Top 5 Pressure Relieving Lumbar Spinal Stenosis Stretches And Exercises

In this video I’m going to share with you the top five pressure relieving lumbar stenosis stretches and exercises, be sure to watch the end of the video because after I share the top five with you, I’m going to cover some stretches and exercises that you should avoid. And they’ll surprise you because many of them are actually recommended by health care professionals.

My name is Dr. David Middaugh fan. I’m a specialist physical therapist at El Paso manual physical therapy. And this channel is dedicated to helping people stay healthy, active and mobile, while avoiding unnecessary surgery injections, and pain medications. Please consider subscribing to this channel so that you don’t miss out on any of the helpful videos that we post every single week.

After you check out this video, be sure to check out our playlist it’s linked in the description below. That’s all about lumbar stenosis pain help. So go find that in the description below. Once we’re done with this video, so that you can learn the exercises that you need to be doing to treat the root of the root problem. Now I’m going to get into the first exercise, it’s called a pelvic tilt.

There’s a lot of research behind this exercise. And it really is super important for making sure that your lumbar stenosis begins to move in the right direction that you begin to heal the nerves, the joints, the discs, all the areas inside the spine that are affected by lumbar stenosis. So this first exercise is one that you really have to master. And it’s not something that you’re going to necessarily keep up over time once you figure it out.

But it needs to be infused in the rest of the exercises. So if you’re having trouble with his with his pelvic tilt that I’m going to show you, then don’t even go on to the following exercises, just stick with this one until you feel like you know what you’re doing. And you can do it on command without struggling so much to get the right muscle movement, right. So to do the pelvic tilt, you’re going to need to lie down with your knees bent just like this.

Get onto your back and put your knees bent at this position, just comfortable, it doesn’t matter if your knees, your feet are a little farther out or close in whatever is comfortable. And as far as how wide to put your feet. Also, whatever is comfortable, there’s no magic number or magic distance that you need to be at. Now, what you do need to be worried about here is flattening your back and squeezing your buns your butt muscles.

So when you do that, you need to do this motion right here, your back in your abs should go down. So you’re smashing your back, because if I had my hand back here, you have to push your back down. And simultaneously when you push your back flat, it should feel like your butt muscles squeezing, almost begin to lift a bit from the surface that you’re on, whether you’re doing this on the bed, or the floor, if you’ve got a massage table like this even better.

And all you’re going to do is push back down and squeeze your butt a little bit and hold it for 10 to 30 seconds. And the point of this is to practice flattening your back and using the correct muscles to do this. Now the muscles that you should feel working are going to be your lower abs and your glutes. The lower abs are below the belly button. So in case you’re confused on where what part of your abs or what just put your finger on your belly button.

And generally everything below your belly button is going to be the lower abs. And everything above the belly button is going to be the upper abs up to your ribcage, of course. So when you flatten out your back, you’ll probably feel everything your abs working, but you need to focus it or bias it a bit more on the lower abs.

And the way that you do that is by thinking about flattening out that low back of yours, the lowest part of your low back above your tailbone, you need to think about squeezing that down against the floor, the table the bed wherever you are, and just hold it there. And you need to practice this motion so that you can get it on command.

Now the mistake that people make often is they tighten up their abs because they realize they’re supposed to feel it in their abs. But they kind of arc their back. They suck in their abs at the drawing. But they do it with their back archt. And so if you have your hand into your back and you feel that you can put pressure on your back as you suck in your abs, that’s the best because you know that your spine is going in the right direction while getting the feedback from feeling your abs working.

What you don’t want is for there to be less pressure on your back on your hand from your back and your abs working, that’s going to be wrong, you’re probably not going to get your butt muscles to work once you start to arc your back and you flatten it out. And the reason for this it’s critically important when you flatten out your back, you move your spine in a position to where it should theoretically take pressure off the stenosis parts.

So there’s two types of stenosis and I talk all about this in another video that you can go find in the inner playlist in the description below here. There’s essential stenosis and lateral stenosis. And both types of stenosis are improved when you push your back flat like I’m describing right now, this motion is incredibly important to get because I’m going to involve it in an all the rest of the exercises. If you can’t get this motion, pause the video here and just practice this, you might do this to the extreme, where you’re doing this every day, every hour, I mean, go lie down.

If you’re as long as you’re at home, and you’re able to lie down somewhere, flatten out your back and just hold it for 1020 30 seconds or more, and feel the right muscles, work the glutes and the lower abs. And just train yourself to get this I can’t stress enough that you will not move forward the correct way if you don’t get this motion down.

