Chiropractor Chandler AZ

Lower Back Exercises

Acute lower back pain can happen with a sudden movement, twist, bending motion, or lifting activity. People can either experience a sharp, stabbing pain right when they injure their lower back, or they can feel it slowly progress over time. Sometimes the pain can increase for 1 to 2 days before becoming severe and limiting.

During the acute phase, our goals are to decrease pain, muscle spasms, and inflammation in an injured area. This is not the time to be aggressive with the injury. You are essentially going downhill, and our goals are to stop the dissent and get you going in the right direction. Ice is an excellent treatment during this time. It does a tremendous job of decreasing pain and inflammation.

Light movement exercises can be performed to decrease pain. Joint movement blocks pain sensors from sending signals to the brain. Light movement also tells the body that it is okay and not as injured is it may think. All exercises should be performed in a pain-free range of motion. If it hurts, stop! Don't go that far. All exercises should be a nice, slow, and controlled rock in a pain-free zone.

After several repetitions. you might find an increased ability to move further without pain. This is not the time to push your luck.

Sometimes people think that if some is good, more is better. This is not the case with acute injuries. Remember, you are going downhill after injuring a muscle, tendon, or joint. Trying to push too hard during the acute phase increases the possibility of exacerbating your injury or increasing your muscle spasms.

All low back exercises with pictures, description, and videos can be found at: http://www.robertsonfamilychiro.com/low_back_exercise_video_series_chandler_az.htm

Acute Pain and Range of Motion Exercises

Knee Side To Side

Perform the knee side-to-side exercises in a slow and controlled manner. Start on your back with your knees bent. Very slowly rock them to your left, stopping before experiencing any pain or spasms. Slowly rock back to a neutral position and toward the right, once again stopping if you experience any lower back pain. Slowly rock your knees back and forth 15 to 20 times.

Knee To Chest

Laying on your back with knees bent, grab your right knee with both hands and pull it toward the chest. You should feel a comfortable stretch and hold for 20 seconds and then release the stretch for a few seconds and then stretch toward the chest again. Repeat with the other leg. If those go well, pull both knees to the chest for a comfortable stretch. For a greater stretch, pull one knee to the chest and straighten the other leg.

Hip Stretch

Another exercise you can perform while lying on your back is to pull your left knee toward your chin. You should experience a light, comfortable stretch in your lower back and hip muscles. Stop if it hurts. After holding for a few seconds, slowly pull your left knee toward your right shoulder. Then pull toward your right elbow. Each position will stretch a different part of the hip. Repeat the raising and lowering of the left knee 10 times. This exercise can then be repeated on the right side. For increasing stretch pull on the ankle and rotate the leg.

Pelvic Tilts

Pelvic tilt exercises can also be performed if the first two are going well. Either in a sitting or lying position, tip your pelvis forward, pausing for a few seconds before tipping your pelvis backwards. Slowly tip your pelvis forward with a pause before rocking backwards. Repeat this 15 to 20 times.

I like to describe these exercises as rusty door hinge exercises. Slowly rock the back joints to increase movement, just as if you were trying to rock a rusty door hinge gate. With a rusty hinge, there is not any advantage to being overly aggressive and kicking the gate open. It is better to be slow and safe in order to decrease pain and reduce the risk of further damage.

Cat / Camel

Start with on your hands and knees hands shoulder width apart. From a neutral quadruped position, lower the stomach to the ground arching the back. Then slowly round the back, pausing at the top. This exercise is basically a pelvic tilt from your hands and knees, which can be more comfortable for some people. This should be comfortable and not painful. Slow and deliberate movements are important.

Sub Basement Exercises

Knee flexion and extension

Start with the knee bent and hanging off a chair, table or bench. Slowly extend the knee. Pause at full extension and flex the knee as far as comfortably possible. The exercise can be made more difficult by adding an ankle weight or resistance rubber band.

Seated hip abduction and adduction

Abduction is taking your upper leg to the side, and adduction brings the leg back to the middle. Initially the exercises can be performed in a chair, but you should quickly advance to a lying or standing position. Once again, the exercises can be made more difficult by adding a resistance band.

Seated hip Internal and external rotation

Internal hip rotation is when the femur and knee turns inward, and external rotation is the opposite motion. In a seated position with your knees bent at a 90-degree angle, place your right foot on the ground and lift the right ankle across the left. Try to keep the femur in the same position while pivoting the ankle. Repeat this motion 10 times, then the opposite motion. By anchoring the rubber resistance band to the bottom of the chair and ankle, the band will apply resistance throughout the motions.

