Prone Press Ups: Complete Guide to Back Pain Relief

Prone Press Ups

What Are Prone Press Ups?

The Simple Definition

A prone press up is a therapeutic back exercise. You lie on your stomach facing down. Then you push your upper body up with your arms while your hips stay flat on the floor.

It looks like a push-up but serves a completely different purpose. You’re not exercising muscles—you’re creating a gentle backward arch that helps your spine heal.

How They Differ from Regular Push-Ups

Regular push-ups work your chest and arms. Your whole body moves up and down together as one unit.

Prone press ups are totally different. Your hips never leave the floor. Your back muscles stay completely relaxed.

You’re not exercising your muscles. You’re stretching your spine into a healthy position. Your arms do all the work while your back just receives the therapeutic stretch.

Why Physical Therapists Recommend Them

Physical therapists love this exercise because it helps 80% of their back pain patients get better. That’s an incredibly high success rate.

The exercise uses the McKenzie Method, developed by New Zealand physiotherapist Robin McKenzie. This approach has over 60 years of research behind it.

It works by moving disc material away from nerves. When discs press on nerves, you feel pain down your legs. This exercise creates space, the pressure releases, and the pain gradually disappears.

How to Do Prone Press Ups Correctly

Step-by-Step Instructions

1. Find a firm, flat surface. A yoga mat on the floor works great. Don’t use a bed or couch.
2. Lie face down on your stomach. Rest your forehead on the floor or turn your head to one side.
3. Place your hands flat on the floor. Position them right under your shoulders, not wider or narrower.
4. Take a deep breath in through your nose. Fill your lungs completely.
5. Press through your hands. Lift your chest and shoulders up while exhaling slowly.
6. Keep your hips glued to the floor. Don’t let them lift even slightly—this is crucial.
7. Straighten your arms as much as comfortable. Don’t force maximum range on your first try.
8. Hold for 10 seconds at the top. Breathe normally during the hold.
9. Lower yourself slowly back down. Take 2-3 seconds for the descent.
10. Rest for 2-3 seconds between reps. Then repeat for 10 total repetitions.

This is the biggest error. Your hips must stay down flat. If they lift, you’re doing a regular push-up instead, which defeats the therapeutic purpose.

Mistake #2: Tensing Your Back Muscles

Your back should stay soft and relaxed throughout. Don’t try to use your back muscles at all. Let your arms do 100% of the work while your back is just along for the ride.

Mistake #3: Going Too High Too Fast

Start small. You don’t need to straighten your arms fully at first. Even a small lift creates benefits. Build up gradually over days and weeks.

Mistake #4: Holding Your Breath

Keep breathing the entire time. Holding your breath creates unnecessary tension throughout your body. Breathe in as you push up, breathe out as you hold.

Benefits of Prone Press Ups for Your Back

Reduces Nerve Pain and Sciatica

Sciatica is excruciating pain that shoots down your leg like electricity. It happens when a disc presses on a nerve root.

This exercise helps through “centralization” of pain. The pain in your leg gradually moves up toward your lower back. This might sound bad, but it’s actually a great sign—it means the disc is moving away from the nerve.

Research shows this works for most people. Studies report 80% success rates for appropriate patients.

Helps Bulging Discs Heal

Your spine has cushions between the bones called discs. Sometimes these discs bulge out backward, pushing toward your nerves.

The prone press up creates a vacuum effect. This gentle suction pulls the disc material forward, back toward its proper position.

This doesn’t happen overnight—it takes consistent practice over weeks. But MRI studies confirm the disc material actually repositions.

Strengthens Your Core

While your back stays relaxed, your core muscles get activated automatically. They work to stabilize your spine during the movement.

Your abdominal muscles engage without conscious effort. You don’t have to think about it. Stronger core muscles support your back better and prevent future injuries.

Improves Posture

Modern life creates terrible posture. We sit hunched over computers and look down at phones constantly. All this forward bending stresses your spine and pushes your discs backward.

