Lower Back Strengthening Exercises - Patient Information Leaflet - University Hospitals Plymouth NHS Trust Derriford Road Plymouth

Patient Information Leaflet

      Lower Back
Strengthening Exercises

            University Hospitals Plymouth NHS Trust
                                      Derriford Road
                                            Plymouth
                                            PL6 8DH
                                  Tel: 01752 202082
                      www.plymouthhospitals.nhs.uk

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Your back and pelvis are supported by a combination of
different muscles. You could think of them as being an
anatomical box that provides support and allows you to
move more easily.
The exercises in this handout are aimed to improve the
strength of your multifidus, diaphragm, transverses
abdominis and the pelvic floor muscles.

Transverse Abdominis (Deep tummy muscle
exercises)
Lie on your back with your knees bent.
Gently draw your lower tummy muscles (below your
belly button) in towards your spine, maintaining a
relaxed normal breathing pattern.
Hold the contraction 10-30 seconds and repeat up to 10
times.

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Pelvic Floor Muscle exercises
It is important to train this muscle too as it works
together with the transverse abdominis muscle.
Tighten the back passage and lift the muscles at the
front, as if you are stopping the flow of urine. Try to hold
for as long as you can and then relax and repeat.

Neutral spine
Tilt you pelvis forward and then back. Establish where
your natural midpoint is and maintain this whilst
performing your exercises.
During all the exercises try to maintain activation of
your transverse abdominis, pelvic floor and a
neutral spine.

Heel slides
   Breathe in, breathe out and engage deep
    abdominals and pelvic floor.
   Gently slide one heel away from you, keeping the
    heel in contact with the floor.
   Gently draw heel back to the starting position
    keeping neutral spine throughout.

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Leg lift
   Engage deep abdominals and pelvic floor. Keep the
    neutral spine throughout the movement.
   Lift one leg so the hip and knee rest at 90degrees.
   Slowly lower the leg down and repeat with the other
    leg.
   To make this harder you can try to lift one leg after
    the other and hold at top, before lowering one by
    one.

Bent knee drop out
   Breathe in, breathe out,
    engage abdominals and
    pelvic floor.
   Allow one knee to gently
    move away from the
    midline.
   As soon as you feel any
    movement in the pelvis
    hold that range, breathe in to hold, breathe out and
    return to neutral, releasing abdominals and pelvic
    floor.

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Shoulder bridge
  Engage deep abdominals and
   pelvic floor and gently from
   the tailbone roll the pelvis off
   the bed.
  Continue to peel the spine off
   the bed lifting your hips to the
   ceiling.
  Gently roll back to the start
   position.
  To make this harder you can
   try with single leg or placing a
   gym ball under both feet.

4-point kneeling
  Position yourself on your hands and knees with
   wrists below shoulders, knees below hips and spine
   in neutral position.
  Gently lift belly button to
   spine and squeeze pelvic
   floor muscles.
  Slowly lift alternate arms or
   legs out straight and draw
   back in.
  You can make this exercise
   harder by trying opposite
   arm and leg lifts.

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Gym Ball Exercises

Wall squats
  Stand with your back to the wall.
    Place the gym ball behind your lower
    back resting on the wall.
  Slowly engage your deep abdominals
    and pelvic floor and bend your knees
    into a squat.
  Slowly stand up to starting position.

Superman
   Lie with the gym ball under your stomach, with
    hands and feet touching the floor.
   Engage deep abdominals
    and pelvic floor muscles
    and slowly raise alternate
    arms up and down in line
    with your back.
   Repeat with alternate
    legs.
   You can make this
    exercise harder by lifting opposite arms and legs.

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Arm and leg lifts
 Sit on the gym ball, maintaining
  neutral spine. Engage your deep
  abdominals and pelvic floor muscles.
 Slowly raise alternate arms up
  above your head and down.
 To progress, lift alternate knees up
  ensuring you maintain neutral spine.
 You can make this exercise harder
  by lifting opposite arms and legs.

Wood chopper
 Lie on the ball, placing the ball underneath your
  shoulder blades.
 Keep knees bent at 90 degrees, hip width apart.
 Raise arms up to the ceiling with hands together.
 Rotate your trunk to either side and slowly return to
  starting position.

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This leaflet is available in large print and other formats and
                                 languages.
                         Contact: Administrator
                             Tel: 01752 432233

Photo copyright:
http://www.fixprogram.com/blog/post/2016/02/26/Pilates-and-the-deep-
core-muscles-of-the-pelvis

University Hospitals Plymouth NHS Trust does not tolerate any form of
discrimination, harassment, bullying or abuse and is committed to
ensuring that patients, staff and the public are treated fairly, with dignity
and respect.

University Hospitals Plymouth NHS Trust operates a smoke-free, policy,
including e-cigarettes. You cannot smoke anywhere on site. For advice
on quitting, contact your GP or the NHS smoking helpline free,
0800 169 0169

Date issued: July 2019
For review: July 2021
Ref: C-353/Physio/SA/Lower back strengthening exercises

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