Strengthening the deep stabilization muscles in the back is a strategy in modern physical therapy to treat normal degeneration of the spine from age or injuries. The strengthening and reprogramming of your back muscles will make re-injury significantly less likely to occur. Your trainer or physical therapist may have you learn exercises in three stages.
Stage 1
Lying on the floor provides a stable environment that allows you to maintain a neutral spine position and activate your deep muscles. One of these exercises involves identifying a neutral pelvis position. Lie on your back with your knees bent and your feet flat on the floor. Relax your arms at your sides. Your lower back should naturally be off the floor. Tilt your pelvis all the way forward until your back arches off the floor. Then tilt your pelvis backward until it pushes your lower back flat. Find the most comfortable position between these two extremes. That is your neutral position.
From there you can progress to leg sliding. Lie on your back with a neutral pelvis, knees bent, feet flat on the floor, and your arms at your sides. Slide your left foot along the floor until your leg is straight. Keep the neutral spine position and squeeze your abs. Bring the left foot back to its bent position. Slide the right foot forward the same way. You may do as few as five reps per leg; ask your physical therapist for a specific recommendation.
Stage 2
In stage 2 you will perfect and correct movements while building enough muscular strength to achieve high numbers of repetitions per exercise, such as 50 reps. A good exercise for this stage is ball-seated marching, an exercise you perform on an exercise ball. Sit up tall on the ball with your feet flat on the floor, your knees above your ankles, and your back in a neutral position. Put your hands on your hips. Lift your right foot a few inches off the floor and hold for 2 seconds without allowing the ball to roll or move. Replace the right foot and lift the left. Continue marching until you can do 50 to 60 reps, or as advised by your doctor or trainer.
Stage 3
By the time you reach the third stage, you should be able to activate your core muscles fairly easily to stabilize your spine in stable and static exercises so that you can add some dynamic movement. Stage 3 works on functional movements for activities of daily living and integrates breathing with exercise. Sports, running, back extensions and swimming are just some of the exercises you may try. You can perform back extensions on the floor, on a machine or on an exercise ball. The back extension on the floor is the easiest of these options. Lie on the floor with your hands interlaced behind your head. Keep your legs relaxed, but squeeze your glutes. Raise your chest off the floor. Exhale as you lift up. Hold yourself up for two seconds. Inhale and lower yourself with control back onto the floor. Stop if you feel pain, but not fatigue, in the lower back. You may start with as few as 10 reps and work up from there.
Tags: your back, feet flat, feet flat floor, flat floor, lower back