WHAT YOU NEED TO KNOW:

What do I need to know about core strengthening exercises? Core strengthening exercises help heal and strengthen muscles of your hips, back, and abdomen to prevent reinjury. They are beginning exercises to help support your spine. Ask your healthcare provider if you need to see a physical therapist for more advanced exercises.

• Do the exercises on a mat or firm surface (not on a bed) to support your spine and avoid low back pain.
  
  
• Do the exercises in the same order every time to train your muscles to work together. Your healthcare provider will show you how to perform these exercises. Do them every day, or as directed by your healthcare provider.
  
  
• Move slowly and smoothly. Avoid fast or jerky motions.
  
  
• Stop if you feel pain. It is normal to feel some discomfort at first. Regular exercise will help decrease your discomfort over time.

How do I perform core strengthening exercises safely? Hold each exercise for 5 seconds. When you can do the exercise without pain for 5 seconds, increase your hold to 10 to 15 seconds. When you can do the exercise without pain for 10 to 15 seconds, add the next exercise. Increase the time you hold each exercise, or repeat the exercises as directed. As you do each exercise, breathe normally. Do not hold your breath.

• Abdominal bracing: Lie on your back with your knees bent and feet flat on the floor. Place your arms in a relaxed position beside your body. Pull your belly button in toward your spine. Do not flatten or arch your back. Tighten the abdominal muscles below your belly button. Hold for 5 seconds. Begin all of your exercises with abdominal bracing. You can also practice abdominal bracing throughout the day while you are sitting or standing.
  
  
• Bridging: Lie on your back with your knees bent and feet flat on the floor. Rest your arms at your side. Tighten your buttocks, and then lift your hips 1 inch off the floor. Hold for 5 seconds. When you can do this exercise without pain for 10 seconds, increase the distance you lift your hips. A good goal is to be able to lift your hips so that your shoulders, hips, and knees are in a straight line.
  
  
• Curl up: Lie on your back with your knees bent and feet flat on the floor. Place your hands, palms down, underneath the curve in your lower back. Next, with your elbows on the floor, lift your shoulders and chest 2 to 3 inches. Keep your head in line with your shoulders. Hold this position for 5 seconds. When you can do this exercise without pain for 10 to 15 seconds, you may add a rotation. While your shoulders and chest are lifted off the ground, turn slightly to the left and hold. Repeat on the other side.
  
  
• Dead bug: Lie on your back with your knees bent and feet flat on the floor. Place your arms in a relaxed position beside your body. Begin with abdominal bracing. Next, raise one leg, keeping your knee bent. Hold for 5 seconds. Repeat with the other leg. When you can do this exercise without pain for 10 to 15 seconds, you may raise one straight leg and hold. Repeat with the other leg.
  
  
• Quadruped: Place your hands and knees on the floor. Keep your wrists directly below your shoulders and your knees directly below your hips. Pull your belly button in toward your spine. Do not flatten or arch your back. Tighten your abdominal muscles below your belly button. Hold for 5 seconds. When you can do this exercise without pain for 10 to 15 seconds, you may extend one arm and hold. Repeat on the other side.
  
  
• Side Bridge:
  • Standing side bridge: Stand next to a wall and extend one arm toward the wall. Place your palm flat on the wall with your fingers pointing upward. Begin with abdominal bracing. Next, without moving your feet, slowly bend your arm to 90 degrees. Hold for 5 seconds. Repeat on the other side. When you can do this exercise without pain for 10 to 15 seconds, you may do the bent leg side bridge on the floor.
    
    
  • Bent leg side bridge: Lie on one side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm so your elbow is directly below your shoulder. Bend your knees back to 90 degrees. Begin with abdominal bracing. Next, lift your hips and balance yourself on your forearm and knees. Hold for 5 seconds. Repeat on the other side. When you can do this exercise without pain for 10 to 15 seconds, you may do the straight leg side bridge on the floor.
    
    
  • Straight leg side bridge: Lie on one side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm so your elbow is directly below your shoulder. Begin with abdominal bracing. Lift your hips off the floor and balance yourself on your forearm and the outside of your flexed foot. Do not let your ankle bend sideways. Hold for 5 seconds. Repeat on the other side. When you can do this exercise without pain for 10 to 15 seconds, ask your healthcare provider for more advanced exercises.

When should I contact my healthcare provider?

• Your pain becomes worse.
  
  
• You have new pain.
  
  
• You have questions or concerns about your condition, care, or exercise program.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.