This is where people fail in doing ab exercises in the correct exercises for their lumbar stenosis is they don’t get this part down and they move into more complicated exercises. And they’re doomed to fail because they haven’t gotten the foundation of the position their spine and their pelvis should be in for those exercises, if you’re going to be practicing this on a regular basis to get it down, because that’s where you’re at right now, what I would recommend is hourly practices motion, you can do it in standing as well.

In fact, we’re going to be doing it for an exercise later on in this video. But just to show you in case you can’t lie down somewhere, you would be standing up like this, and you’re just doing that right there. That’s the same thing as a posterior pelvic tilt. I’m squeezing my butt muscles and sucking in my abs and thinking about flattening my back here. And then I’m going to hold it for 1020 or 30 seconds. And then you can relax and need to just train your body in being able to do this motion in virtually any position as long as you’re upright or lying down like I just described.

The second exercise is a knees to chest exercise, but including that posterior pelvic tilt. So this knees to chest exercise you see all over the place, it’s a great movement to decompress the spine. But I need you to add in that posterior pelvic tilt that we just stress to you. So when you do this exercise, you can do one at a time or both knees, you’re just going to hug your knee in towards your chest. But before you do that, you already have to set your pelvis, you have to tip your pelvis back and flatten your back, then bring your leg up and you’re pulling your knee into your chest.

But at the same time, you’re thinking about pushing your back flat into the table here. And you’re probably going to feel your glute on the leg that’s down working a bit, that’s good. You’re taking pressure off the spine, when you do this, hold it for 10 to 20 seconds, you can go longer if you want. If you feel like this gives you relief. Go for minutes, if you’d like that’s not a problem at all, you need to take pressure off those nerves.

After you’ve done that site for a bit, then do the other side. Think about pushing your back flat. So I got my glutes engaged here my back flat, and then I’m just pulling my knee towards my chest. And I’m going to hold here for 10, 20, 30 seconds or more. The hold is important because if you just do reps when you come up, and like this, or if you bounce here, it’s not nearly as effective as the whole because you practicing this posterior pelvic tilt motion with your with your hips and back is important for you to train your muscles in the endurance aspect and then also to wake up more muscle fibers.

And holding helps to wake up those muscle fibers and train the endurance part of this because over the long term, you’ve got to take pressure off your spine consistently. So if you want to do two legs at a time, you certainly can, it’s just going to be harder to fire your glutes. But before you pull in all the way like this, you would just grab your knees, then flatten out the back and you see how my hips come up because I’m flattening my back.

Then I’m going to pull my, my knees in towards my chest and hold it right here in this now I feel a pretty good stretch going through my back, which is good. You want the back to open up and stretch. The next exercise that you’re going to do is called an angry cat exercise. And again, you’re going to do that posterior pelvic stretch, that posterior pelvic tilt, I’m sorry, she’s going to give it to all fours just like this. And this is also a yoga move called the cat, cat camel or camel cow I forget exactly the name.

I’m sure one of you guys would know and you can comment on there to correct me. But what you’re going to do is that same posterior pelvic tilt and it looks like this you’re shoving your hips forward and pushing your back your low back in that direction if I was lying down, I would of course be pushing into the table that I’m on here the for the bed wherever you’re doing this, but what you should feel is your abs sucking in and your buns tightening up a bit.

Some people will feel it more in the buns, some more in the ABS But you should feel both muscle groups working a bit. And then again, you’re holding for 10, 20 or 30 seconds. And you’re going to do this for I would do it every hour, two or three reps every hour along with the other exercises. So far, a little routine that you can get into hourly is the best for stenosis, just like that, you’re sucking your abs, and pushing your hips in this direction forward, and then relax.

And hold it for 10, 20, 30 seconds, I give a big range, because some people they’re good with 10 seconds or muscles aren’t that strong. And that’s okay, as long as you get in a hold of 10 seconds, that’s great. If you can hold longer than you’re training your muscles to last longer in this position, you’re only going to benefit from it. So go ahead and go longer if you want. So if you do five to 10 reps of this, then we can move on to the next exercise, which is going to be a little more challenging.

This one’s called an AB curl, it looks just like this, you’re going to lie down, just like in the position that you were in for that pelvic tilt, and you’re going to Of course, pelvic tilt. So you do that motion. See why it’s so important to get this down, you just have to get it down, so that you can do it on command. Because every exercise moving forward for lumbar stenosis needs to involve a pelvic tilt to take that pressure off the spine.

So you do your pelvic tilt, then here’s what you’re going to do. Next, you’re going to make a double chin, lift your head, just like that. And already you’re going to feel your abs working. That’s the point of this exercise, maintain your pelvic tilt your back flat, then you’re going to reach towards your knees, and you’re trying to reach your kneecaps.

