McKenzie Back Extension Exercises

By Adam Brown - Physiotherapist and Founder and Advisor to Therapia

By Adam Brown - Physiotherapist and Founder and Advisor to Therapia

Sometimes referred to as ‘sloppy push-ups’ or ‘press-ups’ this exercise was popularized by a New Zealand physical therapist named Robin McKenzie. Robin went on to develop an entire classification and treatment program for orthopaedic spinal conditions. Courses are still taught all over the world and his methods are still widely used.

What are McKenzie Extension Exercises?

McKenzie describes an exercise to passively extend the lumbar spine to the end point of its range of motion in order to help improve extension. They can be performed independently by anyone who has average arm strength with no special equipment required.

What do McKenzie Extension Exercises Do?

The maneuver is designed to help patients to restore lumbar extension range of motion following an injury that has resulted in a loss of this movement. It is also used to reduce and control pain associated with a low back problem.

Who Should Do McKenzie Extension Exercises?

The best way to sort out what back exercise you should be doing is to see a qualified Physical Therapist for an assessment of your condition. However, the following are clues that this exercise may be helpful for your back problem.

  • You have low back pain that comes and goes depending upon what you are doing.
  • Your pain is worse when sitting or bending and lifting and tends to improve after walking a few minutes.
  • You feel stiff when standing up after sitting or driving for an extended period of time.
  • When you sit up straight your pain either improves or moves closer to your spine (for example from your buttock and thigh to your low back).

Are McKenzie Extension Exercises Safe For Me?

Generally speaking, a trail of passive extension exercises will not harm anyone with mechanical low back pain. Even if it is not quite the right exercise for you and therefore does not provide any relief, it is very unlikely that it will cause any significant damage to your spine.

How Do I Perform McKenzie Extension Exercises?

  1. Lying flat on your stomach with hands on the ground as though you were going to perform a push-up.
  2. Keep all lower-body muscles completely relaxed and straighten your arms pushing your upper body up toward the ceiling.
  3. Do not hold your hips down on the ground – simply let them come up if that is what happens when you are relaxed.
  4. Straighten your arms all the way and with your elbows locked breathe out and let your abs and hip muscles sag.
  5. When you sag you will feel the stiffness in your low back.
  6. Hold for 1 second and return to the start position.
  7. Repeat 15x
low back press ups 1
low back press ups 2

The following are clues that you need to seek a medical evaluation rather than treating your back pain yourself.

  • You have unrelenting, constant low back pain.
  • You feel otherwise unwell in addition to your back pain (such as fevers, night sweats, nausea).
  • You are experiencing bowel or bladder changes in addition to your low back pain.
  • You are experiencing progressing neurological symptoms (weakness, and numbness in your legs).

The vast majority of people suffering from low back pain do not ever experience the concerning symptoms above. So if you are dealing with some mechanical low back pain that tends to improve with a short walk, give the McKenzie back extension exercise a try. If you are able to control your pain and improve your movement, keep it up!

Final Thoughts

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