Back Pain? Will Extension Help?

Does Extension Help Back Pain? A Progression Guide from Bob & Brad

So you're dealing with back pain, and you're not sure whether extension exercises are actually going to help. Here's the honest truth: it depends on why your back hurts in the first place.

If you're a flexor — someone whose pain gets worse when you bend forward, sit for long periods, or reach down to pick something up off the floor — then extension exercises may be exactly what you need. Let's walk through how to do them safely, and why the progression matters so much.

Understanding Flexion vs. Extension

Before we dive into the exercises, a quick clarification for everyone on the same page: flexion is bending forward. Extension is arching backward. If your pain flares up when you're flexed (bent), then moving into extension might help calm things down. The goal isn't to force a full backbend — it's to find the position that feels better and gradually work from there.

The Extension Progression: Start Where You Are

Here's what makes Bob and Brad's approach different from a lot of back pain advice out there: they meet you where you are. If lying completely flat on your stomach hurts, you don't start there. You build up to it.

Phase 1: Lying Flat With Pillows

Start by lying on your stomach on a bed or floor. Place pillows under your abdomen or pelvis — anywhere from one to three, depending on what feels tolerable. The goal here isn't comfort; it's tolerance.

Spend 2–3 minutes in this position. If it feels okay and your pain isn't increasing, you're on the right track. Some people can drop a pillow after just a couple of minutes. Others need to stay here for a few days. Your pain is the guide.

Phase 2: Reduce the Pillow Support

As your tolerance improves, start removing one pillow at a time. If you started with three, work down to two. From two, work down to one. Eventually, the goal is to be lying flat on your stomach with no pillow support and no increased pain.

This progression can happen in a single session for some people. For others, it takes several days. That's completely normal, and rushing it doesn't help.

Phase 3: Fist Under the Chin

Once you can lie flat comfortably, try placing a fist under your chin. This is a technique from Dr. Stuart McGill, and here's why it works: it slightly elevates your shoulders, which subtly extends your lower back without forcing the position.

If one fist feels good, try stacking two fists (right fist with left fist on top). This gives you a bit more lift and a bit more extension. Spend 2–3 minutes here, several times a day if you're able.

Phase 4: Prone Prop (Elbows Up)

Now we're getting a little more aggressive. Get up onto your elbows and let your chest come forward slightly while your pelvis stays on the bed or floor. Your low back should sag a bit — that's the extension happening.

Start with just a minute or two in this position; if pain increases, back off. If it feels stable and better, you're building tolerance for the next step.

Phase 5: Baby Press-Ups (Micro Pushups)

Here's where you actively press into extension. Place your hands flat on the bed or floor directly under your shoulders. Using your arms, push your upper body up like you're doing a pushup — but keep your pelvis and low back on the surface. Don't lift your hips.

You might only press up halfway if your back is tight. That's fine. Do 5–10 repetitions, then stop. If you feel pain getting worse, stop immediately and go back to the previous phase.

A key observation from Bob: watch that your waist and pelvis don't move. All the motion should come from the lower back.

Phase 6: Full Extension Press-Ups

Eventually, the goal is to fully extend your arms while keeping your pelvis planted. Not everyone reaches this point, and that's okay. But it's worth working toward.

Do these press-ups 5–10 times per session. You can repeat this 5–8 times throughout the day if you're able and if it's helping.

When You Get Stuck: Overpressure Techniques

Sometimes people get tight and can't isolate the movement properly. If you're lifting your pelvis before your arms are fully extended, try using a strap or rolled sheet across your lower back.

Roll a sheet lengthwise and place it across your lower back and pelvis. Hold the ends with your hands flat on the ground under your shoulders, then perform the press-up with the sheet providing gentle counter-pressure. This keeps your pelvis down and lets you focus the extension into your lower back where you want it.

You can also use a commercial stretch strap (which has loops every six inches for easy hand placement), or ask a friend or therapist to apply gentle downward pressure on your back as you press up. The key word here is gentle — and only if it feels good.

The Golden Rule: Does It Feel Better?

This is the most important part. You should only continue with these exercises if they make your pain decrease. Not stay the same. Not hurt less than other things. Actually better.

Bob puts it this way: "If it feels good, you keep doing it. If it hurts, you're not gonna do this."

Watch for improvements to spread — sometimes the symptoms that are farthest from your center improve first. If you have pain, numbness, or tingling that travels into your leg or foot, you might notice relief in the foot first, then gradually improve closer to your center.

Frequency and Consistency Matter

You can do these exercises multiple times throughout the day — often 5–8 times if you're really dealing with something like sciatica. We know that sounds like a lot, but conditions like this can be serious, and consistent, devoted practice is what gives you the best shot at healing without surgery.

You might need to rest for a minute or two between sessions, especially early on. That's normal and expected.

The Bottom Line

Extension exercises aren't for everyone, but if your pain flares up when you bend forward, they could be a game-changer. The progression is designed to meet you where you are and gradually build your tolerance without forcing the issue. Start with pillows, reduce support gradually, then add active movement once you're ready.

And remember: if it doesn't feel better, don't do it. Your body is the best guide you have.

Want a detailed step-by-step program? Bob & Brad have created a full guide for this progression that breaks down each phase with timing and modifications. If you're serious about tackling this, grab the program and follow it alongside these videos.

Your back will thank you — eventually.