Simple Stretches

Physical Activity, Pacing, and Exercises

Exercises

Please complete the Physical Activity and Pacing Physical Activity modules first. These modules will help you understand how, why, and when physical activity is good for persistent pain. 

Disclaimer: While great care has been taken to ensure that these exercises and advice are prepared in a way that is safe and practical for most people, none of these exercises should be considered specific medical advice.  If you are starting an exercise program for the first time, please consult with your physician to ensure that there is no reason that any particular form of exercise would be unsafe for you.

In this module you will find:

  • neck stretches
  • low back exercises
  • relaxation stretches
  • cardio exercises
  • strength exercises
  • balance exercises
  • Sideways tilt stretch

    • Sit or stand wherever you are comfortable.
    • To stretch your right side, tilt your left ear sideways, towards your left shoulder.
    • You may place your left hand on the right collarbone, to keep the shoulder from rising up.
    • You may also gently reach your right fingers down toward the floor, or hook your right hand underneath the chair to keep the right shoulder down.
    • You may use the left hand to gently apply pressure on the head for an additional stretch.
    • You should feel the stretch in the right side of the neck. If you feel pain in the back of the neck or on the other side, try re-adjusting your posture to sit up taller, tuck your chin in slightly, and gently re-try the stretch.
    • Repeat on the left side.

     

  • Nose to shoulder stretch

    • Sit or stand wherever you are comfortable. 
    • To stretch your right side, tilt your left ear sideways, and bring your nose down and forward towards your left shoulder.
    • You may place your left hand on the right collarbone, to keep the shoulder from rising up.
    • You may also gently reach your right fingers down toward the floor, or hook your right hand underneath the chair to keep the right shoulder down.
    • You may use the left hand to gently apply pressure on the head for an additional stretch.
    • You should feel the stretch in the right side of the neck. If you feel pain in the back of the neck or on the other side, try re-adjusting your posture to sit up taller, tuck your chin in slightly and gently re-try the stretch.
    • Repeat on the left side.

  • Nose up stretch

    • Sit or stand wherever you are comfortable. 
    • To stretch your right side, tilt your left ear sideways, and bring your nose upward, away from your left shoulder.
    • You may place your left hand on the right collarbone, to keep the shoulder from rising up.
    • You ma­­­y also gently reach your right fingers down toward the floor, or hook your right hand underneath the chair to keep the right shoulder down.
    • You may use the left hand to gently apply pressure on the head for an additional stretch.
    • You should feel the stretch in the right side of the neck. If you feel pain in the back of the neck or on the other side, try re-adjusting your posture to sit up taller, tuck your chin in slightly and gently re-try the stretch.
    • Repeat on the left side.
  • Sub-occipital stretch and release

    • Sit with your back supported. Gently nod your head to tuck your chin slightly, opening up the back of the neck. Then look downwards to further stretch the back of the neck. You may use your index and middle fingers to gently press upwards along the neck muscles towards the base of the skull, to provide further release
    • Lie on the floor or hard surface with 2 lacrosse balls or 2 tennis balls in a stocking, placed at the top of the back of the neck, just under the skull. Use your thumbs to press into each ball, to massage the upper neck muscles.  Slightly tuck the chin and nod to increase the stretch.

  • Chin tuck

    • Lie down with your head resting on a fairly flat pillow or rolled towel, so that your head remains straight and not tilted backwards or downwards.
    • Make a small nodding motion with only the top of your neck. Do this by drawing your chin in and elongating the neck gently. It may be helpful to keep your hand on the front of your neck to ensure you do not overuse the large muscles.  This area should remain relaxed
    • Practice this motion in sitting, with your back supported. Make a small nodding motion with only the top of your neck. Do this by drawing your chin in and elongating the neck gently. It may be helpful to keep your hand on the front of your neck to ensure you do not overuse the large muscles. This area should remain relaxed.

Recommendations:

  • Try each stretch once
  • Build a routine for yourself
  • Start with a low number of repetitions and add from there
  • Cat/cow

    • Start by getting on hands and knees, your hands directly under your shoulders, and your knees directly below your hips. Gently arch downward through spine (“tail up”) and then upward (“tail under”). Imagine the movement starting at the top of your head going all the way down to your tailbone.
    • Inhale on cow, exhale on cat.
    • An alternative way is to sit in the chair, sit up tall to create a curve in the small of the ball, then round your back to tuck the tail under.