From seated positions we move to standing. We always want to master the simpler exercise before progressing to harder exercises. Challenging the body's proprioception (balance) system increases your neurologic learning and accelerates your recovery.

The exercises always start with your eyes open. When you feel fairly steady, close one eye. This causes a loss of depth perception. Closing both eyes is significantly harder.

Always perform eyes closed exercises in a safe environment when you can grab onto something for support, such as a wall or cane.

Standing on two feet together

Move the feet closer together with the knees slightly bent. Start with trying to maintain balance and limit the amount of sway.

Standing tandem

Imagine you are standing steady on a tightrope. One foot should be directly in front of the other with the knees bent.

Single leg posterior hip bumps

Stand six inches from a wall on your right leg, with your left held in front. Slowly move backward until you fall into the wall, and then push yourself off the wall with your hips. Once you regain a steady balance on one foot, repeat the exercise. As you improve, move further from the wall.

Side hip bumps

Similar to the posterior hip bumps. Standing with your hip facing the wall, fall to the side. Push off the wall with your hips and regain your balance. You will need to start closer to the wall compared to posterior hip bump exercise. Hip bump exercises can be made more difficult by standing on an unstable surface or with your eyes closed.

Forward lunges

Start with your arms at your sides. If you feel unsteady, do this exercise near a wall, table or sturdy chair to hold onto. Lunge forward with one leg. As with squats, it is not necessary to do a full, deep lunge to benefit from this exercise. Move the forward leg back to the starting position and lunge forward with the opposite leg. Start with one set of 10 and work your way up to two sets.

At first, do not lower your waist all the way to the ground. Perform the exercise in a stable and controlled manner. With increased leg and hip strength you will be able to go lower and perform more repetitions.

Modified bird dog

This is a modified version of a popular yoga exercise that builds coordination between your arms and legs. Stand about a foot from a wall and place your hands against the wall. Move your left hand up above your head while at the same time moving your right leg straight backwards. Your left hand should not be touching the wall and your right foot should be off the ground. Return to the original position and reverse the movement, moving your right hand above your head and left foot straight back off the ground. One set is 10 movements with each limb. Work your way up to two sets.

Equipment

Stability exercises are made more difficult when using a few simple and inexpensive pieces of exercise equipment.

Stretch Bands - Simple and effective for increasing hamstring and hip stretching. https://amzn.to/2rbBPG5

Foam Pads- Are simple foam pads that make all standing exercises slightly more difficulty. Foam challenges the proprioceptive systems by making the surface softer and more difficult to stand on. - https://amzn.to/36CZjEy

Exercise Balls - Therapeutic exercises balls are used for a variety of lower back and core exercises. This is the best $20 you can spend on your health. Buying, inflating, and using this ball can be tremendous for your lower back and core muscles. https://amzn.to/34BB5IZ

Kettlebells - Dumbbell weights can be used for the following exercises too. I personally like kettlebells for additional strengthening and stability exercises, along with its ability to use on the exercise balls or foam. A 5, 10, and 20 lbs weights can complete an exercise set and provide many treatment options. https://amzn.to/34BB5IZ

Vibration Plates - These are fantastic at increasing core, back, hip, knee, ankle, and foot strength. We regularly utilize these in the office, and when used at home can enhance your strength and complete your workout room. These will challenge your neuromuscular, strength, and endurance systems more than any other piece of equipment. https://amzn.to/2JPfFA4

Basement Low Back Exercises

Sometimes you have to start in the basement and that is ok. It is not where you start it is where you end.

Single leg stance

Stand on one foot and stay steady. Your eyes and head should be facing forward with the shoulders and waist aligned. The knee should be pointing straight forward and not rocking inward. Your body weight should be distributed across the middle of your standing foot, while the foot arch is maintained and not flattening inward.

To make the exercises even harder, you can add slow squats or weights to the exercises. The exercises can also be performed on increasing unstable surfaces, such as a folded up towel, foam, BOSU ball, rocker board, wobble board, or vibration plate.

All of the exercises start on the ground and then progress to a more unstable surface.

Calf raises

Standing with two feet shoulder width apart, slowly raise your heels off the ground as you keep your balance. Then slowly lower your heels back to the ground. Initially start with two feet, then progress to single leg when your strength improves.

