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

Sphinx Pose (McKenzie Prone Extension)

Based on the McKenzie Method (MDT), gentle lumbar extension encourages posterior disc material to migrate anteriorly (centralization), relieving sciatic pain radiating down the leg. Sphinx provides a gentle, forearm-supported foundation for extension.

BIOMECHANICAL MOVEMENT DIAGRAM
Clinical back pain images demonstration - DISC CENTRALIZATION (MDT)
DISC CENTRALIZATION (MDT)
🎯 Lumbar Lordosis

Step-by-Step Execution

CLINICAL PROTOCOL
  1. 1 Lie flat on your stomach with your legs extended straight behind you, tops of feet flat on the mat.
  2. 2 Place your elbows directly under your shoulders with forearms flat on the floor parallel to each other.
  3. 3 Gently press down through your forearms and palms to lift your upper chest off the mat.
  4. 4 Relax your glutes and lower back completely, letting gravity create a gentle lumbar arch.
  5. 5 Keep your chin parallel to the floor and hold for 30 to 45 seconds while taking calm breaths.
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KEY FORM CUES

  • ✓ Completely relax your glutes and lower back muscles; the arms do all the supporting work.
  • ✓ If pain centralizes (moves out of leg toward lower back), this is a positive indicator.
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MISTAKES TO AVOID

  • ✗ Do not perform if this causes sharp pain to shoot further down your leg (peripheralization).
  • ✗ Avoid shrugging your shoulders up into your ears.
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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 (extension narrows spinal canal and increases symptoms)
  • Spondylolysis / Spondylolisthesis (pars interarticularis defect)
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 45 Seconds
Repetitions 3 holds
Prescription Sets 1 set
Difficulty Beginner
Position Floor Mat
TARGET MUSCLES
Erector Spinae Multifidus
STABILIZER MUSCLES
Pectoralis Major Anterior Deltoids