  • Pelvic tilt

    • Lie on your back with knees bent, feet flat.
    • Gently tighten abdominal muscles to press the small of the back into the floor/mat.
    • Do not lift your head or body up, and keep your outer stomach muscles and gluteal muscles relaxed.

  • Outer hip stretch

    • Lie on your back. Bring your right leg up, hold your right knee with your right hand, and hold your right ankle/ foot with your left hand. Pull your lower leg/foot towards your chest until the stretch is felt in your buttocks.
    • Repeat on the left side.
    • Alternatively, sit in a chair, place your right foot on a footstool. Let your right knee fall out towards the right side. Press into the inside of your right knee to stretch the outer hip. Sit up tall.
    • Repeat on the left side.
    • Alternatively, cross your right ankle over the left knee, sit tall, and lean forward gently at the waist to stretch the outer hip.
    • Repeat on the left side.

  • Knee to chest

    • Lie on your back and bring your knees gently towards your chest. 
    • You may begin with one knee at a time, holding where you feel a stretch in the back of the hip and low back. 
    • You may rock gently from side to side to lightly massage the low back.
    • Some may find it more comfortable to open the hips a bit wider (by holding your knees out to the side).

     

  • Arch backwards

    Stand or sit, place your hands on your hips, and arch backwards, while taking a deep breath in, then release.

  • Hip flexor muscle stretch

    • To stretch the right side, stand with the left leg forward and the right leg behind, and hold onto a wall or table for support. Keep your low back flattened (imagine tucking your tail under) to ensure the stretch is felt at the front of the hip and thigh on the back leg. Gently press forward from the hip.
    • Repeat on the left side.
    • If you are able, you can perform this stretch in a kneeling position. To stretch the right side, keep your right knee on the ground and put your left foot on the ground in front of you. Keep your low back flattened (imagine tucking your tail under) to ensure the stretch is felt at the front of the hip and thigh on the back leg. Gently press forward from the hip.
    • Repeat on the left side.
  • Hamstring muscle stretch

    • Sit with the right leg extended, heel on the floor, and toes pointed upward. Sit up tall in your back, and gently lean forward at the waist to create a stretch at the back of the leg.
    • Repeat on the left side.
    • Lie on your back, bend the left knee with your foot flat if this is comfortable. Raise your right leg in the air with your hands holding around the back of the knee, or holding onto a strap to secure your leg, and gently bring your leg inward to create a stretch.
    • Repeat on the left side.

Recommendations:

  • Try each stretch once
  • Build a routine for yourself
  • Start with a low number of repetitions and add from there
  • Deep diaphragm breathing

    • Breathe in slowly through the nose for about 4 seconds. Pause briefly, and then exhale through the mouth as slowly as you can (over 4-8 seconds).
    • Imagine you have an umbrella in your ribcage. As you inhale, it opens; as you exhale, it closes.

  • Cat/cow

    • Start by getting on hands and knees, your hands directly under your shoulders, and your knees directly below your hips. Gently arch downward through spine (“tail up”) and then upward (“tail under”). Imagine the movement starting at the top of your head going all the way down to your tailbone.
    • Inhale on cow, exhale on cat.
    • An alternative way is to sit in the chair, sit up tall to create a curve in the small of the ball, then round your back to tuck the tail under

     

  • Shoulder role

    • Sit or stand wherever you are comfortable. 
    • Lift your shoulders up, pull them back, down and forward again, to complete the circle.
    • Roll shoulders forwards.
    • Roll shoulders backwards.

  • Child's pose

    • Start by getting onto your hands and knees, your hands directly under your shoulders, and your knees directly below your hips.
    • Place your hands forward and lean back to elongate the back and stretch. You may find it easier to do this if you relax your head on the floor, and open your knees in order to have more flexibility to sit back further. To stretch along the sides of the upper body, you can reach your hands over to one side, and then the other.
    • If kneeling is difficult for you, you may stretch your back by holding onto a sturdy banister or post, and sitting back to elongate the muscles. To stretch along the sides of the upper body, you may shift your body to one side, and then the other.
    • You may find it easier to sit in a rolling chair, your hands supported on a table, and gently push your feet into the floor to bring the chair away from the table, creating a stretch at your back.

