Spine Conditioning Program (Stretching & Strengthening Exercises)

Reviewed by Dr. Kshitij Chaudhary, Spine Surgeon, P.D. Hinduja Hospital, Mumbai. Last reviewed June 2026.

What This Program Is For

After a spine injury or surgery, a structured exercise program helps you return safely to daily activities, sport, and an active lifestyle. This is a general spine conditioning program covering the whole back — neck through hips — combining strength and flexibility work.

This program should be done under the supervision of your doctor or physical therapist, who can tell you which exercises suit your specific situation and adjust the program to your recovery.

• Strength keeps your back and upper body stable, relieves pain, and helps prevent further injury
• Flexibility restores your range of motion and helps prevent injury; gentle stretching after strengthening reduces soreness and keeps muscles supple

Muscles This Program Targets

• Cervical spine (neck) and trapezius (neck and upper back)
• Latissimus dorsi (side and middle back)
• Back extensors and erector spinae (middle and lower back)
• Quadratus lumborum (lower back)
• Abdominals, and external/internal oblique rotators (side and lower back)
• Gluteal muscles and piriformis (buttocks)
• Hamstrings (back of thigh)

How Long to Follow It

Follow this program for 4 to 6 weeks, unless your doctor or physical therapist advises otherwise. After that, it works well as a maintenance routine, 2–3 days a week, for ongoing protection and health of your spine.

Before You Start

• Warm up with 5–10 minutes of low-impact activity, like walking or a stationary bicycle
• Sequence: do the stretching exercises first, then the strengthening exercises, then repeat the stretches again to finish
• Don't push through pain. You shouldn't feel pain during an exercise — talk to your doctor or physical therapist if you do
• Ask if unsure how to perform an exercise, or how often, rather than guessing

Stretching Exercises

Do these daily, both before and after your strengthening exercises.

1. Head Rolls

Works: neck muscles, trapezius. You should feel this around your neck and into your upper back.

• Sit in a chair or stand with your weight evenly distributed on both feet
• Gently bring your chin toward your chest
• Roll your head to the right so your ear moves toward your right shoulder; hold 5 seconds
• Roll your head back toward your chest and then to the left so your ear moves toward your left shoulder; hold 5 seconds
• Slowly roll your head in a full clockwise circle, 3 times
• Reverse and roll counterclockwise, 3 times

Reps: 3 sets of 3, daily

Tip: Don't shrug your shoulders up during this exercise.

2. Kneeling Back Extension

Works: quadratus lumborum, erector spinae. You should feel this in your lower back and abdominals.

• Begin on your hands and knees, shoulders positioned over your hands
• Rock forward onto your arms, round your shoulders, and let your low back drop toward the floor; hold 5 seconds
• Rock backward, sitting your buttocks as close to your heels as possible, extending your arms; hold 5 seconds

Reps: 10, daily

Tip: Look down at the floor to keep your neck aligned with your spine.

3. Sitting Rotation Stretch

Works: piriformis, external and internal oblique rotators. You should feel this in your buttocks and at your sides.

• Sit on the floor with both legs straight out in front of you
• Cross one leg over the other
• Slowly twist toward your bent leg, placing one hand behind you for support
• Place your opposite arm against the side of your bent thigh and use it to twist further
• Look over your shoulder and hold for 30 seconds
• Slowly return to center, then repeat on the other side

Reps: 2 sets of 4 (each side), daily

Tip: Sit up tall and keep your sit bones pressed into the floor throughout.

4. Modified Seat Side Straddle

Works: hamstrings, extensor muscles, erector spinae. You should feel this in the back of your thighs and into your lower and middle back.

• Sit on the floor with one leg extended to the side and the other bent
• Keep your back straight and bend from your hips toward the foot of your straight leg; reach your hands toward your toes and hold 5 seconds
• Slowly round your spine, bringing your hands to your shin or ankle, head moving as close to your knee as possible
• Hold 30 seconds, then relax for 30 seconds
• Repeat on the other side

Reps: 10 each side, daily

Tip: Keep your extended leg straight as you bring your head down.

5. Knee to Chest

Works: quadratus lumborum. You should feel this in your lower back, front of hip, and inner thigh.

• Lie on your back on the floor
• Lift one leg and bring your knee toward your chest; grasp your knee or shin and pull it in as far as it will comfortably go
• Tighten your abdominals and press your spine to the floor; hold 5 seconds
• Repeat on the other side, then pull both legs in together

Reps: 3 sets of 10, daily

Tip: Keep your spine aligned to the floor throughout.

