Williams Back Exercises

Dr. Paul Williams first published his set of flexion-based back exercises in 1937, as a program for patients with chronic low back pain. The exercise system was based on Dr. Williams’ theory that lower back pain is caused by lumbar lordosis: or, over curvature of the lumbar spine. The goal of Williams back exercises was to “flatten” or straighten the lower spine by strengthening the lower abdominals (to tilt the pelvis forward) and the gluteals (to pull back of the pelvis down, from the top).

Williams back exercises-namely a set referred to as the “first aid exercises”- were used for decades to help people manage lower back pain. Portions of Williams’ principles of flexion-especially the use of abdominal strengthening to reduce stress on the low back- are used in a more preventative capacity today, though his work is no longer the absolute authority in lower back pain.

The main Williams back exercises (the “first aid exercises” mentioned above) are movements designed to decrease curvature of the lower spine through a combination of stretch and strengthening. These exercises include those listed here.

Williams Back Exercises for Relief/ Treatment of Lower Back Pain
1. Pelvic tilt: a small movement, performed while lying in a supine position with knees bent and feet planted on the ground. Trying not to push down through the feet, flatten the small of your back to the ground by pulling the lower abdominals in. (Think of pulling your naval down toward your spine.) Hold for 5-10 seconds, release, and repeat.
2. Single knee to chest: a good lower back stretch. From the starting position described above, bend one knee and use your arms to pull that knee in, toward your chest. Hold 5-10 seconds and repeat with the other leg.
3. Double knee to chest: like single knee to chest, but after you draw one knee up, follow with the other. Hold both knees for 5-10 seconds; then lower one leg at a time.
4. Partial sit-up: similar to what we would call an abdominal crunch. Begin with the pelvic tilt, and curl your head, shoulders, and torso up from the ground. Hold for a moment with the lower back flattened against the floor, and upper body slightly lifted. Release and curl back down. Release the pelvic tilt.
5. Hamstring stretch: accomplished from a seated position. Begin sitting up tall, with legs together and extended out in front of you. Flexing at the hips, lean forward until you feel a good stretch in the hamstrings (back of the upper leg).
6. Hip flexor stretch: sometimes referred to as a lunge. The position for this stretch involves one leg fully extended behind you, and the other bent in front (similar to the bottom of a lunge exercise). From here, tilt the pelvis forward to stretch the hip flexor muscles. Repeat on each side.
7. Squats: similar to the basic strength training movement. In the context of the Williams back exercises, the squat refers to lowering the upper body by flexing the knees. Dr. Williams advocated a series of small “bounces” to be performed at the lowest position of the exercise, before returning to a standing position.
8. Seated flexion: a stretch achieved by slumping all the way forward, in a chair, from a starting seated position. This exercise is used to strengthen the gluteal muscles.

As you can see from this brief review of Williams back exercises, Dr. Williams was a firm believer in using spinal flexion and various stretches as means of relieving lower back pain. In recent decades, as the issue of preventing and relieving low back pain has gained greater attention, the formerly dominant Williams back exercises have had to make way for a myriad of new exercises and methods. However, the comprehensive strength/ stretch nature of Dr. Williams’ program is certainly a model to keep in mind today for anyone combating lower back pain with core strengthening, stabilization, and stretch exercises.