Herniated Disc: Exercises to Avoid and What Helps Instead

What is a herniated disc and why do certain movements hurt?

Between each vertebra sits a disc — a structure with a tough outer ring (annulus fibrosus) and a gel-like inner core (nucleus pulposus). A herniation occurs when the nucleus pushes through or bulges the annulus, sometimes pressing on a nearby nerve root.

The resulting pain can be local (in the back) or referred — traveling down the buttock and leg (sciatica) if the sciatic nerve is involved. Different movements increase or decrease the pressure on the disc and nerve, which is why some activities cause a sharp spike in symptoms while others provide relief.

For most people, lumbar disc herniations improve substantially with conservative care — including physical therapy — within weeks to months 1Ref 1Kreiner DS, Hwang SW, Easa JE, Resnick DK, Baisden JL, Bess S, Cho CH, DePalma MJ, Dougherty P, Fernand R, Ghiselli G, Hanna AS, Lamer T, Lisi AJ, Mazanec DJ, Meagher RJ, Nucci RC, Patel RD, Sembrano JN, Sharma AK, Summers JT, Taleghani CK, Tontz WL Jr, Toton JF; North American Spine Society (2014).An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy.Most lumbar disc herniations with radiculopathy improve with conservative care; surgery reserved for persistent neurological compromise; conservative PT is first-line2Ref 2George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS (2021).Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021 — Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association.APTA CPG supporting directional preference assessment and individualized exercise programming for lumbar disc herniation. Surgery is reserved for persistent neurological compromise or failure of conservative treatment.

Movements and exercises to avoid or modify

Forward bending (flexion) under load: Deep forward bending — especially while holding weight — is one of the most consistent aggravators of posterior disc herniations (the most common type). Avoid: - Heavy deadlifts or Romanian deadlifts during the acute phase - Sit-ups and crunches, which create significant lumbar flexion under load - Toe touches while standing - Picking up objects from the floor with a rounded lower back

High-impact loading: Running, jumping, and other high-impact activities create rapid spinal compression. These are not necessarily permanently off-limits, but should be avoided until symptoms are well controlled and a PT has cleared you to return.

Sustained awkward postures: Prolonged sitting with a slumped lower back, slouching in a chair, or sustained positions that increase your pain should be minimized. The disc is sensitive to sustained pressure, not just movement.

Heavy overhead lifting: Overhead pressing in the acute phase compresses the spine and can worsen symptoms in some presentations.

What exercises are generally safe and helpful?

The right exercises depend heavily on your specific herniation pattern and where the pain radiates, which is why PT assessment matters. That said, for the most common posterior lumbar disc herniation presenting with sciatica:

Extension-based exercises (McKenzie method): Many people with posterior disc herniations experience relief from gentle lumbar extension. The prone press-up is the classic starting point: 1. Lie face down with your hands under your shoulders 2. Slowly press up with your arms while keeping your hips on the floor 3. Go only as far as comfortable — even a small range is fine initially 4. Hold briefly, lower back down; repeat 10 times

If this reliably reduces leg pain (even if it temporarily increases back pain), extension exercises are likely appropriate for you. If it worsens leg pain, stop and consult a PT before continuing.

Walking: Gentle walking maintains movement, reduces compression compared to sitting, and is generally well tolerated. Start with shorter distances and increase gradually.

Swimming or pool walking: The buoyancy of water reduces spinal loading and allows movement that may be painful on land. Backstroke is often better tolerated than butterfly or breaststroke, which increase lumbar extension demands.

Core stabilization — in a neutral spine position: Exercises like bird-dogs (opposite arm and leg raised from a hands-and-knees position) work the deep stabilizing muscles without requiring end-range bending. Neutral spine core work is generally safe; flexion-based core exercises (crunches, leg raises) are not.

Why direction matters: not everyone follows the same rules

An important concept: people with disc herniation do not all respond to the same movements. While extension-based exercises help many people with posterior herniations, some people's symptoms are worsened by extension and relieved by flexion. This is why a directional preference assessment by a trained physical therapist is valuable.

McKenzie Method clinicians (physiotherapists or PTs with MDT training) are specifically trained to identify which direction relieves your symptoms and design a program around that finding. A generic list of exercises does not substitute for this individualized assessment 2Ref 2George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS (2021).Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021 — Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association.APTA CPG supporting directional preference assessment and individualized exercise programming for lumbar disc herniation.

What about sciatica: when does nerve pain change the guidance?

When a herniated disc compresses a nerve root and causes leg pain (sciatica), the goal of movement is to reduce pain that is traveling down the leg — what clinicians call "centralizing" the pain, meaning moving it back toward the spine. Extension exercises often achieve this for posterior herniations.

If leg pain is worsening with your self-management attempts, or if you have significant weakness in the leg, numbness, or changes in bladder or bowel function, you need to be evaluated by a clinician promptly 1Ref 1Kreiner DS, Hwang SW, Easa JE, Resnick DK, Baisden JL, Bess S, Cho CH, DePalma MJ, Dougherty P, Fernand R, Ghiselli G, Hanna AS, Lamer T, Lisi AJ, Mazanec DJ, Meagher RJ, Nucci RC, Patel RD, Sembrano JN, Sharma AK, Summers JT, Taleghani CK, Tontz WL Jr, Toton JF; North American Spine Society (2014).An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy.Most lumbar disc herniations with radiculopathy improve with conservative care; surgery reserved for persistent neurological compromise; conservative PT is first-line.

For most people with disc herniation and sciatica, conservative care including supervised PT produces very good outcomes. The evidence-based guidelines support PT as the first-line treatment before surgery 2Ref 2George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS (2021).Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021 — Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association.APTA CPG supporting directional preference assessment and individualized exercise programming for lumbar disc herniation.

When to see a physical therapist

Self-guided exercise is a reasonable starting point for mild to moderate disc herniation symptoms. Seek PT evaluation if:

• Pain has persisted more than 2 to 3 weeks without clear improvement
• Leg pain or numbness is present
• You are unsure which direction of movement is appropriate for you
• You want guidance on returning to sport or physically demanding work

Gale can connect you with a primary care clinician or physical therapist who specializes in spine conditions.