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For this article, we spoke with physical therapist all-star, Craig, of The Prehab Guys. As a popular physical therapist, Craig has helped thousands of clients and online followers better manage their lower back pain.

Lower back pain (LBP) is both scary and stressful. When you have your first flare-up you may feel like you’ll never get out of it. However, worrying about your pain and feeling helpless only contributes to it. This can make back pain a vicious cycle.

Craig, physical therapist and a founding member of The Prehab Guys, offers an example: “A neurologist once told me that pain can manifest itself physically and a nice example of this is acne. Remember growing up and having a stressful day? The next day you would wake up with pimples. Stress can affect pain the same way.”

For this article, we spoke with physical therapist all-star, Craig, of The Prehab Guys. As a popular physical therapist, Craig has helped thousands of clients and online followers better manage their lower back pain.

It’s important to know that the pain you feel is temporary and you will get past it. On top of this, there are real things you can do to try and prevent future back pain episodes as well as manage it when you’re having a flare up. To better manage and overcome back pain, education is key. The more confident and competent you are managing a flare-up, the more control you will have over your pain. Also with education regarding what movements are safe and ok to do while experiencing low back pain, you will already be taking steps forward in the right direction to experience life without your low back pain.

Read on for real steps to coping and overcoming back pain flare-ups.

Step 1: Educate Yourself About Back Pain

education back pain

Step one for treating back pain is education. Throughout our conversation, Craig underscored the importance of education. This means knowing that lower back pain is extremely common. In fact, at some point in our lives, virtually everyone will experience some degree of back pain—whether it’s acute or chronic. Not being afraid of your pain, and knowing that you’re not alone is one of the first steps to moving forward. You can overcome this!

Step 2: Keep Moving!

“Across the board, the most important thing for individuals with lower back pain, acute or chronic, is to sustain movement,” explains physical therapist, Craig. He adds that in the past, the “old school” approach to back pain was to rest and avoid moving. This is actually one of the worst things that you could do, the human body was designed to move!

Craig, physical therapist with The Prehab Guys, explains, “The big shift is that you need to stay moving…Exercise and movement is the best medicine for LBP. Science and research consistently support this along with education as one of the best interventions for low back pain.”

The only exception to the rule of “keep moving” is to avoid the movements that cause you pain. For instance, if it hurts when you do a certain exercise or bend a certain way, do not force it. Rather gradually re-introduce the movement and with time it should get easier and feel better. If your lower back hurts when you sit at your desk for hours at a time, you should modify what you’re doing by moving more often or building a stretch routine into your day performed frequently.

Craig sums it up, “Healing takes time. Respect time and don’t poke the bruise or pick the scab.”

To summarize, here are the takeaways so far:

  • Know that you’re going to be OK. Almost everyone has experienced back pain in some capacity and they’ve overcome it. Back pain is common!
  • The more you know, the better you’ll do. By knowing the best ways to overcome pain, you can ‘nip it in the bud’ quicker and with more confidence.
  • Keep moving! Counter to the previous notion that “rest is best”, the worst thing you can do is avoid activity. “Motion is lotion” and the appropriate exercise is the best medicine.
  • Healing takes time. Alter the things that are triggering pain. If long car rides are creating pain, build in pit-stops to stretch. If bending over hurts, you can modify the way that you’re moving with body awareness (we will explain this shortly!).

Step 3: Body Awareness

So what exactly is “body awareness” and what does this have to do with my back pain? Body awareness can feel like a foreign concept. In short, body awareness is “understanding the space your body is in and how it’s moving relative to it”. Having better body awareness gives you a deeper understanding of how your movements may contribute to pain, and how you can modify these movements and your body position to reduce pain.

Craig explains that in the face of pain, “You forget how to move”. He adds that “the body is really smart and will do everything it can to not cause pain.” When your body makes these modifications to avoid pain, it can mess with your perception of movement. You may be moving rigidly, or holding your breath. When dealing with pain for an extended amount of time, our body can learn bad movement habits and patterns that may be contributing to the root cause of your pain.

When you practice improving your body awareness you will gain a better understanding of how you move, how you’re positioned, and how certain positions may be contributing to your symptoms. Improving body awareness can help individuals control movement better, therefore allowing you to relearn movement alternatives to those that are causing pain.

