Free Back Pain Exercises Physical Therapy Library
DECOMPRESSION Floor Mat • Intermediate Discs: L3-L4, L4-L5, L5-S1

McKenzie Prone Press-Up (Full Extension)

The gold standard exercise of the McKenzie MDT framework. By pressing up with the arms while keeping the lower body completely relaxed, disc nucleus material is encouraged to shift forward away from irritated nerve roots.

BIOMECHANICAL MOVEMENT DIAGRAM
Clinical back pain images demonstration - FULL MCKENZIE PRESS-UP
FULL MCKENZIE PRESS-UP
🎯 Hydrodynamic Disc Shift

Step-by-Step Execution

CLINICAL PROTOCOL
  1. 1 Lie flat on your stomach with hands placed palms down beside your shoulders (like the bottom of a push-up).
  2. 2 Completely relax your hips, buttocks, and lower back muscles.
  3. 3 Press through your palms to straighten your elbows, lifting your upper body as high as comfortable.
  4. 4 Allow your pelvis and thighs to sag heavy against the mat, creating a deep arch in your lower back.
  5. 5 Hold for 2 to 3 seconds at the top, exhale fully, and lower back down. Repeat for 10 smooth reps.
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KEY FORM CUES

  • ✓ Your arms do 100% of the lifting; keep your glutes and lower back totally limp like a sack of sand.
  • ✓ Centralization of symptoms (pain moving from leg into center of back) indicates successful technique.
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MISTAKES TO AVOID

  • ✗ Do NOT tense your glutes or engage your back muscles to lift yourself.
  • ✗ Stop if pain radiates further down into the foot or leg.
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CONTRAINDICATIONS & WHEN TO AVOID

Do not perform this movement or modify strictly under clinical supervision if you have:

  • Lumbar spinal stenosis
  • Spondylolisthesis / Pars defect
  • Facet joint arthropathy aggravated by extension
SCIENTIFIC FOUNDATIONS & CITATIONS

Clinical Biomechanics & Evidence

This exercise protocol utilizes proven spinal mechanics: active core co-contraction (McGill stabilization), directional preference extension (McKenzie MDT), and non-compressive axial elongation to facilitate nutrient exchange in the avascular intervertebral disc matrix.

• McGill, S.M. (2016). Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Human Kinetics.
• Delitto, A., et al. (2021). Low Back Pain Clinical Practice Guidelines. Journal of Orthopaedic & Sports Physical Therapy (JOSPT).
CLINICAL DOSAGE
Hold Duration 3 Seconds
Repetitions 10 repetitions
Prescription Sets 2 sets
Difficulty Intermediate
Position Floor Mat
TARGET MUSCLES
Anterior Longitudinal Ligament Lumbar Discs (Hydrodynamics)
STABILIZER MUSCLES
Triceps Brachii Multifidus