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Building Core Body Strength with the Exercise Ball

Front walkout - Place chest on exercise ball and walk forward on hands as far as possible,
rolling exercise ball from chest toward feet, keeping stomach muscles tight to keep lower back flat.
Start by moving exercise ball to thighs; to increase difficulty move exercise ball to knees then feet.
Walk hands back to starting position. Repeat 3 to 5 times.
Back walk-out - Sit on exercise ball with arms to sides; walk feet forward as far as possible,
rolling exercise ball from buttocks toward neck, keeping stomach muscles tight to keep lower back
flat and do not raise head. Start by moving exercise ball to upper back; to increase difficulty move
exercise ball to neck. Walk feet back and return to sitting position. Repeat 3 to 5 times. For more
difficulty, complete exercise with arms straight overhead; with exercise ball at neck, lift and
straighten one leg at a time, 5 times each leg.
Reverse crunch - Place chest on exercise ball and walk forward on hands until ball is at
kneecaps, keeping stomach muscles tight to keep lower back flat. Pull the ball up towards
arms by bending at hips and knees, then straighten and push the ball back. Repeat 5 times.
Walk hands back to starting position.
Reverse extension - Place chest on exercise ball and walk forward on hands until exercise
ball is at kneecaps, keeping stomach muscles tight to keep lower back flat. Roll the ball to
thighs by keeping hands in place, moving arms to an overhead position, bringing head and
chest down near floor; return arms to perpendicular to body with exercise ball back at knee
caps. Repeat 5 times. Walk hands back to starting position.
Combination - Complete the reverse crunch and reverse extension in one continuous,
controlled movement, pulling exercise ball up to chest and extending back 5 times.

Lumbar Spine Stabilization Exercises


Fig 1: Support back of thigh with both hands and slowly straighten knee
to feel a stretch in back of thigh.

Fig.2.Tighten lower stomach muscles and buttocks to flatten back.

Figure 3

Lie on side with knees bent and hips flexed. Maintain neutral spine position and slowly raise
and lower upper leg 8 to 10 inches.
Figure 4

With arms relaxed at sides and feet on ball, hold neutral spine positon
while lifting buttocks slowly a few inches off floor.

The lumbar stabilization exercise program includes a range of exercises that typically progress from
beginning to more advanced:

From static (lying) to dynamic (standing or jumping)

From resisting gravity to resisting additional outside force

From predictable to unpredictable movements

From individual components of a movement to the complete range of motion in a movement

At all times the neutral spine position is maintained. Progression to the next exercise generally
depends on learning to maintain the neutral spine properly during the current exercise. The physical
therapist or exercise therapist is trained to help the patient learn the proper technique.
The exercises below are a small subset of those a therapist may recommend. The spine specialist
and therapist design each lumbar stabilization exercise program specifically for each patient based on
the patient's condition.

Examples of Exercises Include:

See Hamstring Exercises Video

Hamstring Stretch - A passive exercise using little muscle effort. Lay on the floor with knees bent and
feet on the floor. Find the neutral spine position and maintain it while slowly straightening one leg and
lifting the heel toward the ceiling while supporting the back of the thigh with both hands (Figure 1).
Hold for 10 to 30 seconds and repeat with other leg. Do 3 repetitions. Can make the leg muscles static
too by using a wall to straighten the leg while resting the leg muscles.
Pelvic Tilt - An active exercise from one position, where the abdominal muscles are isolated and used
to move the spine. Lay on the floor with knees bent and feet flat on the floor. Tighten stomach muscle
and pull the lower back to the floor (Figure 2). Hold for 10 seconds. Do 3 to 5 repetitions.

In This Article:

Lower Back Stabilization Exercises for Back Pain

Lumbar Spine Stabilization Exercises
Video: Why is Exercise Important for Lower Back Pain?
Arm/Leg Raises - A more dynamic exercise introduces movement of the arms and/or legs to
challenge the neutral spine; this exercise is for the hip abductors. Lie on one side with lower arm bent
under head and upper arm resting with hand on floor near chest. Bend both knees and flex hips and
find neutral spine position. Slowly raise upper leg 8 to 10 inches and lower. Do 5 to 10 repetitions and
repeat on opposite side (Figure 3).
Exercise Ball Bridges - An advanced stabilization exercise that introduces unpredictable movement
that must be responded to (the movement of the ball). Lay on floor with both feet propped up on the
exercise ball with legs straight and arms relaxed to the sides. Find the neutral spine position and hold
while slowly tightening the buttock muscle to lift the buttocks off the floor 2-3 inches (Figure 4).

