Science Compares Solutions for Low Back Pain

A corrective exercise called the Lewit was compared to hollowing and bracing in a recent study.

For people with back pain and postural problems, corrective exercise is key. The Lewit, which is an exercise to assist with back pain, was tested recently in a Journal of Strength and Conditioning Research study.

Postural problems are caused by a variety of issues, such as immobility in the hip and shoulder joints. These factors then result in various back problems, like hypermobility of the lower spine or excessive movement at the junction between the lumbar and thoracic portions of your spine. The latter problem is most noticeable when you look at athletes performing an exercise like the overhead press and their ribs begin to pop out as their hands go overhead.

This will cause pain in the lower back, and especially the middle-lower portion. In this study, the researchers compared two traditional exercises to an exercise called the Lewit, created by Dr. Karol Lewit. All of the maneuvers were performed in the same position: supine (on the floor, face up) with the legs elevated in the air. The hip and knee joints were each flexed to ninety degrees. Generally in this position the lumbar spine flattens to the floor, so the participants rotated their hips to create a small, natural curve in the lower spine.

The first traditional exercise from here is called hollowing. Hollowing is when you draw your abdominal musculature in toward your spine. The second exercise was bracing, in which the participants would flex their abdominals hard, as if they were preparing for a punch to the stomach. Both of these movements are frequently used to strengthen the abdominal muscles, stiffen the spine, and eliminate pain.

The Lewit is performed in the same position, but at the end of each breath the lips are pursed and all of the remaining air in the lunges is forcefully expelled. The idea has to do with the associated role of the abdominals on breathing. The ribs are drawn downward during the expulsion, with the goal of maintaining a neutral spine.

Due to the similar body positioning, there was no difference in any of the exercises in terms of spinal positioning. I’d be curious to see the result of this with a legs-straight supine position, especially on the ribs. This is good news though, as none of the exercises caused negative postural adjustments. However, the Lewit did allow for a lower rib position.

Muscular activity, on the other hand, was superior in the Lewit to the hollowing. For the deep abdominal musculature, the Lewit was as effective as bracing, but less effective at working the rectus abdominus (the superficial ab muscles).

In the end, when developing the deep abdominals with corrective exercise, the Lewit is a great option. According to this study it is just as effective as other methods for developing strength, but better at maintaining good rib positioning. Try adding this one to your repertoire.


1. Boyd Badiuk, et. al., “Exercises to Activate the Deeper Abdominal Wall Muscles: The Lewit: A Preliminary Study,Journal of Strength and Conditioning Research, 28(3), 2014

Photo courtesy of Shutterstock.

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