Learn how to sculpt a healthy, beautiful back

By Barbara Russi Sarnataro
WebMD Weight Loss Clinic

Whether you're looking to strengthen your back to help with pain or just to look and feel better, experts say back exercises are a big part of the game.

According to the CDC, back pain is the leading cause of disability in the U.S. in workers under 45 and results in $20 to $50 billion annually in health care and workers' compensation costs in this country.

With exercise and proper strengthening of the back muscles and the abdominals, the muscles that support the back, experts agree the frequency of back pain could decrease.

The back is an area vulnerable to injury. Why? One reason is a weak back and supporting muscle groups. Another is poor form in exercise or lifting or whatever daily activities you perform.

Show Off Your Back

"The back should be just as important a muscle group as the chest and biceps, but it is often neglected," says exercise physiologist Kelli Calabrese.

"The muscles of the back help to keep you upright, and if the muscles are strong, they don't fatigue as quickly," she says, "(so) you're less likely to get injured when lifting or bending."

"We tend to overemphasize pectoral (chest) strength and underemphasize back strength," says exercise physiologist Richard Cotton.

The "show" muscles, as Cotton calls them -- chest, biceps, and shoulders -- tend to get our attention because they are the ones we see and show to the world.

Life Is Hard on the Back

But just the nature of daily living tends to tighten the front of the body, leaving the upper back weak and overstretched, he says.

"We spend a fair amount of our day at computer keyboards," he says.

There's no back work in that. Besides that, without the strength of the core -- the abdominals and the lower back -- posture suffers and lower back pain ensues. Abdominal strength is essential to back strength. You cannot have one without the other.

"If you're only working the abs or only working the back," says Cotton, "you're only doing half the job."

Weakness or tightness in other muscles can pull the back out of alignment as well, says Calabrese, including the hamstrings (back of the thighs) or hip flexors.

Since the back tends to be prone to injury, Cotton says to work back muscles no more than three times a week, being sure to include a rest day in between. He advises beginners to proceed very slowly when strengthening the back, particularly the lower back. Start by trying to complete only five repetitions, he says, wait a day, and be sure you don't experience any discomfort or pain.

It's About More Than Big Muscles

Strength training alone is not enough when it comes to a healthy back.

"It is important to stretch every day," says Calabrese.

As we age, without a balance of strength and stretching, we tend to develop poor posture, she says, which encourages injury as well as making us look and feel weaker, older, and heavier.

Stretching should include a flexion and extension of the spine. For flexion, sit with your knees bent, butt on your heels and arms out in front of you (child's pose in yoga). For extension, place your hands on your lower back for support and gently arch, tightening your abdominals for support.

The Exercises

UPPER BACK

Reverse Fly

1. Starting position: Standing with a slight bend in your knees, bend forward at the waist. Keep your back flat, with dumbbells hanging down towards the floor. Be sure to choose a light weight as the shoulder muscles are small.

2. Begin contracting the muscles of the upper back as you lead up with a slight bend in your elbows. Stop when the elbows are even with the shoulders, pause for a second, and slowly lower to the starting position, stopping just short of the arms hanging down without tension.

3. Picture hugging a beach ball as you return to the starting position. Repeat 10-15 times.

One-Arm Dumbbell Raise

1. Starting position: Place your right knee on a flat bench, bend at the waist, and rest on your right hand. Keep your back flat. Place a dumbbell in your left hand.

2. Slowly pull the dumbbell up toward your abdomen. Pause here for one second and then slowly lower the dumbbell to the starting position. Repeat 10- 15 times.

3. Switch positions and repeat on the other side.

LOWER BACK

Opposite Arm & Leg Raise

1. Starting position: Position body with hands and knees on floor approximately shoulder-width apart. Hip should be flexed at 90°.

2. Raise right arm and left leg off floor level with the back while stabilizing with the back and abdominal muscles.

3. Lower and alternate sides. Repeat 10-15 on each side.

Note: Remember to keep head and back in a neutral position. Shoulders and hips should remain squared and stable throughout movement.

Prone Back Extension (Superman)

1. Starting position: Lie face down on floor with hands down at sides. You may place a rolled towel under forehead to clear face from floor.

2. Tighten the abdominals to support the back, then float chest and head off floor while keeping feet in contact with floor. Be sure the neck remains in line with the spine.

3. Return to starting position. Complete 10-15 repetitions.

4. To increase resistance, extend arms and place hands overhead.

Note: Do not raise head more than 8-12 inches -- excessive hyperextension may cause injury. To vary exercise, raise feet while raising trunk.

SOURCES: Kelli Calabrese, exercise physiologist; spokesperson, American Council on Exercise (ACE). Richard Cotton, exercise physiologist, spokesperson, ACE; chief exercise physiologist, myexerciseplan.com.

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