The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Back-Saver Strategies

Posted in
Fit Tips

Wednesday, Aug 09, 2017

Low back pain, injury, and other back disorders may be the most pressing orthopedic health problem in modern America, at least in terms of prevalence if not severity. In fact, back pain is the second most common neurological ailment in this country; only headaches are more common (NINDS, 2004). According to The National Institute for Occupational Safety and Health, low back pain affects 1,000,000 workers in the U.S. every year and is responsible for more lost work days than any other musculoskeletal disorder (University of Minnesota, 2004).

The key to maintaining a healthy back is controlling lifestyle factors. In all aspects of wellness, there are risk factors which predispose an individual to disease or dysfunction. Understanding these factors and learning to avoid them or significantly reduce them is a necessity. The following are common factors associated with increased risk of low back pain and injury:

  1. Prolonged sitting
  2. Improper posture
  3. Upper body obesity
  4. Muscular weakness and/or imbalance
  5. Cigarette smoking
  6. Low cardiorespiratory fitness

The exercise strategies performed in this Fit Tip can be utilized to improve the strength of the back muscles, specifically the erector spinae. Furthermore, they may be performed in any setting, which should be quite encouraging for those with busy schedules.


Back Extension: See video for all three levels of this exercise. Safety tip: keep the toes/feet on the ground at all times. Lifting the feet off the ground can potentially be dangerous as it creates compression forces in the spine.

  • Level 1 (modification): The modified version of the back extension exercise decreases the length of the lever arm by keeping the arms/hands closer to the head. This in turn reduces the amount of resistance the back has to overcome.

  • Level 2 (intermediate exercise): In this version, the participant extends their arms above the head to increase the length of the lever arm thereby increasing the difficulty of the exercise.

  • Level 3 (amplification): The more advanced version of the back extension exercise increases both the lever arm and the time spent under tension.

Towel Back Extension: Once the participant has mastered the body weight back extension exercises, he/she can further amplify their routine by adding a towel. Safety tip: Keep toes/feet on the ground at all times.

  • Level 1 (Towel Back Extension): Begin the exercise by pulling the towel apart as to create resistance.  Proceed with performing a back extension while maintaining the resistance on the towel.

  • Level 2 (Towel Back Extension with Lat Pull): This exercise builds on to the first level by incorporating a lat pull. Maintain the resistance on the towel throughout the exercise.

  • Level 3 (Towel Back Extension with Lat Pull and Uneven Lever Arms): The advanced version of this exercise utilizes uneven lever arms by pulling down one arm at a time.

Resistance Band Quadraplex: The quadraplex is a great exercise that focuses on stability and strength of the back muscles. These movements are for advanced individuals as appropriate stability of the spine and hips is needed prior to successfully completing the exercise. Safety tip: Ensure that the spine and hips are level and perfectly parallel to the floor at all times.

  • Level 1 (modification): If the participant is just beginning to incorporate the quadraplex, begin with the modified version wherein the only limb that is moving is the leg. Once the leg is extended, it should be in line with the rest of the body. Avoid the common tendency to elevate the leg above the body (i.e. donkey kick). The foot of the extended leg should be dorsiflexed (toes pointed towards the shin) at all times so that the resistance band stays in place.

  • Level 2 (intermediate/advanced): The advanced version of the quadraplex adds shoulder flexion (arm extended forward in line with the body) to be performed at the same time as the leg extension. 

The above back-saver strategies should be utilized for the purpose of preventing back pain and can be quite beneficial for all individuals especially those who spend the majority of their day sitting down. If you experience symptoms of back injury such as backache, radiating pain, numbness or tingling, be sure to contact your primary care physician.


National Institute of Neurological Disorders and Stroke, (2004). Low back pain fact sheet. Retrieved from

University of Minnesota, (2004). Injury prevention: Back injuries in the workplace. Retrieved from