Post Treatment Rehabilitation
Always seek appropriate professional advice prior to any new exercise activity. If you experience any discomfort, please seek medical attention.
Our first exercise is a side plank. Professionally, I see this exercise undertaken without thought of posture, control and stability unfortunately its all about strength and a time task to hold!. I’d just like to run over some of the fundamentals. The first part of this exercise, I’d like to ensure that people are in a neutral position. You need to feel that your pelvis and spine are neutral and you’re long through the back of the neck. To start with its not a bad idea to do this against a wallso you get the tactile information of where your head, trunk and pelvis is in space. From this position here, I’m going to ask you to lift your hips upon a diagonal. We just do this modification at the side plank and then we slowly lower. Now, the essence of this exercise is one that I’m trying to encourage stability through the scapulothoracic ( shoulder blade / upper back ) area and through the trunk. The trunk is dictating all of the movements. You’re breathing using your diaphragm, as we’ve mentioned previously in all the exercises its about control.
For sure, once you’ve gained control of this area, do a standard plank and then there are all sorts of modifications that we can do to challenge various types of movement within the plank. However, essentially, I’m of the opinion that the scapulothoracic area linked to a stable trunk in a neutral is the most important thing during this exercise. I think holding count of 30 seconds should be your target to start off with. If you get any shoulder pain from this, go back to the original modification, which you should find very helpful, lifting the hips in a diagonal, being stable through the back of the shoulder and long through the back of the neck.
Bridging in neutral with pelvic tilt
* While doing this exercise, we recommend squeezing a ball between your knees to improve stability.
The second exercise is the bridging with a modification. I’m doing this in a neutral spine and with a posterior tilt. Essentially, we’re in our neutral spine. I am pressing my feet into the floor and extending on a diagonal, slowly lowering back down also in a neutral position. Sometimes this exercise is done in training shoes but I think we miss out on an awful lot, it really depends on the environment where do the exercise. In my opinion we need to be in bare feet, so much more proprioceptive information ( which is really a sixth sense ) from your feet about what’s simply going on. If the foot goes on to the lateral board, as is often the case, you miss out the connection with your pelvic floor, your diaphragm and your adductor muscle group. ( Simply adding a small ball between the knees should help throughout the exercise )
The essence of the exercise is under control of the diaphragm, you’re lengthening away in your neutral position and slowly lower. The ideal time holding counts in this exercise should be done on a single leg is 30 seconds, so you hold this position making sure that your pelvis is not deviating. It’s still in this neutral position. As I said, it should be ideally 30 seconds holding count and come back down. As we get better with the movement, we can hold it longer. The important thing is that the knee doesn’t abduct. We can challenge the whole movement by feeling that the foot is pressing into the floor, you’re strong through the spine and you just lengthen away.
The pressure you should feel through your posterior chain, you’re stable and you can stay here 30 seconds plus. You can modify this exercise by putting a Swiss ball under the supporting leg and various props can be added to this under the working leg to facilitate further activity and stress is on these areas.
BACK PAIN SOLUTIONS, PILATES SECRETS
Over and over again I see patients, guys in the gym simply over recruiting the core muscles with the very best intentions to do 'good back' exercises, but not able to get the right muscles to work!
If you have problems with your lowerback and not settling then these exercises may be worth looking into, please put by your clinican looking after you first. Also these are particularly useful for post op patients, we use this as a base with all our disc related patients Osteopathically and from a Rehab perspective.
Hope this helps, heres a link to a blog which may help further,