McKenzie exercises for back pain include prone lying, press-ups, standing back bends and, for some people, bending or side-gliding movements. The useful exercise is the one that improves your symptoms and movement. You do not need to complete every exercise in this guide.
Below, watch Dr. Emily Warren, DPT, Cert. MDT, demonstrate extension exercises and explain what to notice afterward. Your observations matter: tell us what changes during a movement and how sitting, walking or lifting feels later. Together, we use those observations alongside your assessment to choose a manageable practice plan for the activities you want back.
Before trying a new spinal routine: tell your clinician about recent surgery, a fracture, osteoporosis or medical restrictions. Stop an exercise that spreads symptoms farther down your leg or brings new numbness or weakness. See when to get medical help.
McKenzie extension exercises: prone lying to press-ups
Extension means bending backward. The three stages below move from resting on your stomach to supporting your upper body with your arms. Use the demonstration to understand the technique or practice a movement already selected for you; the video does not determine which direction your back needs.
Watch Dr. Emily demonstrate prone lying, elbows and press-ups
Follow the movement in the video
- Lie on your stomach (0:14). Before adding movement, notice whether simply lying in this position changes your symptoms.
- Come onto your forearms (0:23). Support your upper body on your forearms, take deep breaths and let your low-back muscles relax. Dr. Emily also shows coming onto the forearms and lowering again.
- Use your arms for a press-up (0:53). Place your hands near your armpits. Gently press your upper body up while letting your back and buttock muscles relax, then lower. Your pelvis and legs remain supported; this is different from lifting your whole body into a push-up.
These are stages, not a checklist. Stay with the stage and range in your plan. At 1:18, Dr. Emily says to continue only if the movement helps symptoms and stop if it does not. The clip mentions about ten repetitions for its example; your own amount depends on your assessment and response.
Dr. Emily presents this progression for some types of sciatica from the low back. Watch the original demonstration on YouTube.
DPT, Cert. MDT
Your story comes first with Dr. Emily
Emily’s early work in neurological rehabilitation shaped her interest in movement, pain and what people want to get back to.
Emily is a credentialed McKenzie therapist. Your history and response to repeated movements help her decide what to practice and what to change; extension is not automatically the right direction. You learn what to notice between visits so the plan can be reviewed against daily life.
Meet Emily and explore her approach · Request a Free Case Review to discuss how to understand which movements help you.
Standing lumbar extension: McKenzie back bends
Standing extension is another backward-bending option. It can be practical during the day when that direction helps and lying down is inconvenient. It is not automatically interchangeable with a press-up because the support, range and response can differ.
Written movement guide: support your lower back with your hands and lean your upper body backward through the range selected for you. Notice where symptoms reach before and after the movement, then compare a relevant task, such as standing from a chair.
Use the response table below to describe what changed. Do not choose standing extension simply because a press-up hurts.
How can you tell whether a McKenzie exercise is helping?
Check where symptoms reach, how strong they feel and what you can do afterward. Before the exercise, choose one everyday task to compare, such as getting up after breakfast. Check it again afterward and note whether the change lasts when you resume normal activity.
| What you notice | What it can mean | Your next step |
|---|---|---|
| Symptoms ease and the task feels easier | This is a useful response to record, especially if it repeats. | Follow the agreed plan. Note how long the benefit lasts before increasing the range or amount. |
| Calf or leg symptoms retreat toward the back | This may be centralization. Location matters as well as pain intensity. | Describe both the retreating leg symptoms and any remaining back pain. Have your clinician interpret the whole response before progressing. |
| Relief lasts only until you sit or resume an activity | The exercise may help symptoms while your tolerance for the activity still needs work. | Record when symptoms return. Review the exercise and the activity together rather than repeating the movement all day. |
| Little change, or discomfort builds as you add repetitions | The technique, direction, range or amount may need review. | Do not add repetitions to chase relief. Ask for a reassessment and a clear review point. |
| Symptoms spread farther down the leg, or new numbness or weakness appears | This is a reason to stop and seek guidance. | Pause that exercise. New or increasing weakness needs prompt clinical evaluation; see the urgent warning signs below. |
A strong stretching sensation alone does not tell you whether the movement is useful. The back-pain progress tracker can help you keep a simple record without monitoring every sensation all day.
How many McKenzie press-ups or repetitions should I do?
Ask for a written starting plan with the movement, range, repetitions or hold, frequency and review point. The example in a video is not a universal dose. Bring your observations from the table to your next review so the plan can change when needed.
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“Having her support has made my situation feel less scary.”
Which other McKenzie movements are used for lower-back pain?
The McKenzie Method is broader than extension. A clinician may assess the following options when another direction helps or when you are ready to rebuild a movement. They are alternatives to assess, not extra exercises to add automatically.
- Knees toward chest (flexion in lying): lying on your back, bring your knees toward your chest and return. This is a supported way to explore forward bending.
- Seated forward bends (flexion in sitting): from a chair, gently bend your trunk toward your thighs, then return upright.
- Standing forward bends (flexion in standing): bend forward from standing, then return upright within your agreed range.
