Managing lower back pains with Williams’ Flexion Exercises

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The Williams’ Flexion Exercises or WFE are a set of related physical exercises intended to improve lumbar bending or flexion and to strengthen the abdominal muscles to manage low back pain without  surgery.

Ortho-surgeons recommend this staple treatment for patients suffering from lower back pains. Physical therapists teach and aid the patients in performing these prescribed exercises. As this is only an initial treatment for those who are suffering from back ailments, patients who fail to improve with this conservative treatment after a series of physical therapy sessions may require surgery as the next option.

These exercises were performed in the supine position on a flat surface. The physical therapist may do some variations depending on the age and mobility of the patient, as the primary goals of performing WFE  were to reduce pain and to provide lower truck stability by enhancing the strength of  the abdominal and hamstring muscles and stretching the hip flexors and lower back muscles.

Here are some variations of the WFE program prescribed for my mom’s physical therapy sessions.

Pelvic tilt. Lie on your back on a flat bed or surface with knees bent, feet flat on floor.  Level and flatten the small of your back against the flat surface without pushing down with the legs. Or it would be easier to push back your buttocks against the surface to make the pelvic tilt then hold for 5 to 10 seconds. In my mom’s case, the therapists counts 1 to 7 then repeated nine times.

pelvic tilt with my son JM as my model

Single and double Knee to chest. For single knee to chest – lie on the same position, back flat on the surface then slowly pull your right knee toward your shoulder, hold for 5 to 10 seconds then place it back straight on the surface. Repeat the procedure to the other knee. As for the double knee to chest, do not pull both legs to chest at the same time, bring first the right knee to the chest then followed by the left knee, hug both knees for 5 to 10 seconds, then slowly lower the leg one at a time starting with the right leg followed by the left. The number of repetitions will depend on your therapy prescription.

single knee to chest with my son JM as my model
double knee to chest with my son JM as my model

Partial sit-up. Lie on your back with knees bent, while holding this position slowly curl your head and shoulders off the flat surface, hold on the position briefly then return slowly to the starting position.

my son JM doing the partial sit up

Hamstring stretch. The therapist may opt this exercise to be done while sitting or lying flat on a surface depending on the patient’s case.  For lying hamstring stretch, bend the left knee with the foot flat on the surface or let it down straight as shown in the picture, then slowly pull the right leg up stretching the legs with knees straight for 5 to 10 seconds then slowly bring it down. Repeat the procedure to your left leg. The hamstrings on the back of the thigh pull on the back when they are tight.

My Mom wit her therapist performing the hamstring stretch

Wall Squat. Stand with feet on equal distance on a shoulder width apart, keeping the back and head stays straight by touching the wall, then slowly lower the body by bending the knees into a squat, move up and down slowly.  The low squat position stretches the legs, hips and back

wall squat


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One thought on “Managing lower back pains with Williams’ Flexion Exercises

  1. for some reasons i have been experiencing lower back pains for more than a week now. thanks for sharing this. i will try to do this exercises + hopefully the pain stops!

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