Active Exercises

There are hundreds of exercises that can target functional weaknesses. Any test that you cannot complete can serve as a starting point; you should perform the test with support (ie ball squat exercise). Functional exercises do not need to be felt at the site of your pain, as they are designed to strengthen weaknesses that are leading to your pain. While you may feel some discomfort while performing functional exercises, you should not have increasing back pain or feel more sore after exercising. If you are working with a teacher or therapist let them know you have completed the Functional Testing and would like to work on the areas indicated.

CORE STRENGTH TRAINING:
In 1996, a team of researchers headed by Dr Carolyn Richardson demonstrated that a core group of muscles are responsible for initiating stabilization of the lower back and pelvis prior to movement. When the lower back is injured, these muscles stop functioning properly and do not regain proper function even when the pain goes away. These muscles need to be retrained, as the once-injured lower back is highly susceptible to reinjury. Unfortunately, most of the popular interpretations of core stabilization boil down to “doing lots of sit ups”. Let’s take a moment to understand exactly what constitutes core stabilization, because without these muscles functioning properly none of the other training will be very effective.

Your core consists of the diaphragm, transverse abdomenus, multifidi and muscles of the pelvic floor.

1. Visualize these muscles in your body (diagram)

2. Visualize your pubic bone and your sacrum moving closer together. Imagine these muscles contacting to cause an elevator to move from the ground floor at your sacrum to the top floor at your navel. If you think this sounds like Kegel exercises, you’re right.

3. Now practice these exercises:

• Table: on all fours with your core contracted and pelvis in
neutral position slowly lift one arm from the ground without
moving anything else.


• Bird Dog: from the table position lift one arm and the
opposite leg.


• Advanced: perform table pose on a ball.


• Advanced: assume bridge pose on a ball and slowly lift one
leg without moving anything else.


If you can do these last two for 10 seconds you have adequate
core strength.

 
BALL WARM UP:
• Get comfortable sitting on your ball. If you feel unstable use a chair or a wall for balance the first few times.
• Next roll to one side then the other. Roll forward then back. Roll in circles on your ball. Bounce on your ball.
• Lift one leg and repeat the above warm ups.
• Then repeat again with the other leg raised.

Take 5 minutes or more to warm up. If you are in a lot of pain this warm up may be all you do for a few days but
make sure you get on your ball and warm up at least once a day.


 
BALL BRIDGE:
• Start sitting on the floor with your ball at your middle back.
• Lift your pelvis towards the ceiling and hold to the count of 10 then return to sitting for the count of 10.
• Repeat 20-30 times.


 
BALL CURL:
• Start lying on floor with your ball under your feet with your pelvis raised from the floor.
• Curl your feet towards your buttocks then return to first position.
• Repeat 20-30 times.
 
BALL SQUAT:
• Start with ball between you and the wall, legs shoulder width and feet about 1-2 feet from wall.
• Bend at the knees until your thighs are horizontal with the floor.
• Rise up to the starting position.
• Repeat 10 to 20 times.

BALL SQUEEZE AND LIFT:
• Start lying on your back, knees bent, feet on floor and ball between your thighs.
• Lift the ball knees towards chest while continuing to squeeze your knees together.
You can hold this position for 10 seconds or return immediately to the starting position.
• Repeat 20-30 times.


 
DEAD BUG:
This is a great lower back and hip workout that requires no equipment.
• Start lying on your back. Bring one leg up then alternately the other. Repeat 10 times.
• With both legs up bring one arm up then alternately the other. Repeat 10 times.
• Bring one leg up and the opposite arm, alternate sides. Repeat 10 times.




Below: Dead Bug excercise series being done on a 1/2 round foam roller to add instability and difficulty.

SUPERMAN:
• Start kneeling with feet against the wall and your ball at your knees.
• Straighten your legs with hands on ground in front of you. Lift one arm and alternately the other.
• When comfortable lift both arms off the ground for 10 seconds and repeat 10 times.

YOGA:
Thank you to Sarahjoy Marsh at Amrita Yoga Studio
 
The first eight postures are used to bring awareness to the belly, breathing and the core muscles.

In makarasana a belly bloster can be used for comfort. With the pelvis in neutral position take slow deep breaths. Feel your belly push against the floor on the inhale, practice rocking your pelvis back during the inhale and forward on the exhale.

Reclined Baddha konasana is a great pose to practice relaxed belly breathing in the supine position. Remember that a muscle that is contracted all the time becomes weak. See if you can completely relax your abdomen in this position. Add a sandbag to your belly for increased awareness.

Now practice deep belly breathing on all fours in the table pose. Moving from here into the cat and cow positions lets you maintain core muscles during pelvic rocking. Breathe in with the cow position and out with the cat. Frog squeezes open the hips and strengthens the gluteals.

Clam shells strengthen the pelvic floor, transverse abdomenals and hip abductors. Try this pose with theraband around your knees for increased resistance.

Bird dog requires firm control of all core muscles. Knee side plank activates the core muscles and strenghtens the quadratus lumborum and hip abductors.

Salambasana targets the pelvic floor and core muscles of the trunk while strengthening the gluteals. The one leg version also strengthens the hamstrings.

One leg bridge gives the hamstrings and gluteals a strong workout. The lunge with wall support allows slow activation of the quadriceps and hamstrings while warming up for the revolved half moon poses that require
strong core muscle contraction for balance.

Knee to chest flexes the hip and with the opposite leg contracted stretches the quadriceps. Door frame pose stretches the hamstrings. Also practice this pose with core muscle contraction and pelvic rocking.

Reclined urdva hastasana works the abdominals and back extensors simultaneously. Breathe fully in and out.
Relax.