When acute pain has subsided
For the past few days you have been doing Exercises 1 to 4 and have been maintaining a lordosis at all times. Once the distortion in the joints has decreased and any damaged tissue has healed, you will need to restore your flexibility and recover your normal function. Flexibility is best achieved by doing flexion exercises, which must be performed in such a way that no further damage or tearing occurs within soft tissues that have recently healed. The risks of further damage are much less when the lower back is rounded in the lying position than when it is in the standing position. Therefore you must now do Exercise 5, Flexion in Lying.
You should begin Flexion in Lying when you have mostly recovered from an acute episode of lower back pain and have had long pain-free periods for two to three weeks, even though you may still feel stiffness when you bend forward. Exercise 5 may also be necessary if you have improved significantly with Exercises 1 through 4 but after two or three weeks still experience a small amount of pain
at the center of your back, pain that seems like it will not disappear.
It is not uncommon for some central, midline, lower back pain to occur when you start Exercise 5, that is, when you do Flexion in Lying. An initial pain that wears off gradually with repetition of the exercise is acceptable; it means that shortened structures are being stretched effectively. If Exercise 5 causes pain that increases with each repetition, stop. In this case, it is probably too soon to start flexion and you should wait and try it in another week or two.
