April 10, 2025 · Written by Dr. Gina Bernal

An Easy Exercise for Low Back Pain

Frequently my patients report low back pain in bed, often with it waking them up. The question often is “How can I fix this?”. Despite using a good mattress, they just can’t seem to go a full night without waking up in pain. While there are a number of things that can be explored to help with this, my go-to for anyone with this complaint is an exercise I call Knee Rocks. In this post, I’ll talk about how to do knee rocks, how they are helpful, and when to do them. 

How do I do knee rocks?

Start by laying on your back, preferably in a place you can easily get up and down easily from. Your bed is actually a good place to start because it’s likely where you’ll find yourself needing to do this exercise anyway. Bring your heels up towards your bottom while bending your knees until you are in a comfortable position, usually about a 45 degree angle of bend in the knees. You don’t need to touch your bottom with your feet. Keeping your knees loosely together, rock them together side to side. Your knees will slide over each other some, and they may come apart a little. Rock on each side to where you are comfortable without letting your bottom come off the surface you are lying on. You do not need to try to bring your knees to the bed or floor; in fact, I recommend only going about 45 degrees from center on either side. Do this until you feel your back loosen up and the pain subsides. You are gently rocking your knees side to side, hence the name.

How are knee rocks helpful?

Back pain in bed is often caused by tightening of the deep back muscles from lack of mobility (like when we sleep or don’t change positions often enough). The muscles go into spasm and become painful. Any arthritis in the area can also become more pronounced by this tightening, as well as by inflammation buildup secondary to limited movement. 

When we do gentle, repetitive movements, several systems are worked upon. For one, our nervous system is calmed by this kind of movement. Reducing nervous system sensitivity then reduces pain signals sent as well as turning down the inflammatory response. Our muscular system can also relax due to the nervous system and pain being turned down. The vascular system benefits from this exercise by increasing blood flow to the area, allowing inflammation and cellular waste to be evacuated while also bringing in fresh blood with nutrients to the site. This movement can also help lubricate the joints of our spine, allowing us to have easier movement of the vertebrae even while we sleep.

When should I do this?

This exercise can be done anytime you have back pain. I have heard many people say they do this in the middle of the night and that it allows them to go back to sleep more easily. Doing this a few times before getting up in the morning can also be helpful as it will warm the back up, allowing for easier movement upon sitting up and going about your day. Performing knee rocks before bed can help reduce night pain, allowing for you to sleep longer. 

Do’s and dont’s to make this successful

Do the exercise, even if you are not in pain. If you notice you have a tight back often upon waking, you might be heading into a possibly painful zone. This exercise is gentle enough that it can be done as a preventative measure for those with tight, but not painful, backs. If you are successful at eliminating the pain, don’t stop doing it  just because the pain has stopped. Keeping your back conditioned is key to staying on top of the pain, so do this daily if possible.

Don’t push yourself too far. The key is easy and gentle. Going as far as to touch your knees to the floor or bed isn’t providing any additional benefit to this exercise, and may cause you more tightness and pain. If you’re finding yourself struggling while doing this exercise, you can increase the muscle spasticity and find yourself back at square one. Just be kind with yourself.

Do use moist heat when possible. If you are going to bed and plan to do this exercise, start by applying moist heat to your back for 10 minutes. This increases the benefits of the exercise and can make it easier to perform.

While knee rocks are not the only way to relieve back pain, they are often well tolerated and found to be an easy management technique. For something so simple, it has a surprising number of benefits that are lasting. Now get rocking!

Be well,

Gina