Now, before keep going, this can be pretty intense. So if your abs are very weak, or you don’t have that pelvic tilt down yet, skip this exercise and come back to it once you’re a little stronger. Now, you may actually be able to do this exercise if you’re decently strong. So proceed, but I’m going to tell you to do 10 reps on this one. But if you can do 10 reps, if you’re capping out at about five or seven, that’s fine stop when you need to this we can get kind of intense.

So back flat bonds are going a little bit at lower abs are going double chin, and I’m already lifting my head and shoulders and trying to reach my kneecaps. And you can see I’m shaky here. And that’s it, I have decently strong abs, I work at it, and you’re trying to keep your feet down, don’t let your feet start to drift up.

You have to keep them down. And you’re holding here for 10 seconds, I am double checking right now that I’m pushing my back flat as I come up, because the tendency when you come up is to compensate and not use your lower abs and force your upper abs to do most of the motion.

You have to struggle with yourself throughout this exercise to make sure that you’re drawing in those lower abs by pushing your low back the lowest part of your low back down against the surface that you’re on. Just to show you another rep here, back flat bonds tight, double chin, lift the shoulders and head, reach towards the kneecaps, keep the feet down, and then do a slow 10 count.

And this is where people tend to count a lot faster than they should, instead of the one 1002 1003 1000 Count cutting, what’s the advice and I 10? Who, and I feel and I’m going to start to sweat. So I’m going to stop on that rep because I have to go treat patients right now. I don’t want to show up sweaty. So let me just pause here there’s one more exercise that I will show you. But let me pause here to tell you something important about this.

The last three exercises, I’ve covered the knees to chest exercise, the angry cat exercise where you’re on all fours and you’re pushing your backup and this last one, I call it an abdominal curl exercise. Those three exercises should be your go to exercises that you’re doing consistently. Of course, the first one I covered the pelvic tilt is one that is a foundation for those three exercises. So you might hang out in the pelvic tilt for a while.

But then once you master that you move into the next three exercises, the AB curl the angry cat and the knees to chest exercise. Those three exercises are the ones that are really going to open up your back and strengthen your abs to keep your back open for the long term. Now this next one that I’m going to show you, this is the last one, this is number five. It’s abdominal bracing. It’s kind of an exercise, but it’s also a posture. It’s hard to categorize this one exactly on what it is.

Some people do feel a stretch while doing it too. But it’s not something that you need to count reps for necessarily. You need to do this one all day long, but it’s subtle, you should be able to do it without anybody knowing that you’re doing this. So what you have to do is suck in your abs and do a little bit of a posterior pelvic tilt.

So you’re going to dry in you can do this seated, there’s standing and walking as well, you’re going to draw on your abs suck in and think about those lowest part of your abs, the low abs below the belly button, try to get those to work just a bit more. And then watch my shoulders and chest here.

When I suck in my abs, I subtly slouch, that’s okay, if you look at me from the side, when it’s sucking my abs, my back rounds out and my mid back a bit, and I’m slouching just a bit of my chest and shoulders. And it doesn’t look bad. I’m not doing that terrible slouch, that people would consider bad posture. It’s just a very mild slouch.

But doing that, that little slouch, takes that little bit of pressure off your low back. And then when you tighten up your abs away, I’m telling you, the way the ABS wrap around your core and they connect to your back through some tendons, they will also take pressure off your back and pull your spine into alignment.

Now if you can do this on a very light intensity, we’ll say on a scale of zero to 100% of 100% is a bracing as hard as I can my abs are sucked in as hard as they possibly can. You don’t want to do that, because you’re not going to last very long. You want to be more at like 10 to 20% intensity. So just a little bit enough to just pull your shoulders and chest down a teeny tiny bit. And you feel your abs working a teeny tiny bit as well, then you can maintain that for a longer period of time.

I can talk while I do this, it’s not interfering with my breathing. I’m doing it right now. You should be able to do things as you get more comfortable with this like walk and move around, do chores around the house possibly drive, you should be able to do anything that you need to do while you’re sitting standing or upright walking, while your abs are drawn in.

Now, here’s the trick with this exercise, you have to do it all day long while you’re awake. Obviously, if you go lay down, don’t worry about it, your body’s not going to compress your spine as much. But as soon as you’re upright seated like I am, you’re standing or you’re walking that you need to be thinking about driving your abs.

The reason why this one is so critical is because you’re probably sitting standing and walking for many times during the day. And if you can now use that time to take pressure off your spine, you’re going to heal it, you’re going to feel better, you’re going to take pressure off the nerves. And that’s going to translate to you being able to stand up and walk for longer periods of time to having less back and leg pain.

