Standing Extension Test

How to Perform the Standing Extension Test:

1.Get into a Neutral Position: Stand with your feet together and knees locked out.

2.Prepare Your Arms: Lock your elbows and raise your arms overhead.

3.Extend Backwards: Extend your back as far as you possibly can.

4.Return to Neutral: Come back to the neutral position.

5.Assess for Pain: Note any pain either going backward or coming back forward, which can be in the spine, hips, or pelvis region.

6.Repeat: Conduct this test several times to evaluate consistency in sensation.

What It Means:

- No Pain: A smooth, pain-free extension indicates healthy alignment and function.

- Pain Provocation: If you experience pain, it's a positive sign, indicating that you may be living in too much extension. The discomfort could be related to underlying issues in the spine, hips, or pelvis region.

What to Do: Avoid Extension:

- No Pain: Maintain a neutral spine position and continue regular activities, being mindful of your body alignment.

- Pain Detected: If pain is observed, consider adjusting your posture and daily habits to avoid too much extension. Consulting with a healthcare professional, such as a physical therapist or chiropractor, might also be beneficial. They can offer individualized strategies to improve spinal alignment and reduce pain.

The Standing Extension Test is a valuable tool to understand your body's response to spinal extension and to identify pain triggers. By evaluating your body's reactions during this test, you can gain insights into your posture and movement habits, allowing you to make informed decisions to promote a healthier back.

Seated Compression Test

How to Perform the Seated Compression Test:

1. Sit on a stable, hard surface, such as a wooden chair or bench.


2. Place your feet flat on the ground and ensure your knees are at a 90-degree angle.

3. Place your hands underneath the seat of the chair.

4. Round your back by slouching slightly, allowing your spine to curve.

5. Pull down on the seat with your hands, applying pressure and slightly compressing your spine.

6. Hold this position for a few seconds, observing any pain or discomfort.

7. While keeping your back rounded, slowly touch your chin to your chest and observe if the pain increases.

Experiment with different degrees of rounding or straightening your back to see if it changes the sensation.

What It Means:

The Seated Compression Test is designed to apply pressure to the spinal discs and facet joints. If you feel pain or discomfort during the test, it may indicate a problem with one or more of the discs in your spine or facet joint issues. The addition of touching the chin to the chest while maintaining a rounded back helps to further isolate the specific area or condition causing the pain by adding flexion to the cervical spine.

What to Do: Avoid Flexion:

If the Seated Compression Test reveals pain or discomfort, it may indicate that staying out of flexion and maintaining a neutral spine position is essential for you. Here's what you can do:

- Maintain a Neutral Spine: Focus on keeping your spine in a neutral position, avoiding excessive flexion or arching. This involves aligning your head, shoulders, and hips in a way that maintains the natural curves of your spine.

- Use Lumbar Support: When sitting, use lumbar support to help maintain this neutral alignment. A rolled-up towel or a specially designed lumbar support pillow can be placed at the small of your back to assist in keeping the proper curve.

- Avoid Flexion-Heavy Activities: Be mindful of activities that require you to bend forward excessively. Modify your movements and utilize alternative methods to pick things up, such as the golfer's pick-up technique.

- Consider Modified Poses: Practice body mechanics that protect your spine, such as bending your knees and keeping your back straight when lifting. Emphasize engaging your core and leg muscles rather than relying on your back.

Standing Heel Drop Test

How to Perform the Standing Heel Drop Test

1. Stand up straight on a stable surface with your feet together.


2. Lift both heels off the ground so that you're standing on the balls of your feet.

3. Quickly drop your heels back to the ground, letting them hit the surface without control.

4. Observe any sensations or pain in your lower back as the heels make contact with the floor.

5. Repeat the test several times to ensure consistency in the sensation or pain observed.

What It Means:

The Standing Heel Drop Test can help identify issues related to the shock absorption capacity of the spine. When the heels drop and hit the ground, it sends a shockwave up the legs and into the spine. If there is pain in the lower back during this test, it may indicate a problem with the discs or other spinal structures that are unable to adequately absorb this shock. This can be indicative of underlying degenerative conditions or specific disc problems.

What to Do: Bracing:

If you discover pain or discomfort during the Standing Heel Drop Test, incorporating a bracing technique might alleviate these symptoms:

- Learn to Brace: Place your fingers into the sides of your abdomen, around the oblique muscles. Try to push your fingers out using your core muscles. This is the sensation of bracing, engaging the core muscles to support the spine.

- Apply the Technique: Once you've successfully braced your core, perform the Standing Heel Drop Test again, keeping the bracing engaged throughout.

- Assess the Result: Observe whether there is no pain or less pain when performing the test with the bracing engaged. The core support may enhance the shock absorption capacity of the spine, reducing or eliminating the pain.

Bracing can be an essential tool in managing back pain by improving stability and alignment, especially during activities that put pressure on the spine. It provides a protective mechanism that can be personalized and applied in daily movements.

Finding Your Neutral Spine Position: A Strategy to Avoid Picking the Scab

Once you have determined what your pain triggers are, the next step is to learn how to avoid them. One powerful way to reduce your risk of back pain is to find and maintain a neutral spine position. This resilient and relaxed position for your back can become a strategy to not "pick the scab," so to speak, and stay away from triggering or aggravating your pain.


The following exercises, along with a video demonstration available on this page, will guide you in finding this neutral, or "sweet spot," position for your back.

Cat Cow Exercise: Identifying the Neutral Position

Step 1: Begin in a tabletop position on your hands and knees.
Step 2: Move between arching (extension) and rounding (flexion) your back.
Step 3: Find the middle ground, where there's no tension. This is your neutral spine.

Wall Plank Exercise: Distinguishing Between Hip and Spine Motion

Step 1: Set up in a wall plank position.
Step 2: Experiment with hip motion and spine motion.
Step 3: Find your neutral spine, where you feel the least tension in your back.

Standing Position: Transferring to Daily Activities

Step 1: Move from the wall to a standing position, maintaining your neutral spine.
Step 2: Align your body so that ears, shoulders, hips, knees, and feet are in line.
Step 3: Keep this alignment to minimize muscle tension and maintain your neutral spine in daily activities.

Implementing the Strategy

Now that you have discovered your neutral spine position, practice maintaining it as you move through your daily activities. This position should become your default posture, as it supports the natural curves of your spine and helps to prevent pain triggers.

- In Sitting: Use lumbar support and keep a neutral spine, avoiding any slouching or excessive flexion.

- In Lifting: Use modified poses and techniques that honor your neutral spine, reducing strain and potential triggers.

The neutral spine position is more than just a posture; it's a strategy to avoid aggravating your specific back pain triggers. Regularly implementing this position into daily movements and activities can lead to a more pain-free and resilient back.

Deep Squat Test

3 reps

Straight Leg Raise Test

Stability Push Up Test