As many as 90% of all adults suffer back pain at some point in their lives. Back pain—lower-back pain, in particular—ranks fifth among the most frequent reasons for hospitalizations.

Worse for women: Their musculoskeletal systems—ligaments, vertebrae, spinal disks, etc.—are more delicate than men's and more vulnerable to injury. Women also tend to be less active, on average, than men, and a sedentary lifestyle is a common cause of back pain.

Most back problems are caused by prolonged sitting or by lifting heavy objects the wrong way, but other factors contribute to back pain, including excess body weight, stress and depression. Even smoking is a factor for reasons that aren't exactly clear.

Simple lifestyle measures-maintaining a healthy weight, not smoking and controlling stress and depression can prevent many cases of back pain. Most important, though, are exercises that strengthen muscles in the back, chest, abdomen, hips and sides. These are the core muscles-the scaffolding that supports the spine and enables the back to flex and twist without injury. Strengthening these muscles can relieve pain and also prevent it.

A Five-Step Plan

The following workout, which takes no more than 20 minutes, targets all of the core muscles. It can be done three to five times weekly (unlike most strength-training workouts, which should be done no more than three times a week, because muscles need time to recover between sessions). These exercises can be done more of ten because the intensity is lower-and they're less likely than traditional workouts to cause back pain or other injuries.

For each of the following exercises…

  • Complete 10 repetitions, rest for one minute, then complete another 10 reps. If you can complete only five or six reps, the intensity is too high and you should do only what you can comfortably manage
  • Work up to an advanced progression. This is a way to increase the exercise intensity by making the movements more difficult.
  • Always warm up—by taking a brisk walk around the block or stepping quickly in place—for five minutes before doing the exercises.

Step 1: Abdominals

Most people's abdominal muscles are weaker than they should be. Strengthening the abdominals is among the best ways to prevent back pain.

Starting position: Lie on your back on the floor with your knees bent and the 2 soles of your feet flat on the floor. Lightly rest your hands on the lower part of the stomach.

The movement: Contract the abdominal muscles until you feel the small of the back pushing toward the floor. Imagine that you're pulling your belly button downward. Hold the "tense" position for three seconds, then relax.

Progression: Do almost the same exercise as above, with this difference. While the abdominal muscles are tight, raise the still-bent right leg a few inches off the floor and hold it up for three seconds, then place that leg down and raise the left leg for three seconds. The entire move will take 10 to 12 seconds.

Step 2: Chest Muscles

Along with abdominal exercises, chest workouts protect the back by strengthening the "front" of the core muscle groups.

Starting position: Stand facing a wall or a counter, about an arm's length away, with your feet hip-width apart and knees slightly bent. Put your palms on the wall (or lightly hold the edge of the counter).

The movement: Holding your body straight, bend at the elbows until you are leaning forward toward the wall or counter about 30 degrees. Pause in this position for a moment, then push with your arms until you're back in the starting position.

Progression: Work the same muscles with more intensity with a modified push-up. Lie facedown on the floor, with your palms directly next to your shoulders, elbows bent.

Keeping your knees on the floor, slowly push up only your chest. Keep your trunk in a straight line from your head to your knees. Push up until your shoulders are over your hands, but don't lock the elbows. Pause for a moment, then lower back down until your nose is about four inches from the floor. Keep your trunk in a straight line throughout the movements.

Step 3: Midback

Many exercises target the upper/lower back, but relatively few target the middle back-a common area for problems.

Starting position: Lie facedown on an exercise mat or carpet, with your arms straight out to

the sides, perpendicular to the body.

The movement: Contract your shoulder blades to lift the arms up and slightly back. Hold the arms in the lifted position, and make four figure eights with the hands. Then lower your arms to the starting position.

Progression: Make the figure eights with the thumbs down or up...or while holding a balled-up sock in each hand...or with the little finger up or down. Varying the movement works different parts of the muscles.

Step 4: Upper Back

This exercise increases shoulder strength as well as back strength.

Starting position: Tie a knot in the middle of an elastic exercise band (available at sporting-goods stores for $2 to $3). Place the knot over the top of a door, and then close the door to anchor the band in place. The two ends should be hanging down on the same side of the door. Sit in a chair facing the door, with your toes against the door. Hold one end of the band in each hand.

The movement: Slowly pull your hands down and in toward your chest. Keep your elbows pointed down and close to your body. Pause for a moment, then slowly let your arms extend back to the starting position.

Progression: When the exercise starts feeling easy, change to a higher-resistance band.

Step 5: Lower Back

This is the area that gives most people problems.

Starting position: Lie facedown on an exercise mat or carpet. Reach your right hand in front of you, palm down. The left arm should be down alongside your body, with the palm up.

The movement: Slowly raise your right arm, chest and left leg about five inches off the floor. Keep your face down, so your spine is in a straight line. Keep your right leg and left hand on the ground. Pause for a moment, then return to the starting position.

Reverse the movement, raising your left arm, chest and right leg, and keeping the left leg and right hand on the floor.

Progression: Kneel on all fours. Raise your right arm straight in front of you while simultaneously raising the left leg straight behind. Keep the abdominal muscles contracted. Pause, return to the starting position. Then reverse the movement.

Optional Exercise: Thighs, Hips And More

This optional exercise is a complex move that targets the upper legs as well as the trunk. It is good for improving stability and balance. The exercise requires the use of a stability ball, available at sporting-goods stores for about $20.

Starting position: Stand with your back to a wall, with the stability ball positioned between your back and the wall. Lean back against the ball, with your feet a bit more than hip-width apart. Hold your arms straight in front of you or crossed over your chest.

The movement: While keeping light pressure on the ball with your lower back, bend at the knees and slowly squat down-the ball will roll with the movement. Squat down as far as you comfortably can. The ball will then be positioned at about the midback.

Keeping pressure on the ball, contract the buttocks and slowly "roll" yourself up and back to the starting position.

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