Also see Exercise Ball Therapy for Lower Back Pain Relief
In addition strengthening exercises, such as those above, stretching and aerobic conditioning are also
an important part of lumbar stabilization physical therapy:

Flexibility is key to successful lumbar stabilization training, because flexibility allows the
muscles to assume the neutral position easily.
Cardiovascular (aerobic) conditioning is an important part of the total body muscle strength
and endurance and should be combined with the lumbar spine stabilization program. Maintaining
a neutral spine during aerobic exercise is for the more advanced patient and protects the healing
back while working out.

Also see Back Stretches and Aerobic Exercise for Back Pain
Stabilization exercises can be rather rigorous and therefore may not be well tolerated by all patients. It
may be advisable for elderly patients or patients in significant pain to use other less strenuous means
of physical therapy.

Neck and Shoulder Stretches

Back Exercise
A stiff back is sometimes accompanied by a stiff neck. The following exercises can be done to stretch
the neck and shoulder area.
Flexion Stretch - Chin to Chest
While standing or sitting, gently bend the head forward while bringing the chin toward the chest until a
stretch is felt in the back of neck.
Lateral Flexion - Ear to Shoulder
This exercise stretches the neck area below the ears as well as the top of the shoulder. To begin,
gently bend the neck to one side as if to touch the ear to the shoulder until a stretch is felt in the side
of the neck. Switch to stretch the other side.

For more detailed descriptions with figures, see Neck Stretches

Corner Stretch
A basic exercise that is important for stretching the chest and shoulder muscles is the corner stretch. It
is performed in the corner of a room.
This neck stretch is done as follows:

Patients stand approximately two feet back from the corner, facing into the corner.

Feet should be together.

Forearms are placed on each wall, and elbows are a little below shoulder height (Figure 1).
Lean in as far as possible without pain. Patients will feel a stretch in the front of the shoulders
and chest (Figure 2).
Hold the stretch for about 30 seconds to a minute.

This stretch can be performed 3 to 5 times per day. It should be done before doing any neck
strengthening exercises.

Levator Scapula Stretch

The levator scapula stretch is also important for eliminating neck pain. The levator scapula is a muscle
that often becomes tight and may be very tender where it attaches to the shoulder blade. This stretch
can be performed while sitting or standing.

Lengthen the muscle by raising the elbow above the shoulder on the side to stretch.
In this position, first rest the elbow against a door jamb. This rotates the outside of shoulder
blade up and the inside of it down, which lengthens the levator scapula muscle (Figure 3).
Second, turn the head away from the side that is stretching and bring the chin down,
stretching the back of the neck (Figure 4).
Third, place the fingers of the other hand on the top of the head and gently pull the head
forward increasing the stretch slightly (Figure 5).
Hold this for about 30 seconds to a minute.

Figure 1 - Corner Stretch

Stand 2 feet back from conrner facing corner, feet together. Place
forearms on each wall, elbows just below shoulder height.
Corner Stretch
Lean in as far possible without pain, hold 30-60 seconds.
Figure 3 - Levator Scapula Stretch
Raise elbow above the shoulder, resting elbow on door jam or wall.

Figure 4 - Levator Scapula Stretch

Turn head away from side being stretched and bring chin down.
Figure 5 - Levator Scapula Stretch
Place fingers from other hand on top of head and gently pull the head
forward, increasing the stretch. Hold 30-60 seconds.


Exercise and Back Pain

Abdominal Exercise

Back Strengthening

Back Stretches

Sciatica Exercises

Spine Rehabilitation

Exercise Doctor Advice

Exercise Forum

Exercise Videos

Related Topics

Physical Therapy Center

Yoga, Pilates, Tai Chi
Diet & Weight Loss Center
All Pain Topics A - Z


Stretching for Back Pain Relief


Figure 8


Figure 21
(larger view)

Figure 19
(larger view)
Almost everyone can benefit from stretching the soft tissues - the muscles, ligaments and tendons - in
the back, legs, buttock, and around the spine.
The spinal column and its contiguous muscles, ligaments, and tendons are all designed to move, and
limitations in this motion can make back pain worse.

See Spinal Anatomy and Back Pain

Patients with ongoing back pain may find it takes weeks or months of stretching and other back
exercises to mobilize the spine and soft tissues, but will find that meaningful and sustained relief of
back pain will usually follow the increase in motion.

Fig. 8. Place hands behind knees and gently pull both knees to chest.
Fig 21: BackSingle knee to chest stretch
Fig 19: Hip and KneeSupine piriformis stretch