So much classic advice about herniated discs is incomplete or just plain wrong. Not every disc herniation requires treatment, rounding your back probably isn’t the cause, and when it comes to herniated disc exercises for athletes, we don’t always need to default to extension-based (McKenzie) protocols. Modern research makes one thing clear:

There’s no one-size-fits-all answer.

Herniated Disc Exercises: Moving Past The Classic Advice

Prevailing outdated thoughts have haunted athletes into the spirit of a fragile back with jelly doughnut discs that are ready to explode ANY moment if their back rounds (flexion).  This fear has been fueled by outdated research using cadaver pig spines hooked up to machines, running through artificial flexion cycles.

But here’s the good news: science has moved on.

Modern research, using dynamic MRIs on living humans, tells a different story. These studies show that discs aren’t as predictable or as fragile as we once thought. In fact, bending forward (flexing the spine) doesn’t always push the disc backward into the nerve roots. In some cases, it may actually push the disc forward, directly contradicting the old assumptions.

What does this mean for athletes? 

This means the classic go-to of extension-based exercises (like prone press-ups) isn’t a universal fix. And no, you don’t have to fear rounding your back every time you lift (see a video here debunking this myth). Yes, you should create tension and brace properly, but that doesn’t mean arching your spine to the extreme or sticking your butt out like you’re posing for an Instagram glam shot.

It’s time to move beyond the one-size-fits-all mindset. When it comes to herniated disc exercises, especially for athletes, personalized, evidence-based movement is what actually leads to recovery and performance.

Herniated Disc Exercises: Find Your Directional Preference

Don’t just jump into classic McKenzie extension exercises. Instead, do exactly what the creator of this protocol, Robin McKenzie, has educated. Start with a directional preference exam, exploring spinal flexion, extension, lateral flexion, and rotation to discover which movements reduce your symptoms by moving pain toward your spine (centralization) and which make symptoms worse by spreading pain outward (peripheralization).

Initially, move in the direction that centralizes symptoms until the hallmark numbness and tingling symptoms of a symptomatic disc herniation have resolved. During this phase, you can use isometric core strengthening (pallof presses, side planks, tall or short planks, etc) as well as keep areas away from the injury strong. Once the neural symptoms have decreased, focus on dynamic core strength, and start to use graded exposure in all spinal positions without fear.

Final Thoughts: 

If someone tells you “just do back extensions for a herniated disc,” know that the science is more nuanced. Your directional preference testing and symptom patterns guide the best approach, not old myths.

If you’re dealing with a herniated disc—or any injury—knowing what to focus on (and what to avoid) can make a big difference.

Grab our free resource [here]  for key insights on what to prioritize after the most common sports injuries.

FAQ

1. Does rounding my back cause herniated discs?
No. Modern research using dynamic MRIs shows that spinal flexion doesn’t automatically push the disc backward into the nerve roots. While proper bracing and tension matter, rounding the back occasionally during controlled movement is not inherently dangerous.

2. Are extension exercises like McKenzie press-ups the only way to treat herniated discs?
Not at all. Extension-based exercises are just one tool. The most effective approach is individualized and evidence-based, using directional preference testing to determine which movements reduce symptoms and centralize pain.

3. How should athletes approach exercise with a herniated disc?
Start with movements that centralize your symptoms and gradually incorporate isometric core exercises. As symptoms improve, use graded exposure to dynamic and rotational movements while maintaining proper spinal control. Personalization is key—avoid one-size-fits-all recommendations.

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Author: 

Dr. Dillon Caswell, PT, DPT, SCS

Doctor of Physical Therapy | Board Certified Sports Specialist

Hope Evangelist | Top-Selling Author & Speaker | Human Performance Expert