As far as back pain goes, there are some amazing lower back pain exercises out there and so much to choose from. I attempt to give over my very best ones that have worked for me personally as well as for my patients.

Cat Back Flat? Sounds like a Dr. Seuss book, huh? Well, it's not. Not that I know of anyway. It's actually a nice rhyme to remember two amazingly simple exercises for the lower back, in order to correct the posture and reduce lower back pain. The Cat stretch, and what I like to call Back Flat.

There are mainly two types of people with two types of lower backs that have lower back pain. Let's focus on that area. Of course the body being a functional unit, will compensate and there will be effects all along the spine itself as well as in the periphery as far as the posture goes. Thus pain in other areas as well as the upper back is possible too. Here we focus on the lower back.

Naturally, the body should have a natural Lumbar Lordosis, or curvature of the lower spine which arches inward. If I look at the body sideways, from the person's left side, the lower back should be shaped somewhat like a C. Natural, relaxed and non exaggerated.

Ballet dancers and female gymnasts often have an exaggerated lordosis and their lower back arches inward and their butt really sticks out. No good in the average person.

Or, the lower spine can be too Kyphotic or straight and even somewhat arch outward and start straightening out. The area then looks flat and almost like a pillar. Blech. This sometimes is visible as it affects the posture and causes people to hunch forward.

What to do, what to do, what to do???

Patients often ask me, “Why / how did this happen?” I don't have an answer most of the time and am very honest about it. Except for certain cases of specific illnesses, accidents, falls, breaks, etc. the actual mechanism may be unknown.

Okay, sure there are cases of overly overweight or underweight people, people born with a shorter or larger limb, people with very large or small heads, or whatever other interesting phenomenon that brings about changes in the body's structure and biomechanics. However, being that I am not The Creator, I have no idea how / why these things came about, and even the best guess or theory will not cut it, if there is no known mechanism of injury or cause.

What is known and visible, is what’s happening in the body and along the spine that need to be dealt with. So we work with what we have. The mechanisms and compensation of the body. These are the findings, assessments, and diagnoses, so to hell with why or how it happened (though knowing may help direct us of course). We need to work and solve the issue! So let's do it.

When we take the body into consideration, we cannot differentiate between the structure and the soft tissue in the following sense. They are a functional unit and one affects the other. Muscles move bone, and bone that is out of place will affect the muscles (tendons and ligaments, etc.). It's the ol chicken and egg thingy. Whatever the case, we use these exercises to get our muscles to affect, move, and correct the body's structure as much as possible.

Granted their may be cases of naturally or artificially fused vertebrae, screws and metal plates holding bones in place, and all sorts of things that may be difficult to move. They are stuck and held in place. The idea however, is to get the area to be mobile and maximize the movement as much as possible into correction, through the muscles and with the help of gravity.

The Cat stretch is for those with a kyphotic or more straight lumbar spine where we want to work to increase the lordosis curve. Back Flat is for those with an exaggerated lordosis and lumbar curve, where we want to work to straighten it somewhat.

I have used the Cat with success even with a patient who has three lumbar vertebrae held in place with metal plates. He likes doing the exercise and it gives his lower back more mobility.

You get on your hands and knees / all fours. Using gravity as a helper and as you breathe in, slowly arch your lower back and neck together at the same time, letting the weight and support fall on your hands and knees. This is done more passively. The lower back and neck thus sink towards the floor as your butt sticks out. Be gentle with the hyperextension of the neck especially please.

Then as you breathe out, pull your stomach in, pull your chin in to your chest, let your shoulders roll forward, and straighten your arms and elbows more as you lightly push towards the floor, arching the upper back outwards. This is done more actively as you work against gravity. In both parts the breathing engages the diaphragm and helps it move in tandem with the spine.

In Back Flat you lie on the ground in situp position flat on your back, knees bent at 90 degrees, with feet flat on the floor, hands at your sides. Active part: Slowly pull your stomach in using the lower abdominal muscles, while you roll your hips backward toward the floor, flattening your back. Pulling your anal sphincter in as you do this will give you a better feel for the exercise and will increase the effect along the spine. Then release as you passively come back to beginning position. Braethe out during the active part and in during the passive part as this also works with the mechanism of the body's diaphragm.

For both exercises work in sets of 10 repetitions each, and try to work up to 3 sets.

Obviously these are both great exercises for anyone to do in order to maintain suppleness, stability, and flexibilty of the lower back and spine. Depending on your specific type of lower back and what it needs, will indicate which exercise to do more often and what to be more specific about.

Get to it.

Wake up and start living!!!