Oftentimes people will with lumbar stenosis, some have back pain, but they almost all have leg pain of some sort, sometimes numbness tingling, some people have overlapping sciatica symptoms. And in a lot of people have burning and just weakness in the legs, those symptoms will begin to reduce the more time you spend with less pressure on your back. And if you just do the exercises that I said the ones where I was on the table, that’s not enough, because that’s just going to be a small amount of time during the day that you’re taking off pressure.

And of course, the idea is that you’re going to gain strength and begin to take pressure more pressure off over time. But if you can also stand, walk and sit by taking pressure off by sucking in those abs, it’s going to help you even more, you’re going to get better even faster than you could if he didn’t. So this is an important exercise, you have to do this suck in those abs, just 10 to 20% make sure that you do a little baby slouch to take some pressure off your back. And this is how you need to sit.

This is how you need to stand when you stand up to same thing. You’re just standing like this, instead of your normal stance, you might feel like your abs aren’t doing much and your back’s a little bit curved, need to flatten that curve a bit, get these glutes to work out a little bit. And those lower abs to tighten up a little bit as well.

That’s how you would stand and then walk eventually, whenever you go somewhere in the house, at the store, at your workplace, wherever you might be, you need to suck in those abs a little bit. Now realistically, what I tell people to do is, if you can do this 80% of the time that you’re upright, that’s excellent, because it’s not realistic to do this 100% of the time, you just can’t do that you’re going to be focused and thinking about other things. And when you’re starting this out, you’re likely not even going to even do 80%.

If you can start at 10 or 20% of the day doing this, then great. That’s a good starting point. But Mark your way up to 50%. And eventually 70 and 80% would be the best place to hang out at. All right now let’s talk about exercises that you need to avoid because they’re going to make your lumbar stenosis worse. The first group of exercises that you should absolutely avoid is going to be back strengthening exercises.

Now what I mean by that they’re exercises that make your muscles in your back, work and burn. I’m talking about the ones that are right in this area right here. Not the glutes though. is a good to work but above the glutes in this area in your lower back. If those muscles are getting stronger and stiffer over time, they’re going to compress your back bones, the joints and they’re going to close the spaces that are causing the stenosis problem already, that’s going to actually feed into the problem.

Now, oftentimes, people do these exercises and actually feel some relief immediately or right after doing the exercise. And the reason for that is just because you’ve used the exercise of the muscles, and anytime you exercise, it generally feels good. So you get the endorphin release, the effective exercise is making you feel good. But strengthening that muscle over the long term actually feeds the problems.

So you want to avoid back strengthening exercises. The two common ones that are given to people by their healthcare providers are Superman exercises and bird dog exercises, just to show you what those look like. Here they are a Superman exercise, you’d lie flat like this. And then you usually reach your arms out and then you’re picking up your legs, and your arms and upper body. And this exercise, you might do reps where you’re coming up and down.

Or you might just hold it like this, this exercise strengthens those back muscles. And it is just not good for your back, it’s going to make the stenosis worse over time. The other one that’s commonly done is called a bird dog exercise where you’re on hands and knees just like this. And then you’re picking up an opposite arm and opposite leg, just like this. And you can work your glutes here, but it also works your back muscles.

For some people, it almost only works for back muscles. And that’s just not good. They’ll alternate sides and they’ll have you do many reps. And the feedback that they’ll give you is they’ll say, we’ve got to strengthen your back muscles because that’s where the stenosis is. And we those muscles are probably weak. And so we need to get them stronger.

Now my question is always did they test the back muscles because back muscles can kind of be tested. And if you’ve determined that those back muscles are truly weak, then you have a reason to strengthen them. But if you just made the assumption as a healthcare provider, that because you have a back problem like lumbar stenosis, then you need to strengthen the back muscles, that is very short sighted thinking. And you have to pit the abdominal muscles against the back muscles.

And oftentimes, if you do an abdominal muscle test, people are extremely weak in the abdominal muscles. That’s why all the exercises that I just showed you that you should be doing are abdominal focused and glute focus as well. The back muscles tend to be very strong because they’re compensating for weak abdominals and weak glute muscles.

The second group of exercises that you should absolutely avoid are hip flexor exercises. Now your hip flexors are right here on the front of your hips. And they’re responsible for picking up your knees and thighs in this direction. So the two common exercises that people often get that are hip flexor exercises, or marching exercises like this, you might do it in seated or in standing to he’ll stand up and have you march like this, that’s using your hip flexors.

