The Origins of the Williams Flexion Exercises
The Williams flexion exercises were originally based on the Regen squat exercises in the early twentieth century. Specifically, the Regen exercise used squatting to emphasize the convexity of the lumbar region. Later, Dr. Paul Williams devised a modified version of the Regen exercise. The modified Williams flexion exercises focused on patients with chronic low back pain caused by degenerative disk disease, lumbar lordosis, and decreased disc space. Originally, the exercises were developed to be used by pre-middle age men and women. Then, Dr. Williams theorized that the human evolutionary process towards standing erect put extra pressure on the lumbar discs. Moreover, he believed that patients should perform the lumbar flexion exercises prior to adulthood. Specifically, Dr. Williams suggested that lumbar discs rupture in most people by the age of twenty. The Williams flexion exercises strengthen the body and promote proper posture to decrease lumbar pressure.1
Williams Flexion Exercises Protocol
Dr. Williams theorized that all pain is caused by the stress of poor posture on the intervertebral discs. Resultingly, he believed that patients who do not regularly perform spinal flexion will accumulate disc damage. The Williams flexion exercises pdf and the Williams flexion exercises handout detail the goals and methods of the exercises. Primarily, the exercises open the intravertebral foramina, strengthen the abdominal and gluteal muscles, mobilize the lumbosacral joints, and stretch the back extensors, hip flexors, and facets. Further, the exercises combat natural, physical degeneration. There is a detailed list of exercises and instructions for how to perform them. Additionally, there are Williams flexion exercises pictures that show patients how to perform the exercises. Of course, patients should perform the exercises regularly to maintain strength and flexibility. Fortunately, there are medical professionals who teach patients how to perform the exercises safely.2
When to Use the Exercises
The Williams flexion exercises are beneficial to patients who need low back flexion exercise. For example, patients who have spinal stenosis, lumbar spondylolisthesis, sciatica, or degenerative disc disease will benefit from lumbar strengthening. Additionally, the exercises can be used to recover from a herniated lumbar disc or a bulging disc. However, patients who have a bulging or herniated disc have to be cautious. The lumbar flexion can worsen the disc damage, and patients should consult their doctor or physical therapist before trying any exercises. Generally, the exercises are safe and beneficial to most patients. Patients of almost any age can try them, and they are modified for patients who have limitations. Moreover, physical therapists will often recommend similar exercises to patients who are recovering from injuries and ailments. In fact, some patients have professional supervision when they perform the exercises.3
When Not to Use Them
Unfortunately, there are situations where patients should not try the Williams flexion exercises. For example, patients who suffer from acute disc herniation, vertebral compression fractures, or non-mechanical back pain should not perform lumbar flexion. In general, patients who experience pain or worsened symptoms while performing low back flexion should stop the exercises and seek expert medical advice. Centralization is the movement of pain felt in the buttocks and legs to the back, and it indicates that the exercises are helping. On the other hand, worsening symptoms in the buttocks and legs indicate that the exercises are not helping. Patients who are unsure about their physical condition and reactions should seek professional opinions. Sometimes, exercise can do more harm than good in certain situations. Patients should always pay attention to their reactions and be aware of any changes. Mindfulness is an important skill.4
Supine, Sitting, and Standing
Initially, patients should perform the Williams flexion exercises in a supine position. They should lie down on a supportive and comfortable surface, but using a bed is generally not recommended. Later, after the supine exercise is easy, the patient can try the more advanced sitting and standing exercises. First, the sitting position lumbar flexion has to be performed in a chair. Next, the patient will have to lean forward, bend the lower back, and reach for the floor between their knees. Finally, they should hold the bending position for a few seconds before returning to the starting position. Similarly, patients who perform standing lumber flexion have to bend forward and reach towards their feet. Patients should not push themselves too hard to reach their feet, and it is okay to build up flexibility over time. Of course, the exercises should never cause pain.5
Seven Exercises to Minimize the Lumbar Curve
Dr. Williams suggested seven types of exercises to minimize the lumbar curve: pelvic tilt exercises, partial sit-ups, single and bilateral knee-to-chest, hamstring stretching, standing lunges, seated trunk flexion, and full squats. Each exercise strengthens the lumbar and abdominal regions. Additionally, patients should also perform some exercises in the opposite direction to counter some excess forward stretching. The exercises can be part of a regular routine, and patients should be compliant with any exercise regime they are prescribed by a physical therapist or doctor. Initially, some patients may need to be assisted when performing the exercises. Furthermore, there are also modifications that make the exercises easier for patients who need assistance. Of course, patients should always ask for help because it is safer to ask than develop an injury from performing the exercises improperly.6
More About the Exercises
First, the patient performs pelvic tilt exercises in a flattened supine position with knees bent. Second, partial sit-ups put stress on the rectus abdominus. Third, the patient pulls one or both knees towards the shoulders in the knee-to-chest. Fourth, the hamstring stretch flexes the hip to relieve tight hamstrings. Fifth, standing lunges can reduce pain and spasms in the lower back. Sixth, seated trunk flexion stretches the lumbosacral soft tissue structure with a forward slumped position. Seventh, the full squat includes bouncing the buttocks multiple times in a squat position to deepen the flexion. The Williams flexion exercises are a staple of low back pain physical therapy programs. Additionally, athletes use the exercises to prevent pain and improve core strength.7
References:
2, 6, 7 http://www.lb7.uscourts.gov
3, 4, 5 https://www.verywellhealth.com