Summary of "The Back Pain Exercise Tier List"
Summary of “The Back Pain Exercise Tier List”
This video ranks 14 back pain exercises across seven key categories to evaluate their effectiveness for healing and managing back pain. The categories used for evaluation are:
- Ease of entry: How accessible the exercise is when in pain
- Short-term value: Immediate relief potential
- Long-term value: Ability to rebuild tissue and improve spinal health
- Scalability: Progression potential
- Potency: Relevance and impact on back pain
- Safety: Risk of injury or flare-ups
- Simplicity: Ease of correct execution and equipment needed
Exercises are rated from F (worst) to S (best). The presenter’s credibility comes from personal experience with chronic back pain and extensive trial and error.
Key Wellness Strategies & Exercise Evaluations
1. Instant Relief Stretches (e.g., twisting legs, scorpion moves)
- Ease of entry: Moderate (gentle stretches possible)
- Short-term value: Minimal, temporary relief only
- Long-term value: None
- Scalability: None (dead-end drills)
- Potency: Low, mostly passive and not targeted
- Safety: Risk of reinjury present
- Simplicity: Low, no form guidance
- Overall: F tier – Not recommended; no healing effect.
2. Decompression (hanging from a bar)
- Ease of entry: Easy for most
- Short-term value: High relief sensation
- Long-term value: Limited; risk of ligament laxity and instability if overused
- Scalability: None
- Potency: Moderate (direct spine relief)
- Safety: Generally safe but can cause flare-ups
- Simplicity: Simple
- Overall: D tier – Good for early relief but diminishing returns.
3. McKenzie Cobras (spinal extension press-ups)
- Ease of entry: Very easy
- Short-term value: Good for nerve pain relief
- Long-term value: Minimal; passive movement without strengthening muscles
- Scalability: None
- Potency: Moderate (nerve pain relevant)
- Safety: Safe but can irritate facet joints if overdone
- Simplicity: Simple
- Overall: D tier – Useful as a relief tool only.
4. McGill Big Three (curl-up, side plank/clamshell, bird dog)
- Ease of entry: Good for early rehab (post acute phase)
- Short-term value: Helpful for desensitization and micro-movement tolerance
- Long-term value: Limited; builds some stability but not enough for full recovery
- Scalability: Low
- Potency: Moderate
- Safety: Very safe
- Simplicity: Easy to perform
- Overall: B- tier – Valuable early-stage exercises.
5. Glute Bridges
- Ease of entry: Easy, pain-friendly
- Short-term value: Minimal for back pain relief
- Long-term value: Low for spine protection; can test but not build back strength
- Scalability: High (from bodyweight to heavy)
- Potency: Low relevance to back pain
- Safety: Safe at low levels; risk if heavy
- Simplicity: Simple form
- Overall: C tier – Helpful for glute activation but limited back benefit.
6. Cat-Cow (spinal flexion and extension mobility)
- Ease of entry: Easy
- Short-term value: Mild passive mobilization
- Long-term value: Potentially beneficial if done consistently
- Scalability: None
- Potency: Low (no strengthening)
- Safety: Generally safe
- Simplicity: Simple
- Overall: C tier – Good for movement but not a game changer.
7. Nerve Gliding
- Ease of entry: Very easy, micro-movements
- Short-term value: Immediate relief for nerve pain
- Long-term value: High; helps fascia remodeling over months
- Scalability: Yes, by increasing stretch intensity
- Potency: Moderate; targets nerve-related pain and fascia
- Safety: Very safe if done gently
- Simplicity: Extremely simple
- Overall: A tier – Highly recommended for nerve pain management.
8. Deadlifts (conventional barbell)
- Ease of entry: Difficult when injured
- Short-term value: None for immediate relief
- Long-term value: Good if done correctly over years; risk of injury high if form is poor
- Scalability: Very high
- Potency: High relevance to spine and strength
- Safety: Risky if done improperly or during pain flare-ups
- Simplicity: Complex form, hard to master
- Overall: C tier – Powerful but requires skill and caution.
9. Romanian Deadlift (RDL)
- Ease of entry: Easier than deadlift, starting from standing
- Short-term value: Warm-up and blood flow benefits
- Long-term value: Good for back and hamstring strength
- Scalability: High
- Potency: Moderate (targets larger back muscles)
- Safety: Safer than deadlift but still risky if overloaded
- Simplicity: Moderate difficulty
- Overall: B tier – Good strength builder with proper technique.