And what you need to know about those hip flexors is most of those muscles come up and attach onto the front of the spine. And when you use those muscles a lot. It actually compresses the lumbar spine quite a bit. It’s the number one compressive muscle attaching to the lumbar spine, the psoas muscle, which is one of the primary hip flexors.

So why in the world would you want to strengthen the muscle that is the primary compressive muscle it squashes the discs, it makes the foramen the holes smaller where the stenosis happens, it just makes that smaller, it doesn’t make sense to strengthen these muscles. The other one that’s commonly given is leg raises. So for this one, people are usually lying on their back. And they’re doing some version of this right here where they’re picking up their leg and that is directly a hip flexor strengthening exercise.

And you do not want to be doing that if you have lumbar stenosis, chances are those muscles are already strong. And it’s the same thing if, as I said with the back if they haven’t tested out your hip flexor strength, then why would you be doing hip flexor exercises? The reasons for doing exercises of any muscle group should be because that muscles weak. And if you’re if your healthcare provider isn’t directly testing your muscles because that’s a normal thing.

That’s a thing that especially the physical therapy field, you should have your muscles tested to determine where the weaknesses are. And if that hasn’t been done and assumptions have just been made, then I would strongly question if that healthcare provider is really giving you the best exercises for your condition and the ultimate test, which you’d have to find out the hard way is if you’re getting worse by doing these exercises, then it’s obviously not a good thing for you, you should feel like you’re getting better by doing the right exercises not worse.

And it’s not always a situation where you have to get worse before you feel better. With lumbar stenosis, you should feel like you’re consistently improving as long as you’re working on the right things. And the third group of exercises are these actually stretches that you should avoid are going to be any stretches that are looking at stretching this area out right here, the number one exercise people give for this one is a figure for type exercise.

So with a finger for exercise, you usually crossing a leg over and pulling your knee in some people do it seated like I am right now. And see when I pull my knee in right here, I feel a stretch right to this area right here. Or they might do it lying down with your leg crossed. And sometimes they’ll pull this side up, or they’ll reach under and pull this leg up. And that’ll put a big stretch right through here.

Now, this isn’t as detrimental as strengthening the hip flexors or the back muscles. I often have patients come in with lumbar stenosis problems, and they do that exact stretch. And I’ll just have a discussion with him about it, I’ll say, look, how often are you doing because if you’re doing it all the time, like several times a day, then it could actually feed into the problem because that with lumbar stenosis, your nerves are irritated.

Usually that’s what’s causing the weakness, the pain into the legs. And if you’re doing this kind of a stretch, you’re stretching the nerve, the sciatic nerve runs right through that area. And the stretch sensation that you’re getting from your body might actually not be a muscle stretching, but the nerves stretching. And that stretch kind of feels good in the moment.

But it irritates nerves in the long term. And so if you’re doing the stretch all the time, you could be keeping your problem there longer than it needs to be. But the thing is a stretch is not strengthening the muscle.

Technically, there’s small cases where that happens. But most of the time, people don’t get as intense with your stretches enough to strengthen the muscle. And that’s a whole other topic for another day. Because you can actually strengthen a muscle by stretching it, which is backwards thinking but it happens. But you don’t want to irritate your nerves by doing any any of these stretches. So that’s one, the other one would be reaching for your feet. Like if you’re standing up and you’re bending over reaching down for your feet, or some people will do this sitting down this way.

And they’re reaching for their feet, or they’ll have one leg up and they’re reaching this way, or they’ll have their legs open and you’re reaching one way or the other way of V stretch. Any of those stretches also stretch out your nerves. And in the case of lumbar spinal stenosis, it’s going to keep the nerves aggravated for longer than they need to be. The only time I tell people Yeah, go ahead and stretch.

If it’s very occasionally, you know, it’s not every day, they feel like they’re getting a benefit from it. Because some people truly are getting better consistently, despite the stretching. I think they’re just not stretching very intensely. So I’ll say go for it. That’s fine. As long as you’re strengthening your abdominals and you have that posterior pelvic tilt down just right, then I’ll tolerate you doing your stretches just fine.

What I won’t tolerate though is you’re strengthening your hip flexors and strengthening your back muscles. Those two muscle groups are directly opposed to your abdominal strengthening and glute strengthening. And they’re going to add compression into the lumbar spine and feed into the lumbar stenosis problem. Right friends.

I hope this was comprehensive enough for you on what to do for lumbar stenosis. If you liked this video, give it a thumbs up. If you have any benefit from these exercises. Please comment on here if you have any other questions, comments on here as well and share this with somebody that you think needs to hear this, I’m sure you have a friend or family member some loved one that’s dealing with lumbar stenosis. Please share this with them so that they can get help as well. Thanks so much for watching, and I’ll see you in the next video. Bye