Recommendations:

  • Try each stretch once
  • Build a routine for yourself
  • Start with a low number of repetitions and add from there

General principles:

  • Always begin with 3-5 minutes of “warm-up”, where you gradually increase your speed and/or difficulty level.
  • Finish with 3-5 minutes of “cool-down”, where you gradually return to resting level so that your cardiovascular system is prepared for you to get up from the bike.
  • You should begin with an amount of time, speed, and difficulty that feels light to somewhat hard, and that you feel you can recover from within the day. You can slowly build by adding 1-2 minutes per week, or 1 level of resistance per week.
  • Walking

    You can practice walking indoors or outdoors depending on your fitness level and confidence in your balance, as well as other factors such as the space you have and the weather conditions.

    If needed, you can walk with a cane, walker, or with your hand placed on a railing or against the wall for balance. Bring a trusted friend or family member if you have concerns about your balance and safety.

    If you have access to a treadmill, you may start at a slow speed with no incline, and you may gradually increase the speed and/or incline as you feel ready. You can use the safety clip and hold onto the handles for increased safety.

    For walking outdoors, consider starting with a flat surface and progress to more challenging terrain such as hills, grass, or trails.

    If you have access to a pool, you can walk back and forth across the pool or while holding onto the sidewall. Walking fast will increase the difficulty and resistance on your muscles; walking slowly will challenge your balance with minimal resistance on your muscles.

  • Stationary bicycling

    You may cycle on either a recumbent or an upright bicycle.  Sit on the seat, and set the seat height so that your feet can reach the pedals with only a slight bend in the knee at the furthest extension of your leg.  You may increase the resistance level to add challenge on your muscles and on your cardiovascular system.  Always begin with 3-5 minutes of “warm-up”, where you gradually increase your speed and/or difficulty level, and finish with 3-5 minutes of “cool-down”, where you gradually return to resting level, so that your cardiovascular system is prepared for you to get up from the bike. You should begin with an amount of time, speed, and difficulty that feels light to somewhat hard, and that you feel you can recover from within the day. You can slowly build by adding 1-2 minutes per week, or 1 level of resistance per week. 

  • Elliptical

    Step onto the machine safely, by holding onto the handles. Most machines have a green button that says “start” or “quick start”, which need to be pressed for the timer and other settings to turn on.  Begin by pushing one foot forward, and the foot pedals will begin to cycle around. You may hold onto the steady handles or the moving handles if you feel comfortable. 

    You may slowly add resistance to the machine by pressing the “up” arrow on the display, until you feel that the tension on your muscles is “somewhat hard”.  Always begin with 3-5 minutes of “warm-up”, where you gradually increase your speed and/or resistance level

    Finish with 3-5 minutes of “cool-down” where you gradually return to resting level so that your cardiovascular system is prepared for you to stop the machine.

Recommendations:

  • Pick forms of exercise that you most enjoy
  • When possible, add a social element (do it with someone) 
    • this will help you be accountable to do it
    • it may make it more enjoyable as well!

 

  • Step up

    • Position yourself behind a stair or sturdy footstool, with a stable support nearby to hold onto if necessary. 
    • Place one foot on the step and slowly rise onto the stair, holding your other leg in the air if possible.
    • Descending from the stair must be done slowly and with control in order to make the muscles do the work.
    • To make the exercise easier, use a step with lower height.
    • To make the exercise harder, use a higher step, and try to balance on the stair without using your hands.

  • Sit to stand

    • Stand in front of a chair with your arms crossed over your chest.
    • Sit back towards the chair slowly by bringing your buttocks backwards and allowing your knees to bend.
    • Keep your chest up but allow your chest to come forward over your knees.
    • When you reach the chair, stand back up by pushing your feet into the ground and standing up fully straight.
    • To make the exercise easier, stand in front of a chair and use your hands to hold the kitchen counter in front of you for support. You may only sit part-way down if needed, until you are strong enough to control the whole movement
    • To make the exercise harder, do not use a chair, and perform a squat. Sit down to an imaginary chair, and then stand back up fully.