Side steps foam

Start by standing on your right leg with the left held slightly above the ground. Step to the left and shift weight to the left leg. Then lean back to the right and raise your left foot off the ground. Once you are steady on your right leg, repeat the exercise 10 times per side.

Single leg hip abduction

Standing on one foot, abduct the raised leg to the side. Concentrate on slow and steady leg movements while maintaining balance. A rubber band can be added around the legs to make it more difficult.

Step ups

Start with a three-inch aerobics step. Stand behind the step and practice stepping forward and up the step while keeping your knee pointing forward. Try not to shift your body weight to the side, compensating for hip and knee weakness. Over time and improvement, increase the height of the step. Increase stride length to add difficulty.

Modified plank

You can do a modified plank exercise off the side of your bed or a sturdy table. Position your arms on the table or bed so that they are directly below your shoulders. You may want to grasp your hands together to be more stable. Now move your feet straight out behind you. Imagine a straight line that connects your head, shoulders, hips and feet. That is the perfect plank. Start by holding this position for 10-15 seconds and work your way up to sixty seconds.

Modified push-up

The difference between a modified push up and a full military push up is that you pivot from your knees as opposed to your feet. You can also do full push ups off of a wall, or an incline push up off of a bench using the modified position.

Plank From Knees

Planks are a tremendous exercise for increasing rectus abdominis and oblique muscle strength, which is commonly lost in people with chronic knee pain. Plank exercises can be modified by starting on your knees instead of feet, which makes the exercise significantly easier. Start where you can and then progress as you are able. People with back pain and weakness increase strain on their knees. Getting the core stronger will reduce some of your knee pain.

Foundation Low Back Exercises

Bridging exercises

Start on your back with knees bent and feet shoulder width apart. Slowly raise your waist toward the ceiling, trying to pick your pelvis up toward the ceiling but not extending your back. The idea is to create a straight line from your shoulder through the waist and to the knees. Concentrate on slow and steady movements up and down, keeping the waist level at all times. Avoid swaying or tipping the pelvis during the movement.

Bridging exercises start with two feet apart and then move to two feet together. Then move to a position with one foot on top of the other and next, on one leg with the lifted knee bent. Finally, the lifted knee is kept straight. The progression is mastering 3 sets of 10 with two feet apart before moving on to two feet together. Then progress to one foot on top of the other for 3 sets of 10 before moving onto single-leg position.

Glute bridge:

The glute bridge builds strength in all of the gluteal muscles: Maximus, Minimus and Medius. The ball makes you unstable and requires more core stabilization and strength. Eyes can be open or closed for increased difficulty.

Roll out on the ball until it is resting under your shoulders, supporting your upper back. As with the plank position, having your feet shoulder width apart makes the exercise easier, whereas keeping the feet and knees together is more challenging. Cross your arms across the chest. Slowly lower your hips to the floor and then raise them back up to a tabletop position. Watch out for any side-to-side movement (usually indicating pelvic instability from weak hip stabilizers). Also, be careful not arch your back, since this can cause lower back strain. Repeat ten times for two-to-three sets.

Esther's clamshell:

Our physical therapist, Esther Kim, showed us this neat and very challenging variation on the clamshell exercise. Start by lying on your side, with one hand in front to support your trunk and the other supporting your head. Raise your hips off the floor with knees bent, knees and feet together. Keeping the feet together, slowly open and close the knees in a clamshell motion. Repeat ten times on each side for a set.

Bird dog:

Start out in the quadruped position on the mat, with both hands and knees on the floor. Slowly extend the right arm straight forward and left leg straight back. Your arm, torso and leg should form a straight line. Bring the arm and leg back down to the floor and reverse. Ten arm and leg lifts on each side constitute one set.

Door frame touch

This exercise works to strengthen your knees and pelvic stabilizers. Stand in the middle of a doorway frame, about a foot behind the frame itself. This is a single-leg stance exercise, and the knee of the standing leg should be slightly bent. Slowly twist to the left and touch the frame with your right hand; then slowly turn to the right and touch the frame with your left hand. Make sure that you are twisting your whole body when you touch each side of the door frame, not simply reaching for it. Touch each side of the door frame ten times for one complete set.

45, 90, 180

Laying flat on your stomach, raise your leg while keeping the knee straight. The movement should come from extending hip and not rolling your pelvis. Perform 10 repetitions with the right leg before 10 repetitions with the left. Next, keeping the knee straight and toes pointed toward the floor, move the foot to the side abducting the hip. You will feel more muscle activation on the side of your glutes. Once again, perform all 10 repetitions before switching legs.

