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Date issued: July 2019  

For review: July 2021

Ref: C-353/Physio/SA/Lower back strengthening exercises

PDF: Lower Back [pdf] 1MB

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.

 

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.

 

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.

 

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.

 

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.

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.