- Side glides: move the pelvis sideways relative to the upper body, sometimes with wall support. The direction and setup need individual selection.
Read McKenzie assessment and flexion-based exercises for more about how forward- and backward-bending approaches differ.
What is the McKenzie Method, and why does direction matter?
Mechanical Diagnosis and Therapy (MDT), often called the McKenzie Method, starts with your history and an examination of how symptoms and movement change with repeated movements and positions. Those findings guide the plan and the self-management skills you practice outside the clinic. Read the McKenzie Institute’s overview.
A directional preference is a direction associated with useful improvement during assessment. Centralization describes symptoms moving from farther down the leg toward the back. This is clinical information, not proof that a disc has physically moved back into place. We also consider your strength, sensation and function.
In a randomized low-back-pain trial, people with a directional preference improved more over two weeks with matching exercises than with opposite-direction or nondirectional exercises. That supports choosing a movement from an assessment rather than assuming one routine fits everyone.
Dr. Emily Warren is a McKenzie-certified Doctor of Physical Therapy. See how she uses these findings in one-on-one McKenzie physical therapy in Holladay, serving Greater Salt Lake City.
Why do press-ups make my back or leg pain worse?
The movement may not fit your presentation, or the setup, range or amount may need adjustment. Pause a press-up that worsens the pattern and use the response table to describe what happens. A different direction or approach may fit better; a higher press-up or harder stretch is not automatically the answer.
Should my hips stay down during a press-up?
In Dr. Emily’s demonstration, your lower body stays supported while your arms raise your upper body. Let your back and buttock muscles relax rather than squeezing them to lift higher. If the position feels awkward, show your clinician the version you are doing so you can adjust the setup together.
What if I cannot comfortably get onto the floor?
You can still get help with your back. Tell us if floor access, your wrists or another health issue makes the demonstration impractical. We can begin with a position or task you can manage and discuss an appropriate alternative.
What if I have followed the routine and still feel stuck?
Bring three questions to a review: What changed? What still limits me? What is the next change to the plan? Your technique, symptom response and daily activity all matter. Read when to seek help with self-treatment or how to review a PT plan that has stalled.
What happens after we find a movement that helps?
Relief is a starting point. We then build strength and tolerance for the activity you want back: sitting through a workday, lifting a child, walking farther or returning to recreation. That may include a gradual increase in activity, changes of position and adjustments to the exercise plan.
If pain has lasted for months or an MRI has made movement feel frightening, we also address your concerns and help you build confidence. Manual therapy or dry needling may help selected symptoms alongside movement practice. Read our chronic-back-pain guide and how pain sensitivity can affect movement.
Get help turning the videos into a plan you understand
What have you tried, what changed, and what are you still unable to do comfortably? Bring those questions and the activity you want back. Dr. Emily can help you understand the next step.
Local PT: meet one-on-one with Dr. Emily at our Holladay clinic, serving Greater Salt Lake City, for an assessment and a starting plan practiced together. Your first PT appointment is 60 minutes. Request a Free Case Review to discuss whether this is the right next step.
Virtual health and wellness: get live movement coaching, an exercise program with videos and support with questions between visits. Request a Free Case Review or see how virtual appointments work.
More questions about McKenzie exercises
Are McKenzie exercises the same as stretching?
No. The response to a selected movement helps guide management. Feeling looser or noticing a stretch is useful to describe, but does not by itself establish which movement belongs in your plan.
Can McKenzie exercises help with sciatica or a herniated disc?
They can be part of care when the assessment identifies a useful response. Sciatica symptoms or a scan finding do not automatically tell us which exercise to choose. See sciatica care and what to do after a herniated-disc MRI.
How long does it take to feel a change?
Some movement responses become apparent during assessment, while building tolerance and strength takes continued practice and review. A fast symptom change and a lasting return to activity are different milestones. See McKenzie treatment timelines.
When should I stop and get medical help?
Stop an exercise that consistently worsens the pattern or brings new symptoms. New or increasing weakness warrants prompt clinical advice. New difficulty urinating, loss of bladder or bowel control, or numbness around the genitals or anus requires emergency evaluation. Discuss recent surgery, a fracture, osteoporosis or other medical restrictions before starting a new spinal routine.
About our clinical approach: Dr. Emily Warren, DPT, Cert. MDT, is the owner of Mindful Movement PT and a McKenzie-certified Doctor of Physical Therapy. We combine individualized assessment, pain education and progressive movement to help you return to the activities that matter to you.
Google review: Cathy S.
“Emily helped me get my strained back muscles strong again by doing simple stretches, which also helped my knees that were sore.”
Choose your next step
Ready for local PT? Your first 60-minute appointment includes assessment, explanation and a starting plan practiced together. No referral is needed.
Want to talk before deciding? Tell us what you want back and what has been difficult. We will contact you by phone or text to arrange a Free Case Review.
In-person care is at our Holladay clinic, serving Greater Salt Lake City. For support from elsewhere, ask us about virtual health and wellness coaching.
Call/text (385) 332-4939 if you need help choosing an appointment.