Mend Physical Therapy Blog and Injury Information

Posterior Chain Strengthening Superior To General Exercise For Patients With Chronic Low Back Pain

March 16, 2021


Chronic low back pain is a common condition described as pain lasting longer than 3 months in duration. At this point in a patient’s recovery, active interventions such as graded aerobic exercise and strength training take on a greater importance in a patient’s recovery. These interventions are most valuable in order to reduce the pain and disability associated with this condition. Exercises are prescribed based on a patient’s areas of weakness which commonly include muscles which extend or straighten the upper and lower back as well as the hips. Collectively, these muscles are described as the posterior chain and can be targeted with exercises such as deadlifts, bridges, hip thrusts, bird dogs, and lumbar extensions over a ball or GHD machine. A recent article describes the benefits of these exercises compared to general strengthening.

Tataryn and colleagues published a review of the available literature on this specific form of strengthening compared to other exercise interventions (Sports Medicine. 2021). Authors included 8 studies of over 400 patients with chronic low back pain who were either prescribed posterior chain exercises or general exercise. The participants who received general exercise performed aerobic and strength training exercises. In comparison, the majority of the posterior chain participants’ exercises involved extensors of the mid and lower back, as well as, the hips. They reported while both groups improved their pain and disability scores, greater effects were noted in the posterior chain focused groups. In addition, longer programs lasting > 12 weeks were more effective than those lasting 6-8 weeks.

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