What movements does a healthy back need?

A healthy back needs training in 5 directions: flexion (bending forward), extension (bending back), hinging (deadlift pattern), rotation (twisting), and side bending. Most people only train one or two of these, leaving the others weak and unprepared for daily life.

Is it safe to round your back when lifting?

In most cases, yes - with appropriate progression. The back muscles are designed to handle flexion under load. Avoiding it entirely leads to weakness. The key is building tolerance gradually, starting with bodyweight movements before adding load.

What is a Jefferson curl and is it good for back pain?

A Jefferson curl is a controlled spinal flexion exercise performed with intentional rounding of the back. When progressed appropriately - starting with no weight and building gradually - it is an effective tool for building back strength and reducing pain over time.

How do I start exercising with back pain?

Start with movements your back can tolerate at low intensity - gentle flexion, extension, and rotation with no added load. Gradually increase range of motion, then volume, then weight over time. The goal is progressive loading, not avoidance.

Why is rotation important for back health?

Rotation is one of the most common movements in daily life - walking, running, reaching, sports. When it goes untrained, the back becomes unprepared for rotational forces and injury risk increases. Training rotation progressively helps the spine handle everyday demands safely.

5 Movements Every Back Needs (and how to start training them)

Hannah Breal, PT, DPT
14 hours ago
3 min read

In Part 1 of this series, we talked about the self-fulfilling cycle that keeps most people stuck in back pain for years - the pattern of avoidance that makes backs weaker, less capable, and more prone to injury over time.

If you haven't read that yet, start there first: https://events.made2movept.com/for-your-bad-back

This post is about what to actually do instead.

Diagram of 5 essential back movements including flexion, extension, hinging, rotation, and side bending for back pain recovery at Made 2 Move Physical Therapy

Your spine was designed to move

Our spines - with 33 vertebrae and hundreds of joints - were built to move. not just in one direction. not just in neutral. in lots of different ways.

Most people have been taught to keep their back flat at all costs. which means there are muscles and joints that go completely untrained for years. and then life asks for those movements anyway - picking something up off the floor, reaching across the car, carrying a kid on one hip - and the back isn't ready for it.

Here are the 5 movements every back needs, and where to start training each one.

1. Flexion (bending forward / rounding)

This is the most feared movement for most people with back pain. the instruction to never round your back has been repeated so many times that most people genuinely believe flexion is dangerous.

It isn't. when you pick something up, your back is either rounding - or it's fighting rounding. either way, force is going through those muscles. which means we have to train them to handle that force, not avoid it.

Start with: cat cow, seated Jefferson curl

Build to: Jefferson curl with weight, rotational Jefferson curl

2. Extension (bending back / arching)

Extension is important for standing tall, walking, overhead lifting, and stabilizing under load. most people never train it because they've been told arching your back is dangerous.

It's a movement your spine is built for. avoiding it leads to weakness in the exact positions your back needs to be strong in.

Start with: prone press up, Supermans

Build to: GHD extensions, Sorenson holds, reverse hyper

3. Hinging

The hinge shows up constantly in daily life - picking up groceries, lifting weights, cleaning up toys, gr

abbing a suitcase. it's one of the most fundamental movement patterns we have.

When the back is sensitive, hinging becomes scary and people stop doing it. but training the hinge teaches the spine and hips to share load, builds low-back and glute strength, and makes lifting things in real life feel safe again.

Start with: hip hinge, PVC good mornings

Build to: barbell deadlifts, barbell good mornings

4. Rotation (twisting)

Life is rotational. walking, running, sports, rolling in bed, reaching across the car - rotation is everywhere. it's also one of the most avoided movements in the gym, which means most people are completely unprepared for it when life asks for it.

Training rotation helps the spine handle everyday forces, improves core control, and builds a more adaptable, resilient back.

Start with: lumbar rotations on the floor

Build to: rotational deadlifts, cable rotations, landmine work

5. Side Bending (lateral flexion)

Carrying bags, holding a kid on one hip, reaching to the side, balancing while moving - side bending is one of the most overlooked movements in the gym and one of the most used in daily life.

Building strength here improves stability, balance, and the ability to handle the "weird angle" forces that Life constantly throws at us.

Start with: standing side bends, side plank

Build to: weighted teapots, incline side bending, suitcase carries

How to actually start

Look at that list and find the movement you've been avoiding the most. that's where to begin.

Pick one. start with the beginner version. don't load it heavily, don't push through significant pain, just start moving your back in a direction it hasn't been in a while. when it feels comfortable, progress. when that feels comfortable, progress again.

For the full breakdown - videos, progressions, modifications, and a 10-week plan to build all of this into a routine - download the free guide below.

Get the free guide

The back pain guide has everything in one place: exercise progressions, video demonstrations, how to modify based on where you're starting, and a 10-week sample plan.

Download it here: https://share.hsforms.com/1Bo6UGCJvRSGJEEB4qTRTlQnpyim

Our spines were designed to move. avoidance doesn't protect us - it makes things worse. the goal is a strong, capable, resilient back that can handle real life.

Book Your Appointment

Want to understand your body better, move with confidence, and stay active for life?

I write a weekly letter on pain, movement, and health — sharing how I actually think about injuries, training, and taking care of your body (without the fear-based nonsense).

If this sounds helpful, you can sign up to get the letters here.

Written by Hannah Breal, PT, DPT, Co-Owner of Made 2 Move Physical Therapy, helping Charleston and Charlotte move pain-free for life.