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Initial health status, fitness and functional assessments including genotype & biomechanics

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Back Stability

Because the body is a complex unit of interconnecting systems, any treatment must address the whole, even though it targets a single system. Thus, back stability is part of a holistic approach centreing on muscle balance. Muscles affect the support of the spine, posture and both our ability to move and the way we move. If we examine the biomechanical factors at work in the back, we can see that there are three elements that combine to restore the muscle balance that is vital to back stability; correction of segmental control, shortening and strengthening lax muscles, and lengthening tight muscles.

Strength and stability of the arms and legs also depend on stability of the back and trunk of the body to provide a firm base of support. 

In sport or lifting, if the stability of the back and trunk is poor, then some of the energy of the limb action is lost in the instability e.g. imagine playing tennis on ice - the slippage results in loss of power as the stability is lost and the body twists awkwardly to maintain balance.

When lifting, if the spine is unstable, power is lost as the pelvis tilts and the lumbar spine moves out of neutral position.  It is important to train the stability structures of the back and trunk before concentrating on training limb or back muscles for sport or lifting performance.

Back stability training is important for individuals with or without back pain who wish to improve their back stability.  It is particularly important for those suffering either long-term chronic back pain with a history of acute episodes or those who have suffered their first major episode of back pain and wish to regain control!

Core strengthening aims to improve stabilisation and support to the spine. This is achieved by re-training specific trunk muscles, which may be under used.

Once these stabilising muscles have been re-trained the muscles of the arms and legs will have a more stable base to work from. This allows you to carry out arm and leg movements with more control and is thought to improve the quality of your movement.

     •     It will provide more support for your back and may reduce the risk of back injuries.     

     •     It will provide a more stable base for arm and leg movements, improving the control and quality of your movements.

     •     It will improve your muscular co-ordination during movement.

It is important to learn the core strengthening exercises in stages so as to ensure you are using the correct muscle to do each activity.

Stage 1 Contracting Deep Muscles: There are two main deep stabilising muscles that support your lower back: the Multifidus muscle and the Transversus abdominis muscle.

In order to practice getting Transversus and Multifidus muscles to contract, it is easiest to get on all fours (hands & knees).

Without moving your back, or pelvis, draw your stomach up gently - try to bring your belly button up towards your back.

Now try it lying on your back - imaging you are trying to fasten a very tight pair of trousers. But don’t suck up towards your ribcage (this uses your six-pack), instead pull your lower tummy in, using your deep abdominals, towards your back. Sometimes it helps to try pulling the base of your pelvis (your symphysis pubis) slightly up towards the ceiling.

Practise the same movement when standing and sitting.

This is a very subtle movement so it is best to get your technique checked by the osteopath.

This movement should not be confused with breathing in - it is important to breathe normally while activating the stabilising muscles.

Once you have mastered the contraction, try to hold the contraction for four seconds, and repeat the exercise in sets of ten. Once you have mastered this, you're ready to move on to the next stage

Stage 2 Increasing Deep Muscle Endurance: Now try to hold the muscle with about 30% contraction all the time.

Practice while you are doing everyday activities, such as sitting at the computer, watching TV and when exercising Once you have mastered this you will be ready to progress to stage 3.

Stage 3 Arm and Leg Movements: The whole point of Core Strengthening is to increase the support for your back and trunk in order to provide a more stable base for arm and leg movement.

Now you are ready to practise the Back Stab birddog.pdf correctly.

Start on all-fours, on your hands and knees.

Start by contracting the deep stabilisers (as described in Stage 1) and hold this contraction. Then raise your right arm straight out to the horizontal. Perform the movement slowly and in a controlled fashion - there should be no wobbling or unwanted movement of the trunk. Hold the arm up for four seconds and then slowly lower.

Repeat for the left arm.

Next, whilst maintaining the same position, contract the deep stabilisers and then slowly lift your right leg up straight to the horizontal. Hold it there for four seconds and then slowly lower. The movement should be controlled and there should not be unwanted movement of the trunk or pelvis.

Repeat for the left leg.

Once you have mastered these exercises and can perform them slowly and in a controlled manner, contracting your deep stabilisers throughout, you can practice the full Bird-dog exercise.

To perform the full Bird-dog, contract the deep stabilisers and then slowly lift your right arm and left leg at the same time out to the horizontal.  Hold them there for four seconds and then slowly lower.

Repeat for the left arm and right leg.

Once you have mastered these exercises, whilst maintaining a contraction of the deep stabiliser muscles, you can start doing advanced core strengthening exercises.

Stage 4 Advanced Core Strengthening Exercises: It is highly recommended that you seek advice that you are performing these initial stages correctly before moving onto these more advanced exercises.

Wobble Cushion: Practice Stages 2 and 3 whilst sitting, kneeling and standing on a wobble cushion.

We recommend Togu Dynair cushions as they are self-inflating and so will always provide the correct amount of support.

Gym/Swiss Ball: Practice Stages 2 and 3 whilst sitting and lying in different positions on a gym ball.

Back Stab Side Bridge.pdf: Lay on your side on an exercise mat. Keep your body and legs straight. Push up on your forearm. Hold for 6 seconds. Roll over and work the other side.

Side-bridge with abduction: Lay on your side on an exercise mat. Keep your legs and trunk straight. Push up on your forearm and hold. Steady yourself and raise your top leg up and hold for 4 seconds