THE COX® EXERCISES
TO ACCOMPANY CHIROPRACTIC MANAGEMENT OF LOW BACK PAIN


General Instruction

Do Not Sit when you have low back pain. This increases the pressure within the disc and the joints of your spine. If doctor prescribes a belt to wear, remove it to do these exercises. if your doctor agrees, it is good to alternate hot cold on your low back before doing these exercises. This is done by applying moist heat in the form of a towel for 10 minutes followed by 10 minutes of ice therapy in which a moist cool towel is placed on the skin with an ice bag on top of it. Place the heat on the back 4 times and ice on the back 3 times beginning and ending with heat.

If your doctor suggests nutritional supplementation, be sure to follow it closely.

Do these exercises on a firm surface such as the floor or a mat. Do not be alarmed if discomfort is noted during exercise. If this pain is great, stop consult your doctor before continuing.

The Cox(tm) exercises are to be used in conjunction with your chiropractic care and should be discussed with the chiropractic physician before use.

What Works For Me

 I use exercises 1 through 3 exclusively. I have increased my count from a slow count of 4 in the beginning to a count of 6. As I progress I plan to add repetitions and the count. I find it takes me about 20 minutes a day to do these exercises and it really helps my sciatica.

I have a herniated disc at L4-L5. In fact the MRI shows that the left half of the disc is gone. This can cause serious pain in my left leg. As my leg grows stronger I plan on adding exercise 4 and 5 back into my routine.

I find that if I skip my exercises in the morning I have a painful day. Just 20 minutes of stretches in the morning makes my day mostly pain free.

This document came from my chiropractor, Dr. Dennis Seivers. It is copyrighted 1985 by James M. Cox. Only text in red is mine. It is used without permission.
Exercises for the acute severe low back pain patient.


Exercises 1. Pelvic Tilt.
While standing or lying tighten the abdominal and buttock muscles so as to flatten your back. Repeat this several times throughout the day. Contract the muscles and relax approximately 6 times at each session, holding each contraction for a slow 4 count.


Exercise 2. Pelvic Lift.
Lie on your back with your knees flexed and your feet flat on the floor as close to the buttocks as possible. keep the knees together. Tighten the muscles of the lower abdomen and buttocks so as to flatten your low back against the floor. Slowly raise your hips up from the floor and hold for a slow count of 4, Repeat this exercise 6 times. If you cannot raise your hips from the floor, merely tighten the belly, the abdominal and buttock muscles and wait until you can raise the hips.


Exercise 3. Knee-Chest.
Lie on back and draw the right knee up to the chest and pull the knee down upon chest. Do this for a slow count of 4 and repeat 6 times. Repeat the same, exercise with left knee brought to the chest. Relax between each session. Repeat With both knees brought up to the chest.

Exercises after the acute pain has diminished. Do the following exercises if you feel no pain in your low back upon coughing, sneezing, or straining to move the bowel.



Exercise 4. Hamstring Stretch.
Lie flat on your back and raise the right leg straight upward without bending the knee. Place your hands behind the knee while keeping the knee straight, pull the leg straight up so as to stretch the muscles behind your thigh. Repeat this 6 times on the right leg and then do it on the left.


Exercise 5. Abdominal Strengthening Exercises.
Lie on your back. Flex knees and place feet on floor close to buttocks. Either cross arms over your chest or place hands behind the head to support the head and neck. Do the pelvic tilt which is exercise 1. Then raise the shoulders from the floor by contracting the abdominal muscles. Feel the abdominal muscles tighten. Raise the shoulders as high as you can as you slowly tighten the abdominal muscles. Relax the abdominal muscles and allow the shoulders to return to the their resting position on the floor. Repeat this exercise as many times as possible, starting with as many repetitions as you can. When you can do 50 repetitions, we feel you should level off.br>

Exercise 6. Gluteus Maximus Strengthening.
Lie on stomach and raise the right leg off the floor while keeping the knee straight. Turn the foot out ward while lifting the leg. Hold the leg up In this position for a count of 4 and slowly let it down. Repeat this 6 times. Repeat the same exercise with the opposite leg. Relax following this exercise. Be sure to tighten the buttock muscle first and then the muscle behind the thigh.


Exercise 7. Low Back Strengthening.
Do this exercise with doctor approval. Lie flat on stomach with arms along side, palms down. Slowly raise chest from floor. Feel the muscles of the low back tighten. Hold the chest up from the floor for a slow count of 4 and slowly let it down. Rest between each session. Repeat this 6 times.


Exercise 8. Outer Thigh Strengthening.
Lie on side. Turn the toes inward on the right foot and lift leg upward. Repeat this 6 times on right and then 6 times on the left. You will feel pulling in the outer thigh and pelvis.


Exercise 9. Inner Thigh Strengthening.
kneel on floor. Extend your right leg as far to the side as possible, keeping the knee straight and the arch of the foot on the floor. Slide your foot along the floor until you feel the stretch of the muscles inside your thigh. Then lower the pelvis to add stretch to the Inner thigh muscles. Do it slowly and hold for a count of 4. Repeat it 6 times on the right leg and then repeat with the left side. These muscles which are tight at the beginning, will loosen and stretch with subsequent exercise sessions.


Exercise 10. Combination Knee, Chest, and Hamstring Stretch.
Lie on your back. Perform exercise 4 with the right leg, then draw the knee to the chest as in exercise 3, then repeat with the left leg. Perform this six times with each leg, alternating right to left. This is a combined muscle stretching technique for the thigh and low back muscles.