Core Stability 1 – Therapy Department

Core Stability 1 – Physiotherapy

What is it and why is it so important?

The core is the area around your trunk from the ribs downwards.

A lack of core stability contributes to poor balance and the continuation of lower back pain. Additionally, without a stable core more advanced movement patterns can be difficult to achieve.

The exercises in this leaflet are designed to activate the main core stabiliser muscles called the transverse abdominus and multifidus.

Imagine these muscles like a corset giving support to the lower spine.

It is important to try to keep a neutral posture through your back and pelvis when doing these exercises. A neutral spine is when your back is not arched, rotated or leaning to either side – your therapist can explain this to you as needed.

Breathing

Breathing in and out at the right times whilst doing your exercises is one of the most difficult things to learn. It is important because some muscle groups work better on the outward breath. For this reason you should try to breathe out during the active part of the exercise that requires the most effort.

Core stability exercises 1

1. On your back with your legs bent and feet together.

Breathe in to prepare

• As you breathe out, pull in your abdominal muscles as if you are trying to bring your belly button towards your spine.
• Keeping your abdominals tight as you breathe in and out five times.
• Do not let your back move.

2. Position yourself lying on your back with your knees bent. Squeeze your stomach in and slowly lift your bottom off the bed.

3. Lie on your back with your knees bent and feet together.

Breathe in to prepare

• As you breathe out, pull in your abdominals and gently and slowly straighten one leg by sliding your heel along the floor. 
• Breathe in and bring that leg back to the starting position.
• Repeat five times on each leg alternatively. Your pelvis should not move as you move your leg.

4. Whilst lying down, bend both of your knees up.  Keeping one knee still (imagine you are balancing a cup on it) roll the other leg out to the side, slowly and carefully. Bring the leg back to the middle tightening your stomach muscles as you go.

5. Whilst lying down, bend both of your knees up.  Roll your legs from side to side in a controlled steady manner.

6. Whilst lying down, bend both knees up placing your feet on the bed.

• Lift your arms together/holding a light ball/alternately in a slow and controlled manner keeping your elbows straight and your thumbs moving up, palms facing into each other.
• Try to keep your abdominal muscles engaged throughout and the movement slow and controlled.
• If you feel that moving your arms higher above your head becomes too difficult and you are struggling to maintain control, keep the movement smaller within the range you feel you can control.

7. Position yourself lying on your side with your hips and knees bent. Squeeze your stomach muscles in. Lift your top knee away from your bottom knee while keeping your feet together. Ensure your hips stay on top of each other, do not roll backwards.

8. Position yourself lying on your side. Start with your top leg resting on the bed. Slowly lift your leg up away from the bed as high as you can go. Ensure that your hip and knee are kept straight and your foot points forwards.

Ensure you keep your hips on top of each other. Do not roll backwards.

9. Position yourself lying on your back with one leg over the side of the bed. Start with your hip straight and knee bent. Squeeze your stomach muscles. Slowly bring your knee up to your chest keeping your knee bent. Ensure that both of your hips stay in contact with the bed throughout the movement.

10. Whilst sitting on a firm surface/chair, keep both feet flat on the floor.

• Use your abdominal muscles to control the movement of your pelvis and trunk. Tighten your abdominal muscles, bringing your belly button towards your spine and controlling the movement of your tailbone backwards and your trunk into slumped position with your head and shoulders relaxed. Then grow tall from the bottom of your back, through your trunk to sit strong and straight but without lifting your shoulders to your ears.
• Repeat these movements, engaging your abdominal muscles throughout.
• Find a neutral posture with a comfortable but strong sitting position, keeping your abdominal muscles engaged.
• When your feel you have control of this position, you can challenge yourself by lifting your arms alternately or holding a light ball between both hands, or by slowly marching your legs. It is important to maintain a strong trunk, keeping your pelvis stable throughout and to rest if/when you feel you are unable to do this.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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