  • Push up variations

    • Stand in front of a wall with your hands placed just wider than your shoulders and slightly below shoulder height.  Your feet should be further away from the wall than your shoulders, so that you are on an angle. Keep your body straight while you control the movement of your upper body toward the wall, and then push away.
    • To make the exercise easier, you may use a light elastic band held around your back, and push forward with each hand into the resistance of the band.
    • To make the exercise harder, position yourself at a lower angle to the ground (such as using a kitchen counter) to perform your pushups.

  • Band rows

    • Sit or stand with an elastic exercise band secured around a solid object in front of you.  It can either be at chest height, or lower (even ground level) if needed.  Examples of places to secure the band include doorknobs, bannisters, and bedposts. Keep upright posture, and pull the band towards the lower ribs, while keeping your elbows in close to the side of your body. You do not need to go past the front of your ribs. Imagine you are squeezing your shoulder blades together as your pull the band in.
    • To make the exercise easier, loosen the band as much as you need to, and only use one end of the band at a time.
    • To make the exercise harder, tighten the band by standing further back, or use both ends of the band at once to increase tension.

  • Bicep curls

    • Sit or stand with small weights in your hands. If you do not have weights, you can use a grocery bag with a few items in it, or use an elastic exercise band.  Bend your elbows to bring the weight upwards, without swinging or twisting your body. Slowly lower the weight to your side again
    • To make the exercise easier, sit, use a lower weight, and perform only one side at a time.
    • To make the exercise harder, stand, use a heavier weight, and lift on both sides at the same time.
  • Bridge

    • Lie on a firm surface with your knees bent at about 90 degrees. A mat on the floor is ideal.  Keep your knees bent and squeeze your buttocks together, and then raise your hips off the floor to hold in the air. Hold a minimum of 2 seconds, and lower slowly.
    • To make the exercise easier, lift only partway as far as you are able, or simply squeeze the buttock muscles together to start the movement. If you are not able to get onto the floor, you may do the exercise on a firm mattress or
    • To make the exercise harder, hold the lift for up to 20 seconds, or try to alternate small leg lifts while keeping the hips level.

Recommendations:

  • Try each stretch once
  • Build a routine for yourself
  • Start with a low number of repetitions and add from there

General guidelines:

  • For balance exercises, please ensure that you keep yourself safe at all times. 
  • Stand near a stable support, like a wall, railing, or kitchen counter. 
  • If you have a lot of weakness in your legs or likelihood of your legs giving out, consider having someone you trust stand by, and a chair behind you to sit in if you need to.

 

  • Stand in narrow stance

    • Place your hand lightly against a stable support as you step one foot in front of the other.  To make it easier, you can step your foot slightly to the side to widen your support base a little.
    • Try to hold this narrow stance position for 30 seconds without holding on for support.  If needed, you can start at 10 seconds and slowly build up.

  • Stand on 1 leg

    • Place your hand lightly against a stable support as you lift one leg in the air.  To make it easier, you can lightly rest your toes on the floor or on top of a step. 
    • Try to hold this 1 leg stand for 30 seconds without holding on for support.  If needed, you can start at 5 seconds and slowly build up.

  • Stand on 1 leg on soft surface

    • If you can stand on 1 leg with no difficulty, then try standing on either a folded towel, folded yoga mat, cushion, or other soft surface.
    • Maintain your balance while your muscles have to work harder to keep you stable.
    • Try to hold this 1 leg stand for 30 seconds without holding on for support. 

  • Stand on 1 leg with movement

    • If you can stand on 1 leg with no difficulty, then try adding slow movement with your opposite leg, up and down, while keeping balance.
    • Try to repeat 10 lifts with each leg in this position without losing balance

     

  • Bird-dog

    • Start by getting onto your hands and knees on a comfortable but firm surface.  Keep your low back flat and straight with your stomach muscles lightly tensed.
    • Slowly raise 1 arm in the air while keeping this stable position. If able, slowly raise your opposite leg straight behind you.
    • Try to hold 5 seconds, and gradually increase up to 15-second holds on each side.

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