// Back health on the ball - Incorporating preventative back health exercises

by Lisa Westlake


Eight in ten Australians will experience a signifi cant bout of back pain at some stage of their adult life, with many suffering recurrence or ongoing symptoms. This means that many of our clients are suffering some degree of pain or debility. The importance of modifying exercises and providing custom designed options for these participants was discussed in part one of this article (Network magazine Spring 2008). In part two, we consider the all-important role of fitness as a means to prevention, by specifically incorporating back health into mainstream fitness classes and programs.

Back mobility and strengthening is rarely the goal of a fi t, healthy person’s exercise plan. It is usually when it is too late, i.e., after injury has occurred, that a person seeks exercises to improve posture, spinal stability and mobility. After all, spinal integrity and control do not have the same perceived appeal as a six pack torso and muscular, defined thighs and butt! However, with the odds in favour of us and our clients experiencing back pain, considering back health exercises as a regular and vital inclusion of any class or training program is imperative. Prevention is always better than cure.

As discussed in part one, several factors can lead to compromised back integrity and weakness. There is usually a collection of lifestyle issues, such as poor posture, repetitive actions, compromised spinal stabilisation and overload that contribute to pain or injury.
In order to help beat the odds and prevent the occurrence or recurrence of back pain, instructors should include mobility, core stability, posterior strengthening and specific flexibility into their classes and programs. These are to counterbalance stiffness, weakness or poor recruitment of stabilisers, overuse of anterior muscle groups and tightness of certain muscles that lead to poor posture.

The fitball provides an appropriate platform for the above exercises, as it is unstable, provides excellent support in the prone position allowing posterior strengthening and is mobile, enabling effective mobilising and easing into stretches.

The following fitball exercises address these four elements of back health – mobility, core stability, posterior muscle strength and flexibility – and can be included in classes and general fitness programs for participants looking to prevent, rather than manage, back pain.

MOBILITY

Gentle hip circles and pelvic tilts sitting on the ball are a fabulous way to keep the lower back moving freely. More upbeat movements can be used for pain-free clients who are looking to warm up and workout.

FITNESS MOBILITY AND WARM UP: CURL AND SWING (photo 1)

Standing, hold the ball in front of the body, ‘step curl’ right and then left as the ball is swung in a wide arc from side to side. Allow the ball to swing like a pendulum.



CORE STABILITY

Core stability exercises can be performed in several positions on the ball. Focusing on maintaining spinal alignment while performing any upper body strength exercises seated on the ball incorporates core control into training. Increase the stability challenge by bringing the feet closer together, raising one foot off the floor or adding asymmetrical action.

SEATED CORE STABILITY, FITNESS: DELTOID RAISE WITH LEG RAISE (photo 2)

• Sit tall on the ball, feet hip width apart
• Elbows bent, holding hand weights by the hips
• Elongate the spine and engage the core abdominals
• Perform lateral raise, as one knee is extended to lift the foot off the ground
• Lower the arms and leg and repeat raising the second foot.

Progression: To increase the challenge to stabilise, simultaneously raise just one arm and leg on the same side (photo 3).



STABILITY HOVERS

Fitball hovers or planks require stabilisation of the shoulder girdle, spine and pelvic girdle.


FITBALL PLANK (photo 4)

•  Kneel on the floor with the forearms resting on the ball
•  Recruit the shoulder and spinal stabilising muscles by drawing the shoulder blades gently downwards and the lower abdomen inwards
•  Straighten the legs to lift the body to the plank position and hold for 5 to 10 breaths
•  Check that the shoulders do not shrug, upper back does not round, lower back does not arch and that there is no bending at the hips.

Progression: Raise one leg and hold for 5 breaths, repeat on second leg.



SUPINE STABILITY, ON THE FLOOR HAMSTRING LIFT AND ROLL
(photo 5)

• Lie on back with the back of the heels right on top of the ball
• Slowly lift your hips off the floor, then bend your knees to roll the ball inwards
• Roll away and lower your pelvis back to the floor.

Progression: to increase the stability challenge, raise your arms off the floor.



SUPINE STABILITY: ASYMMETRICAL FLY (photo 6)



• Holding hand weights, slowly roll down to supine on the ball, so that the head, neck and shoulder blades are all supported and in alignment
• Raise the hips, engage the core muscles and lift the hand weights to above the chest
• Slowly lower the right arm to shoulder height and then return back to starting position, focusing on keeping the body and the ball still and stable
• Perform x 10, then repeat on the left arm.

Progression: Bringing the feet closer together decreases the base of support, and so increases the challenge.


POSTERIOR MUSCLE STRENGTH


Strengthening posterior muscles helps to prevent problems associated with muscle imbalances. Lying prone on the ball supports the lumbar spine and pelvis and allows full range of movement for extension of upper and lower limbs.

PRONE WIDE ROW (photo 7)
• Lie prone over the ball, feet firmly on the ground and chest raised slightly so that the head, neck, body and legs are in alignment
• Slowly raise hand weights upward and outwards, bending the elbows as the shoulder blades are drawn inwards and downwards. Lower the hands back to being in front of the base of the ball.



SWIM KICK
(photo 8)
• Find the horizontal balanced position on the ball, legs extended and hands resting lightly on the floor
• Perform a slow controlled kicking action, keeping the knees straight to hone in on the gluteals.

Progression: Continue kicking as each arm is alternately raised forward for 10 kicks.



FLEXIBILITY
Maintaining general flexibility is always recommended. In general, anterior muscle tightness compromises posture and back health with muscles such as hip flexors and pectorals being specific culprits. Numerous stretches on the ball are possible.


BACK AND CHEST STRETCH (photo 9)
After being in a seated position all day, there is nothing better than gently arching the back over the ball.

•  From the seated position, with the hands resting on the ball, slowly roll the back and walk down the ball, keeping the tail bone in contact
•  Place hands behind the head and slowly roll back, allowing the back to arch gently
•  Allow the elbows to ease back to increase the stretch across the chest
•  Hold for 10 breaths, then slowly roll forward and back to upright sitting.



By incorporating these exercises into your classes or training sessions you can help participants and clients to maintain a healthy back and lower their chances of joining the eight out of ten statistic.


 


Lisa Westlake, BAppSc (physio)

Lisa has worked in the health and fitness industry for over 20 years. Australian Fitness Network named her Fitness Instructor of the Year in 2000 and Presenter of the Year in 2003. Through her business, Physical Best, Lisa combines physiotherapy and fitness to create classes and programs for a variety of ages, levels and abilities, and is well known for her work in developing the Fitball program in Australia. Visit www.physicalbest.com for more details.


NETWORK • SUMMER 2008 • PP47-50