At a glance

Lying on your front and pressing the chest up while the hips stay down, taking the lower back into extension. Excellent for some backs, wrong for others: the leg symptoms tell you which.

What it works

Primary muscles

Arms and shoulders, which do the lifting

Also involved

Lumbar extensors, kept deliberately relaxed
Hip flexors and abdominals, lengthened at the top

Equipment: None. A firm surface: the floor rather than a bed.

How to do it

1
Lie face down, hands flat under your shoulders as if about to do a push up, forehead resting down, legs and buttocks relaxed.
2
Press through your hands to raise the chest, letting the lower back sag into an arch. The hips stay on the floor: the back extends, the body does not plank.
3
Keep the back and buttock muscles switched off and let the arms do all the work. Rise only as far as is comfortable, which may be a few centimetres at first.
4
Pause for a breath at the top, then lower slowly back down.
5
Repeat rhythmically, paying attention to the leg. Symptoms easing or retreating towards the spine is the green light; anything spreading further down the leg is the signal to stop.

How much to do

10 repetitions

Every 2 to 3 hours during a flare, if extension is your direction

The response sets the dose. Symptoms centralising towards the spine justify repeating through the day; symptoms moving down the leg mean stop and get assessed.

Stop and get assessed if

Stop and get assessed if leg pain moves further down the leg, if pins and needles or numbness appear or spread, or if you notice any change in bladder or bowel control, which needs same-day medical review. This exercise suits some backs and not others; getting worse with repetitions is a finding to take to an assessment, not something to push through.

Common mistakes

Arching up using the back muscles: The back should be passive, carried by the arms. Clenching turns a mobility exercise into a strength one and compresses the very joints you are trying to free up.
Hips lifting off the floor: The anchored pelvis is what makes the extension happen in the lumbar spine. If the hips rise you are doing a push up, and the back gets none of the benefit.
Forcing full range from the first repetition: The first few are always the stiffest. Range builds across the set and across days; pushing into sharp pain just makes the back guard harder.
Judging it by the back instead of the leg: Watch the leg, not the back. Slightly more central back ache with less leg pain usually means the right direction. Leg pain moving further down the leg means stop.

Making it harder

Straighten the elbows fully as comfort allows, breathing out at the top so the back sags a little further.
Add a two or three second hold at the top once symptoms clearly centralise.
Standing extension, hands on hips: the portable version for during the working day.

Making it easier

Prop onto your forearms instead of your hands and simply rest there for 30 seconds at a time.
Before that, just lying flat on your front for a few minutes is a real starting point for a back that has not tolerated extension in a while.

Prone Press Up