Strengthening Exercises

Do these daily, sandwiched between your stretching sets.

6. Bird Dog

Works: back extensors, erector spinae, gluteal muscles. You should feel this in your lower back and buttocks.

• Begin on your hands and knees, shoulders over your hands and hips over your knees
• Tighten your abdominal muscles and raise one arm straight out to shoulder height, level with your body; hold until balanced
• Slowly lift and extend the opposite leg straight out from your hip
• Tighten your buttocks and thigh muscles and hold 15 seconds
• Slowly return to start and repeat with the opposite arm and leg

Reps: 5, daily

Tip: Keep your stomach muscles tight and your back flat to stay balanced.

7. Plank

Works: back extensors, erector spinae, quadratus lumborum, abdominals. You should feel this in your middle to lower back, abdominals, and glutes.

• Lie on your stomach with your forearms on the floor, elbows directly below your shoulders
• Tighten your abdominal muscles and lift your hips off the floor
• Squeeze your glutes and lift your knees off the floor
• Keep your body straight and hold 30 seconds — if you can't, keep your knees down and hold with just your hips lifted
• Return slowly to start and rest 30 seconds before repeating

Reps: 5, daily

Tip: Don't let your pelvis sag toward the floor — keep your stomach muscles tight.

8. Modified Side Plank

Works: quadratus lumborum, external and internal oblique rotators. You should feel this in your lower back, waist, and abdominals.

• Lie on your side, bottom leg slightly bent, top leg straight
• Position your elbow directly under your shoulder, forearm extended on the floor in front of you
• Tighten your abdominal muscles and raise your hip off the floor
• If you can, straighten your bottom leg and lift your knee off the floor too
• Keep your body straight and hold 15 seconds
• Return slowly to start and repeat on the other side

Reps: 5, daily

Tip: Keep your neck aligned with your spine — don't shrug your shoulder up to your ear.

9. Hip Bridge

Works: lower back extensors, erector spinae, gluteal muscles, hamstrings. You should feel this in your lower back, buttocks, and back of your thigh.

• Lie on your back, arms at your sides, knees bent, feet flat on the floor
• Tighten your abdominal and gluteal muscles and lift your pelvis so your body forms a straight line from shoulders to knees
• Hold 15 seconds
• Return slowly to start and repeat

Reps: 5, daily

Tip: Center your weight over your shoulder blades — don't tense up in your neck.

10. Abdominal Bracing

Works: abdominals. You should feel this in your stomach muscles.

• Lie on your back, knees bent, arms at your sides
• Tighten your abdominal muscles so your stomach pulls away from your waistband
• Hold 15 seconds

Reps: 5, daily

Tip: Flatten your lower back into the floor.

11. Abdominal Crunch

Works: abdominals. You should feel this in your stomach muscles.

• Lie on your back, knees bent, hands behind your head with elbows open wide
• Tighten your abdominal muscles and lift your head and shoulder blades off the floor
• Keep your back flat to the floor and hold 2 seconds
• Lower slowly and repeat

Reps: 2 sets of 10, daily

Tip: Relax your neck — don't pull on your head with your hands.

Common Questions

Who is this program for?

Anyone recovering from a spine injury or surgery, working to return to daily activities or sport, or looking for a general maintenance routine to keep their back strong and flexible long-term.

Should I do this without seeing a doctor first?

No — this is a general program, and it works best when supervised by your doctor or physical therapist, who can tailor it to your specific injury, surgery, or recovery stage.

What if an exercise causes pain?

Stop. You shouldn't feel pain during any of these exercises. Mention it to your doctor or physical therapist before continuing.

How is this different from the neck-specific exercises?

This program addresses the whole spine — neck, mid-back, lower back, and hips — as a broader strength and flexibility routine, typically used during structured rehab after injury or surgery. If your main issue is neck pain specifically, see Neck Exercises for Pain Relief & Prevention, which is more targeted for that.

Can I continue this indefinitely?

Yes. After the initial 4–6 week rehab period, continuing 2–3 days a week as a maintenance routine helps protect your spine long-term.

About Dr. Kshitij Chaudhary

This page was written by Dr. Kshitij Chaudhary, a fellowship-trained spine surgeon at P.D. Hinduja Hospital, Mumbai, trained in complex spine surgery at Harvard Medical School (Beth Israel Deaconess) and the Twin Cities Spine Center, Minneapolis. Learn more about Dr. Chaudhary →

This information is for general education and does not replace a consultation with your doctor.