Here are two important exercises to improve body awareness by better controlling your posture and spinal movement:

1. Pelvic Tilts (on back, hands and knees)

10-25 reps 2-3x a day during a flare-up (or once a day for prevention)

2. Pelvic Tilts (seated/ standing)

10-25 reps 2-3x a day during a flare-up (or once a day for prevention)

Step 4: Mobility Exercises

By improving the mobility in your lower back, lumbar spine, and supporting muscles you can offer your back greater support and flexibility. This can improve movement patterns, posture, and mitigate risk of unnecessary stress and strain on the back.

These are the best mobility exercises that target your back and can help improve chronic or acute back pain:

3. Cat cows

10 reps x 2, 3-4 times a week (perform when you feel stiff/ tight)

4. Open books

10 reps x 2, 3-4 times a week (perform when you feel stiff/ tight)

5. Work break mobility flow

Repeat routine 3-4 times a day, 5 times a week/ during work hours

6. Hip flexor stretching

10 reps x 2, 3-4 times a week (perform when you feel stiff/ tight)

7. Glute stretching

10 reps x 2, 3-4 times a week (perform when you feel stiff/ tight)

8. Quadruped rock back

10 reps x 2, 3-4 times a week (perform when you feel stiff/ tight)

9. Child’s pose stretch

10 reps x 2, 3-4 times a week (perform when you feel stiff/ tight)

Step 5: Stability Exercises

If you’re experiencing a back pain flare-up, stability exercises may or may not cause more pain. Stick to the above mobility exercises if you find the stability exercises painful.

Once your flare-up has passed, it’s time to introduce stability exercises. These exercises are all about prevention and maintenance. Our backs are resilient and very strong! Stability exercises are an excellent way to strengthen the low back and hips along with promoting confidence that your body is strong and can handle physical stress. By performing these exercises you will strengthen the muscles that support the spine. Stability exercises give you more control over movements, contribute to healing injuries, mitigate the risk of future injury, and of course, reduce pain.

10. Low Back Control & Hip Flexor Strengthening Exercise

10-25 reps, 1-2 sets, 3-4 times a week

11. Bridge exercise (progressions for glute strengthening)

10-25 reps, 1-2 sets, 3-4 times a week

12. Hip flexor strengthening

10-25 reps, 1-2 sets, 3-4 times a week

Bonus Exercise!

Once you’ve worked through body awareness exercises and mobility exercises (plus the optional stability exercises), try adding in this strengthening and performance core exercise. This exercise strengthens your core (abdominals) which will relieve pressure from your lower back (lumbar spine).

Advanced level strengthening / performance core exercises

Lower Back Pain Exercise Round-Up

# of Reps # of Sets Frequency
Body Awareness
Pelvic Tilts (on back) 10-25 1 2-3x a day (flare-up) OR 1x (prevention)
Pelvic Tilts (seated/standing) 10-25 1 2-3x a day (flare-up) OR 1x (prevention)
Cat Cows 10 2 3-4x a week
Open Books 10 2 3-4x a week
Work Break Routine 1 3-4 Once a day
Hip Flexor Stretching 10 2 3-4x a week
Glute Stretching 10 2 3-4x a week
Quadruped Rock Back 10 2 3-4x a week
Child’s Pose 10 2 3-4x a week
Back Control/ Hip Flexor 10-25 1-2 3-4x a week
Bridge 10-25 1-2 3-4x a week
Hip Flexor 10-25 1-2 3-4x a week
Bonus: Core 5 10 3-4x a week

Use These Tools to Confidently Combat Back Pain!

Although back pain can feel tricky and complex, you have a lot more control over it than you think. By understanding that you can help yourself overcome and prevent pain by following a few simple rules and participating in your health, we hope you feel more confident managing your low back now and in the future.

Ultimately, when it comes to back pain, it’s most important to pivot away from what isn’t working for you (and your back) and lean into a deeper understanding about back pain, your body, and to adopt the daily exercises that will serve you today and tomorrow. Like we said before, back pain is very complex and we are learning more and more about the brain’s role in back pain. When experiencing back pain, take these physical steps to stay moving and exercising but also consider what else in your life mentally could be contributing to your symptoms!

We hope that you now have the tools in your toolbox to address your pain and work towards a long-term solution.

In pain? Preparing for surgery? PeerWell Health helps you fast forward to better with 1:1 doctor visits, physical therapy, and a custom at-home program for your condition. 


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