The Concept of William’s Flexion Exercises

INTRODUCTION

Williams believed that the root cause of all pain is due to the stress-induced on the intervertebral disc by poor posture. So to cure this problem he developed flexion exercises, also latter known as Williams lumbar flexion exercises are a set of seven exercises which is related to improving lumbar flexion, avoiding lumbar extension and strengthening the musculature. abdominal and gluteal to control non-surgical lumbar pain. The system was first created in 1937 by Dr Paul C. Williams (1900-1978), then a Dallas orthopaedic surgeon. Even after such a long time, Williams flexion exercises is well accepted among the physiotherapist and is in trend in urban areas like physiotherapy service in south Kolkata for curing back pain. 

 

Basic exercises

Williams believed that back pain was the result of human evolution moving from a quadruped position to a vertical position, proposing that the standing position was the cause of back pain because it placed the lower back in a lordotic curve. Williams developed seven exercises to reduce the lumbar curve.

Pelvic tilt exercises, partial abdominals, bilateral knee-to-chest and knee-to-chest, stretching of the hamstring muscles, standing push-ups, sitting trunk flexion and full squats.

1- Pelvic tilt exercises:

Lie forward on your back with your knees bent and feet flat on the floor. Flatten your lower back against the floor, without pushing down with your legs. Hold for 5 to 10 seconds.

2- partial abs:

The athlete is in the “hooked” position (in the supine position with the knees bent and the feet flat). With hands behind the head, the athlete raises the upper part of the torso until the scapulae clear the rest surface and the tension is placed in the rectus abdominus. After returning to the starting position, the position is repeated for a specific number of repetitions.

3- From the knee to the chest:

Single knee to the chest. Lie backwards with your knees bent and stretch your feet flat on the floor. Pull your right knee slowly towards your shoulder and hold for 5 to 10 seconds. Pull down the knee and repeat with the other knee.

Double knee to the chest. Start as in the previous exercise. After pulling the right knee to the chest, pull the left knee to the chest and hold both knees for 5 to 10 seconds. Slowly lower one leg at a time.

4- Stretching the hamstrings:

In a supine position, the athlete places both hands around the knee. The athlete straightens his knee and pulls the thigh towards his head so that the hip flexes. Williams believed that flexible hamstrings are necessary to achieve complete flexion of the lumbar spine. Although the tight hamstrings limit the lumbar flexion when standing with the knee stretched, we now know that the tight hamstrings actually tilt the pelvis backwards and promote trunk flexion.

5- Standing lunges:

This exercise actually results in an extension of the lumbar spine when done correctly. However, it is a good stretching exercise for the entire lower extremity, especially for the iliopsoas, who may be a perpetrator of lower back pain if it is abnormally tight or in spasm.

The athlete begins the forward thrust in standing position with the feet shoulder-width apart. Then, he or she takes a big step forward with the right leg and plants the foot in front, keeping the body relatively straight. The knee should remain on your ankle and not extend over the fingers to minimize stress on the knee joint.

6- Flexion of the sitting trunk:

This exercise is done by sitting on a chair and flexing forward in a reclined position. The maximum flexion of the trunk is obtained and the direct stretching of lumbosacral soft tissue structures occurs.

7- Full squat position:

For doing the full squat position you have to bring the feet shoulder-width apart so that there remains the maximum range of motion available between the hips and knees. This will result in the lumbar spine rounded inflexion. 

 

For years, Williams’ flexion exercises were the mainstay of most back pain prevention and care programs. They certainly achieved the goal of flattening the lumbar spine and were defended by physiotherapists who worked with sports and industrial injuries. Although success was limited, William’s comprehensive program helped advance the idea that strong abdominal muscles are needed to prevent low back pain and improve core strength. Currently, the Williams’ flexion exercises are being adopted by different physiotherapy centres in urban areas like the physiotherapy service in south Kolkata is well accustomed to this exercises and is keeping it in trend to cure different types of the back problem.