In practice I tend to see a lot of chronic low back pain patients. A primary reason for chronic low back pain can be weakened core muscles particularly the intrinsic muscles of the spine. Although osteopathic treatment can help I also like to prescribe exercise to my patients to help improve their core strength to help with more long term spinal health.

The core muscles are located around the abdominal region, back, pelvic floor and hips. These muscles are responsible for balance, posture, trunk stability and are the foundation for movement. If they are weak, other muscles have to compensate, which is where poor posture and back pain come in.  

Keep your fingers there, now cough or laugh. As you cough or laugh you’ll feel a contraction in the muscles under your finger. This is your core ‘firing up’ (primarily transversus abdominis).

This is the contraction you want to establish and maintain throughout the exercises so practice doing this by coughing again and trying to hold the contraction for at least 30 seconds.

If you find you’re holding your breath, try counting out loud. This is important as many people use their diaphragm to hold the contraction rather than their core muscles.

It takes some practice to do and generally men take a bit longer to master it than women who are perhaps more used to doing pelvic floor exercises.

The exercises are very simple and can be followed as below.

1). Spine mobilisation

This will mobilise your spine and provide a good stretch down your back. Stand with your feet hip width apart and your knees slightly bent. With your core contracted, put your chin on your chest and slowly roll down through your spine. Keep your knees slightly bent.

Think about articulating one vertebrae at a time, feeling the stretch down your back until you’re bent over with your neck relaxed and your arms hanging down, like a rag doll. Then roll back up, stacking one vertebrae on top of the other. Bring your head up at the very end to finish the exercise.

2).Leg raises A

Lie face up with knees bent and feet flat on the floor hip distance apart. Contract your core and raise one leg off the floor until the knee is above your hip-joint, keeping your knee bent. Make sure that your pelvis is tilting toward you. Sometimes when the back starts to ache it means that the lumbar spine is arching and the pelvis is rotating forward away from you.

3).Leg raises B

In the same starting position as the previous exercise, contract your core and raise one leg then straighten it out in front of you, keeping a bend in the knee. Raise as high as you can without losing the natural curve in your spine, then, making sure you’re still holding in your core, press your low back into the floor and tilt your pelvis in towards you. This time you want to lose the curve. Hold, then return to your starting position and repeat the other side.

4). Plank hold

On your front, with your core contracted, prop yourself up on your elbows and raise onto your toes so your entire body is off the floor . You’re aiming for a ‘dish’ position, so rather than having your back dead straight, you want to tilt your pelvis forwards to achieve a slight upward curve, like a bridge. This takes pressure off your back and works the core harder.

You'll need to work at these exercises for a good four to six weeks on a daily basis before you will notice much change. It can take some time to master these exercises and do them properly as it may take a bit of conscious effort to get the core muscles under control if you haven't been using them properly for a while.

If you're finding them difficult I can demonstrate them to you at a session in one of my Vancouver clinics.