Limbering up your back first thing in the morning gets the blood flowing to feed your muscles, moves lymph to remove waste products that cause pain and softens the connective tissue that restricts movement. This is the toning and stretching routine I give out at my Neuromuscular Therapy center near Boston. Best done in bed before you get up and start using your muscles, it takes only ten to fifteen minutes once you’ve learned the routine and practiced it a few times.  Please pay attention to the details. They are important.

1. Hip hike: Lying down, bring one hip up toward the shoulder, keeping the hips flat on the surface (floor or bed) and contracting the waist muscles on that side. Lower that hip and raise the other hip upward in the same way.  Alternate doing at least 10 hikes on each side.

2. Single knee-to-chest: Lying down, bend one knee and bring it up to your chest.  Using both hands, pull the knee closer to the chest with your hands or arms clasped behind the knee where it bends. Exhale and stretch for 1-2 seconds. Return the leg to the surface, and repeat 10 times.  (Do both sides.)

3. Double knee-to-chest: Do the same as #2, but bring both knees to your chest at the same time. Contract your belly muscles to try to raise your hips up off the bed or floor.  You should feel a pull in your low back.

4. Drop-over trunk rotation: Lying down, bring your knees to your chest and extend your arms out to each side for support.  With the knees together and keeping your shoulders flat against the surface, drop both knees over to the side, rotating the trunk (upper body above the waist) until you feel a pull at waist level.  Stretch for 1-2 seconds and bring the knees back to your chest. Repeat to the other side and alternate 10 times on each side.

5. Gluteus (buttock) stretch: Do the same as #2, except bring your knee to the opposite shoulder.  You should feel the pull in your buttocks.  Stretch both sides. If you want to go deeper to stretch the piriformis, hold your knee to your shoulder and reach for your ankle with the other hand. Pull your ankle toward the bed or floor. Exhale and stretch for two seconds, release and repeat 10 times.

Repeat the hip hike here if your back still feels tight.

6. Cat and cow: Turn over onto your hands and knees.  Tip the pelvis/hips and pull your navel inward as if you were trying to touch your back with it. Tuck your chin to your chest. This will arch-round the back like an angry cat.  Focus on the lower back and let the rest of the back follow. Exhale and stretch for 1-2 seconds.  Then tip the pelvis the other way to sag your back like an old cow and stick out your bootie. Bring your chin upward and stretch for 1-2 seconds.  Focus on working the lower back.  Repeat 10 times.

7. Hip waggle: Now wag your hips like a dog wagging its tail.  Do it slowly, stretching for 1-2 seconds in both directions so you can feel the stretch on each side of your waist and ribs. Repeat back and forth 10 times.

8. Seated trunk stretch: Sit on the edge of your bed or on a chair, perching on the edge with your knees apart.  Reach down for your ankles.  Pull your stomach toward your lap to stretch for 1-2 seconds.  Return to an upright position and repeat 10 times.  If this is painful, support your back by putting your hands on your knees, lowering yourself using your arms then pushing yourself back to upright. Your goal is to bring your torso between your knees.

9. Seated twist: Sit up straight and put your left hand on the outside of your right knee or thigh. Put your right hand on the seat right behind your right hip. Pull against your thigh with your left hand as you push up and away from your seat with your right hand to assist the twist. Exhale and hold for two seconds. Release to your original position. Repeat 10 times on each side or alternate back and forth.

10. Standing side bends: Stand up and place your palms on the sides of your thighs.  (Pick a point in front of you to watch so you don’t twist your body when you bend.)  Reach down your thigh toward the knee as far as you can. Exhale as you stretch for 1-2 seconds. Return to an upright position and side bend to the other side.  Alternate, repeating 10 times on each side.