I’m having this lower-back pain that kills me. What do you recommend?

About 1 in 5 clients from my former professional practice complained about low back pain (LBP), no matter what gender or age. The majority of clients took pills to cope with the pain, but they didn’t know that exercise, diet and lifestyle play significant roles in the prevention and treatment of LBP. Once their physicians ruled out other conditions, such as a disc herniation and structural deformities, we were ready to strengthen the back.

If you are prone to LBP (which is linked to muscle deficiencies/imbalances) and have medical clearance to participate in an exercise program, or if you are one of the lucky few who has not experienced LBP, I recommend incorporating this preventive routine into your schedule. The next time you lift a heavy box without any problem, your back will thank me!

The Low Blow

The jury is still out on all the causes of low back pain (LBP), but we know that among the factors are poor posture, excess weight, and lack of strength and flexibility of the back and surrounding muscles, including the hips.

The lumbar muscles support your body weight, and when you stand (in the upright posture) the disc pressure is equivalent to 100% of your body weight. When you depart from the upright posture and bend or twist the spine, the compression forces can increase up to 200%.

Moves to Back You Up: The Routine

Functional strengthening programs for the back should include controlled extension, flexion and rotation movements of the spine that mimic your daily activities. The latissimus dorsi, abdominals, obliques, quadratus lumborum and the erector spinae muscles (see diagram below) are important for providing stability to the mid and lower back regions. Developing strength and endurance in these muscles will help support your body in any activity or sport.

Aerobic: 3–5 times a week, 30–60 minutes.

Select low-impact activities such as swimming, cycling, walking and the elliptical machine, among others.

Strength: Perform the routine 2–3 times a week after warming up for 10–15 minutes.

• Beginners should start with one circuit and perform 12 reps using body weight.

• Intermediates or the advanced should perform 2–3 circuits of 15 reps per exercise. Weights can be added, but make sure to keep proper technique at all times.

• When performing the exercises, remember to draw in the navel about an inch, which will contract the transverse abdominal muscles without bringing about any forward flexion of the trunk by the rectus abdominis or the obliques.


The combination of aerobic and strength training is best. This circuit resistance program incorporating multi-joint exercises trains both the cardiovascular and muscular systems, and helps to increase and sustain bone density.

  1. Lunge with diagonal shoulder raise

  2. Bent over row, followed by dumbbell row on a Swiss ball*

  3. Good morning on a Swiss ball*

  4. Plank with leg raised

  5. Side plank with trunk rotation

  6. Pike (abdominal core exercise)

*Note: You will need a Swiss ball and one pair of dumbbells. For exercises 2 and 3, place your feet against a wall for support.


  1. Upper back

  2. Piriformis (muscle in the gluteal region of the lower limb)

  3. Hamstrings (back of thigh)

  4. Hip flexors/knee extensors

  5. Adductors (thigh region)

Hold each exercise for 15–20 seconds. Repeat each twice.



To nourish those back muscles and keep bones strong, make sure to include plenty of food rich in anti-inflammatory properties, such as omega-3 fatty acids (flax seeds, walnuts, salmon), ginger, the enzyme bromelain (from pineapples), calcium, vitamin D, olive oil, berries, turmeric spice and cruciferous vegetables (broccoli, cauliflower, Brussels sprouts).


Have support that allows you to maintain a slight lumbar curve of the spine; both feet should be planted on the floor, head forward shoulders relaxed.


Don’t bend your back, lift from a squat position, and don’t twist the spine at any time. Keep the load close to your body.


If on your back, place a pillow under your knees; if on your side, place a pillow between your knees. Avoid prone (belly down) position.


Studies show that sit-ups and extension of both back and legs simultaneously in prone position (such as the “superman”) can provoke an excessive compression of the lumbar spine.