Yudu - sportEX medicine - 1999-2010

PATIENT ADVICE Back stability and strengthening

Your rehabilitation programme This exercise programme has specific exercises to help stretch and strengthen tight muscles as well as improve the stability of the core muscles used to maintain a good posture during daily activities. It is important to ensure the exercises are performed with good technique as a good postural control is important at all times and will help prevent possible problems in the future.

Stability exercises 1 Begin on hands and knees and hold your spine stable in neu- tral throughout the rest of the exercise. Push your feet and knees into the floor and keep your elbows slightly bent. Keeping your back and head straight, raise one hip out to the side and return to the starting posi- tion. Repeat on each side 5 times

2 Stand upright keeping your buttocks and stomach muscles tight and maintain a neutral spine position. Balance on one leg keeping your spine neutral and gently throw a ball. Repeat on each leg hold- ing for 20-30 seconds. When you are able to achieve this progress by standing on an unstable surface such as a wobble-board, trampet or a mattress of a bed. Begin by using a wall for support and and progress to balancing with no support. Repeat the process balancing on each leg

3 Lie on your back with your knees bent, tighten your stomach and but- tock muscles to hold your spine in a neutral position. Move alternate arms and legs together 10-15 times keeping your spine stable.

Strength and stability exercises 4 Lie on your back with your legs in the air and knees straight if possible (slightly bent if the stretch is too much in the back of your legs). Hold onto a solid object behind your head and tighten your stomach muscles to raise the hips and feet straight upwards. This is a small, slow movement and takes some practise to do well. Repeat this exercise 5-10 times

5 Standing upright in the position shown, securely anchor a Tubi-grip or equivalent rubber tubing to a solid object over- head. Grasp the tubing with both hands and pull down and across the body as if paddling on one side in a canoe (with a single bladed paddle). Keep your stomach and buttock mus- cles tight so your spine maintains a neutral position. Do this movement 10 times and then repeat on the opposite side.

6 Lie on your back with your legs out straight in front. Perform a pelvic tilt, tilting the pelvis upwards and neutralising the spine so it flattens a little against the floor. Holding your back flat in the position slide your heels up to your body as shown in the diagram. Repeat this exercise 10 times.

Stretching exercises 7 Bend down with your weight spread equally through your knees and hands. Bend your knees and sit back on your heels leaving your hands out in front as in the diagram. Hold this stretch for 30 sec- onds and repeat 3 times.

8 Roll up a small towel so its about 2- 3 inches thick. Sit back against a chair as shown with the towel propped between your back and the chair. Place one foot on the chair and your hands behind your neck and lean backwards until you feel a gentle stretch in your back. Hold for 20 seconds and repeat 3 times.

The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for special- ist medical advice in each individual case. To the extent permissable by law, the publisher, editors and contributors accept no liability for any loss, injury or damage howsoever incurred (including negli- gence) as a consequence, whether directly or indirectly, of the use of any person of the contents of this article.