hands. Place one hand on the other palm and straighten up the legs and back as you raise your hands over your head. Stretch upward, then bring the arms back down to your sides. As you bend forward, bring your head forward as well so that the backs of each vertebral space open up. As you straighten, try to open the fronts of each vertebral space as well as the back (don’t let the backs close up again). You should feel that there is more space in the spine and you feel taller.

Try to breathe with the movement – breathing in as you bend down and scoop the arms, and breathing out as you straighten up. Keep the movement in time with your breathing, but keep the breathing soft and relaxed.

Sometimes this exercise can release a lot of internal heat – this is ok.

Focus on opening both back and front of the vertebrae.

4. Neutral Standing Posture – release tension in the body and drop the centre of gravity.

This standing posture is very important in Qigong. The correct alignments are precise, and correction from a good qigong or tai chi teacher would be very helpful. Some key points:

• The feet are parallel, roughly shoulder-width apart.
• The knees are bent, but do not extend beyond the toes.
• The legs form an A shape and the knees do not drop inward.
• There is a sense of sitting backward, so there is a bend in the ‘kua’ (the inguinal crease or ‘bikini line’).
• The upper body shifts so the centre of gravity is over the point Kid 1 ‘Yongquan’, which is on the sole of the foot, 1/3 of the distance from the base of the toes to the heel.
• The abdomen is stretched like a drumskin, while the top of the sternum is dropped.
• The pelvis drops downwards, while the head lifts upwards.

Relax in this posture with the intention that the body weight drops into the ground. The centre of gravity should drop from the centre of the chest to the lower abdomen. This will create some traction to elongate the spine.

Focus on relaxation.

5. Kidney Breathing – create space in the abdomen and lower back.

This is an advanced form of abdominal breathing. In abdominal breathing, the belly expands during inhalation and contracts during exhalation. This is because the abdominal muscles are relaxed and the diaphragm moves downwards as the lungs expand, creating pressure in the abdomen and pushing its contents outward. With practice, the lower back will expand as well, especially in the region of the kidneys. The rhythmic movement in the abdominal cavity massages the internal organs, keeping them perfused with fresh blood (the blood is also well oxygenated as a result of the deep breathing).

Start by breathing in deeply and allowing the abdomen to expand. Do not force the breathing or the movement of the abdomen. If you find this difficult, try lying down and placing one or both hands on your abdomen. If you still have difficulty, breathe out completely while drawing the belly inwards, then when you expand the abdomen will relax outward – this is the movement you are trying to replicate during a normal deep breath.

Once you are comfortable with standard abdominal breathing, move one or both hands onto your lower back, near the bottom of the ribs. As you breathe in, you want to feel a little expansion of the area under your hands. This may take some practice.

Focus on expanding the lower back area on inhalation.

6. Strengthening the Core – stabilise and strengthen the body

This exercise looks simple, but there is a lot going on.

Start in the neutral posture described above. Place your left palm on your abdomen, just below the belly button, and your right hand, palm outward, on the small of your back. Now swap hands. Some important points:

• Keep the shoulders and arms loose.
• The hands should pat the belly and back (fairly gently) at the same time.
• The legs should straighten (but not completely) each time the hands pat the body and bend slightly while they swing.
• As the legs straighten and bend, the torso expands and contracts.

Once you are comfortable with the movement, you can add more refinements:

• As the right hand comes forward to pat the belly, the right shoulder comes forward slightly and the left hip also comes forward, creating a slight twist in the torso. The abdomen then twists in the opposite direction when the left hand is brought forward. This movement is subtle.
• As the right hand comes forward, the left foot pushes against the floor slightly to bring the left hip forward. This creates more of a diagonal twist through the torso. Again, this is a subtle movement.

These twists of the torso engage many of the smaller core muscles, building stability and strength to support the back.

Focus on engaging the small muscles within the core.

How much should I do?

Aim for two sessions a day to get the most out of these exercises. Do not do more repetitions than is comfortable, but here is an idea of how many repetitions you might do in a session when you can perform the exercises comfortably.

Warm-Up Stretches:

Arm stretch: Twist left and right a couple of times, holding the twist for about 5 seconds each time

Shoulder rolls: 10 repetitions forwards then 10 repetitions backwards

Hip rotations: 8-10 rotations in each direction

Spinal Wave:

10 repetitions, or as many as needed to feel the wave travelling smoothly up the spine.

Upholding the Moon:

8-10 repetitions, or as many as needed to feel the opening of the vertebrae.

Standing Posture & Kidney Breathing:

Start by standing for about 30 seconds but gradually build up to around 5 minutes. Once you are settled comfortably into the standing posture and are sinking your weight into the floor, you can shift your attention to your breathing. Start by expanding the abdomen as you breathe in, then aim to expand the back as well.

Strengthening the Core:

Start with about one minute but gradually build up to around 5 minutes. Initially, just move the hands, then add the knee bending/straightening and the expanding and contracting of the core. Next, add the shoulder and hip movements, then finally add the diagonal twist by pushing from alternate feet.

Final Notes

These exercises come from my qigong training under various teachers. However, simply performing these physical movements is not the same as practicing them as qigong exercises, which involves working in particular ways with the body, breathing and mind.