10. Six-Pack Ab Work (crunches, sit-ups)
- Ease of entry: Moderate; may irritate spine if injured
- Short-term value: None for back pain relief
- Long-term value: Minimal for back pain; general core benefit
- Scalability: Low
- Potency: Low relevance to back pain
- Safety: Potential to aggravate pain with spinal flexion
- Simplicity: Simple form
- Overall: C tier – Not essential for back pain rehab.
11. Reverse Hyperextension
- Ease of entry: Difficult for sensitive backs
- Short-term value: Good pump and activation
- Long-term value: Strong for spinal erectors and glute strength; protects SI joint
- Scalability: Limited variations, but bodyweight regressions possible
- Potency: High for back strength and protection
- Safety: Moderate risk; not for beginners
- Simplicity: Simple form
- Overall: B tier – Effective but less accessible.
12. Seated Good Morning (hip hinge from sitting)
- Ease of entry: Very easy; accessible for fragile backs
- Short-term value: Good immediate feedback and relief
- Long-term value: High; scalable with holds and reps, builds spine and glute endurance
- Scalability: Very high
- Potency: High relevance to spine and hips
- Safety: Safe if done with proper load and control
- Simplicity: Easier than RDL; form exposes hip mobility limits
- Overall: A tier – Highly recommended as a starting and progressing exercise.
13. 90-Degree Back Extension Machine
- Ease of entry: Difficult for injured or fragile users
- Short-term value: Possible pump and relief if level is manageable
- Long-term value: Good for spinal flexion and decompression training
- Scalability: Limited, very challenging progression
- Potency: High for spinal muscles and decompression
- Safety: Moderate risk of flare-up
- Simplicity: Simple form but requires control
- Overall: B tier – Potent but not beginner-friendly.
14. 45-Degree Back Extension Machine
- Ease of entry: Relatively easy; many levels available
- Short-term value: Immediate desensitization and activation possible
- Long-term value: Very high; builds stability, decompression, recompression, and deep spinal tissue
- Scalability: Excellent; from assisted holds to heavy weighted reps
- Potency: Very high; can both heal and harm if misused
- Safety: Safe with proper progression and caution
- Simplicity: Simple form, focus on tempo and control
- Overall: S tier – Best overall exercise for back pain rehab.
Jefferson Curl (loaded spinal flexion)
- Ease of entry: Difficult; risky for injured backs
- Short-term value: Possible relief but risk of irritation
- Long-term value: Good if done after building strength; targets deep spinal tissues uniquely
- Scalability: High (elephant walk → bodyweight → loaded)
- Potency: Extremely potent but risky
- Safety: High risk if unprepared
- Simplicity: Complex; requires skilled coaching
- Overall: B tier – Specialty exercise for advanced rehab only.
Key Takeaways and Methodology for Back Pain Exercise Selection
- Start with exercises that are easy to enter and safe for sensitive backs, such as nerve gliding, seated good mornings, and the McGill Big Three.
- Use exercises with short-term relief as temporary tools but avoid relying on them exclusively (e.g., decompression, McKenzie cobras).
- Progress to scalable, potent exercises that build strength, stability, and spinal tissue health over time (e.g., 45-degree back extension, Romanian deadlift).
- Avoid quick-fix stretches and passive drills that don’t build tissue or strength.
- Prioritize safety and proper form to avoid flare-ups or reinjury.
- Understand that some exercises are best suited for later stages of rehab (e.g., Jefferson curl).
- Embrace a long-term mindset: healing back pain takes time, patience, and progression through appropriate exercises.
Presenters / Source
- The video is presented by an individual with lived experience of chronic back pain, who has become an expert through personal trial and error.
- The presenter references their own program and community: LowBackAbility.com (LBA), which offers a comprehensive back pain rehabilitation blueprint.
Overall Summary
The best back pain exercises balance accessibility, safety, scalability, and potency to progressively build spinal strength and tissue health. Passive stretches and quick relief tricks are mostly ineffective long-term. Exercises like the 45-degree back extension machine and seated good mornings rank highest for their ability to safely and effectively rehabilitate the back over time, while nerve gliding offers excellent nerve-related pain relief with minimal risk. Deadlifts and Jefferson curls can be powerful but require advanced skill and caution. The video encourages a strategic, long-term approach to back pain rehab rather than chasing immediate relief.
Category
Wellness and Self-Improvement