The prone press up does the opposite. It bends your spine backward, counteracting hours of bad posture. It resets your spine to a healthier position.

Increases Spinal Flexibility

A healthy spine bends in all directions—forward, backward, and to the sides. Many people lose backward bending ability and can’t extend their spine anymore.

This exercise brings that flexibility back. It restores your natural range of motion. Better flexibility means less stiffness and easier movement throughout your day.

When Should You Do This Exercise?

Best Times During the Day

• Morning: Do 10 reps right after waking up to set your spine up for the day.
• Mid-morning: After 2 hours of sitting or computer work.
• Lunch break: Before or after eating to reset your posture.
• Mid-afternoon: Another bout after more sitting.
• Evening: Before bed to undo the day’s stress on your spine.

During Back Pain Episodes

When acute pain hits, this exercise often helps immediately. Start gently with just 5 reps.

If pain reduces or moves toward your back (centralization), keep going. This is a very good sign.

Do the exercise every 1-2 hours during acute episodes. Aim for 6-10 sessions per day. The frequent repetition helps disc material move faster.

Who Should Do Prone Press Ups?

Who Should NOT Do This Exercise?

Emergency Warning Signs

Progressive Variations for All Levels

Beginner: Elbow Prone Press

If full prone press ups feel too intense, start here. Prop yourself up on your elbows instead of your hands—this creates less extension.

Intermediate: Standard Hand Position

This is the classic version. Hands under shoulders, push up until arms are straight or nearly straight. Hold for 10 seconds, lower slowly. Perform 10 repetitions per session.

Advanced: Full McKenzie Extension

Once the standard version feels easy, push harder to create more arch. Let your head drop back slightly. Hold for 15-20 seconds. Increase to 15 repetitions.

Modified Versions for Limited Mobility

• Wall Version: Stand facing away from wall, lean back and arch
• Chair Version: Sit and arch backward over chair back
• Standing Extension: Stand with hands on hips, lean backward gently

How Often Should You Do Them?

Real Results: What Studies Show

80% Success Rate Data

Multiple studies show impressive success rates. About 80% of appropriate patients improve significantly when it’s the right exercise for their type of back pain.

Pain Centralization Research

A 2010 study in the Journal of Orthopaedic & Sports Physical Therapy used MRI scans before and after prone press ups. They saw actual changes in disc fluid.

Pain reduction correlated with increased water diffusion in discs. The exercise was creating real physical changes—not just perceived improvement.

Long-Term Benefits

A 2024 study published in Nature looked at long-term effects, following patients for 6-12 months. Extension exercises maintained benefits over time—patients didn’t relapse after stopping therapy.

Clinical Trial Findings

A 2025 quasi-experimental trial tested McKenzie exercises specifically, showing significant reduction in leg pain and dramatically improved function.

Common Questions

How Long Until I Feel Relief?

Some people feel better immediately—after just one session. Others need 3-5 days of consistent practice. If you experience centralization (leg pain moving to back), relief usually follows within days.

Can I Do Too Many?

Stick to recommended amounts. If you do more than 100 reps per day, you might create soreness. Listen to your body—gentle soreness is fine, sharp pain isn’t.

What If It Hurts?

A gentle stretch feeling is normal. But sharp, stabbing pain isn’t right. If pain worsens, stop immediately and try the gentler elbow version.

Troubleshooting Your Technique

My Hips Keep Lifting

Solution: Focus on pressing hips down deliberately. Do hip flexor stretches separately. Start with the elbow version.

I Feel Pinching in My Back

Solution: Don’t push up as high. Focus on lengthening your spine. Engage your abs gently to distribute the curve evenly.

No Relief After Two Weeks

Solution: Consult a physical therapist for assessment. Try flexion exercises instead. Get imaging done to rule out serious issues.

Pain Moves Down My Leg

Solution: Stop immediately. Try flexion exercises like knee-to-chest stretches. See a physical therapist within a week.