Lower Back Spasm Release

Pulling knees into the chest – is an indispensable part of any lower back spasm release program. As easy as it may look, on the acute stage of a back pain episode it needs to be performed under the qualified supervision of one of our spinal rehabilitation coaches.

You should begin Pulling knees into chest lying when you have mostly recovered from an acute episode of lower back pain and have had long pain-free periods for two to three weeks, even though you may still feel stiffness when you bend forward.

This exercise may also be necessary if you have significantly improved with restoring lumbar lordosis but after two or three weeks still experience a small amount of pain at the centre of your back, pain that seems like it will not disappear.

It is not uncommon for some central, midline, lower back pain to occur when you start pulling knees into chest, that is, when you do Flexion in Lying. An initial pain that wears off gradually with repetition of the exercise is acceptable; it means that shortened structures are being stretched effectively.

If this exercise causes pain that increases with each repetition, stop. In this case, it is probably too soon to start flexion and you should wait and try it in another week or two.

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 The correct way to perform Pulling knees into the chest:

  • Lie on your back with your knees bent and your feet flat on the bed or on a soft surface on the floor.
  • Brace your low back by sucking your navel in hard. If your tummy is weak, push in with one hand on the front of the tummy for reinforcement.
  • With the other hand behind your thigh, pull one leg up to the chest. As soon as the foot is off the floor you can use both hands to pull the leg on to the chest.
  • Bracing your tummy in the same way, pull the other leg onto your chest and cross both ankles.
  • Place both hands around your knees and gently but firmly pull your knees as close to your chest as pain permits 
  • Once you have maintained this position for a second or two, lower the legs and return to the starting position

It is important that you do not raise your head as you perform this exercise. It is also important that you do not straighten your legs as you lower them.

Each time you repeat the cycle of movements in this exercise, try to pull your knees a little closer to the chest, so that by the last repetition of this exercise you have flexed your back as much as possible.

You can use this exercise to treat stiffness in the lower back that may have developed since your injury began. While damaged tissues may now have healed, they may also have shortened and become less flexible. It is now necessary to restore their elasticity and full function by performing flexion exercises.

Begin these exercises with caution. Do only 5 – 6 repetitions per session, and repeat the sessions three or four times per day. As you have probably realised, once your knees are bent in this exercise, you have eliminated the lordosis. Therefore, to reverse any distortion that may result, this and all other flexion exercises must always be followed immediately by a Cobra (Extension in Lying).


Your own physical condition and diagnosis may require specific modifications or precautions. Before undertaking any course of self-treatment you should consult a doctor or a physiotherapist.

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