The last part of this exercise is to lift your foot at a 45 degree angle in a linear line. This is the hardest of the three for most people. Only go as far as you can without straining or rotating your femur. Build up to 3 sets of 10 on each leg. To make the exercise harder, go through the movements with a resistance rubber band.

The exercise can also be performed standing or with resistance bands for added difficulty.

Side step ups

Just like it sounds. Step onto the step sideways. Focus on keeping your waist as level as possible and controlling your torso rock. Step both up and down the steps each direction.

Backward step ups

Practice going up the step backwards. Reverse the exercises stepping down to the ground backwards. Going slowly is much more difficult than moving quickly. Slow movements require you to use more hip stabilizers than when going fast, so go slow.

Square dance

Stand on your right leg with the left held slightly in the air. Keeping all your weight on the right foot, reach the left behind you and tap the ground without supporting any body weight. Then reach the leg forward and tap a point in front of your right leg. Next, reach back and to the left, tapping the ground, then reach forward and to the left. Think of tapping the corners of a square. Repeat 10 times on each leg.

Once you have become comfortable with the square dance exercise, begin crossing behind and in front of your body. When standing on your right leg, your left foot will tap a point behind and to the right of your body. Likewise, when standing on your left leg, tap a point in front and to the left of your body.

These exercises are enhancing your knee and hip balance, stabilization, strength, and endurance.

Slow walk resistance

With a mild resistance rubber band around your ankles, begin walking in a straight line. Do not move fast. Focus on slow, controlled movements and maintain resistance for most of the movement. The walk can be exaggerated with a swinging leg to the side, or a monster-type walk.

Duck walks

Side-to-side walks increase lateral hip, knee, and ankle strength. Place a resistance band around your ankles and keep tension on the band throughout the exercise. Initially, move slowly, stepping with the lead leg to the side and even more slowly as you bring the trail leg back toward the middle. Don't lose tension on the band as the trail leg nears the lead leg. There are three positions for duck walk:

1. Toes pointing straight forward the entire time.
2. Toes pointing inward the entire time.
3. Toes point out the entire time.

Moderate Exercises

Seated leg-raise:

Sit on the ball with your arms crossed. Slowly raise the left leg, lower it and then raise the right leg. Repeat ten times with each leg for a set. Eventually you can add a weight to hold in front of you or to the side for added difficulty.

Abdominal curl-up:

The ball should be positioned to support your lower and middle back. With your arms positioned so that your hands are supporting your head and neck, tighten abdominal muscles and curl up slowly. Return to the original (supine) position. To add challenge, twist while curling, first to the left and then to the right.

Lateral curl up:

Start with your feet on the floor, lying on your side with the ball under your hips. You may want to prop one of your feet against a wall to anchor yourself. Curl up sideways, then lower back down to the starting position. Repeat for a total of ten lifts on each side.

Cross Crawl Ball:

Start in a prone position with your hands and feet touching the floor and the ball under your trunk. Slowly lift the left arm and right leg off the floor and extend them so the they are aligned with the body (straight out to the front and back). Lower them back to the starting position and lift the opposite limbs. A set consists of ten lifts on each side.

Inner and outer thigh lift:

Start out lying on your side, with the ball positioned between the feet and lower legs. Raise both legs up towards the ceiling, keeping them in alignment with your trunk. Repeat for a total of ten lifts, then switch sides (ten more lifts) for one set.

Hamstring curls:

Begin by lying prone on the mat, elbows out and head resting on your hands. Grab the ball between your feet and lower legs. Bend the knees and slowly lift the ball towards the ceiling, then lower it back down to the floor. Repeat nine more times for a set.

Plank on the ball:

For beginners, start with your feet slightly apart and the ball under your chest. Your head, shoulders, back, hips and legs should ideally form a straight line. Raising your hips too high makes the plank easier but less effective, while letting them fall towards the ground can cause lower back pain.

Once you have mastered this position, progress by positioning your forearms on the ball with the elbows slightly apart and hands together. To make the position more difficult, bring your feet together. Then try lifting one leg off the ground.

Plank and roll

Before you attempt this exercise, you should be able to hold the plank position on the ball for 30 seconds. Start out in the plank position on the ball. Roll the ball back and forth under you, keeping your hips and feet stable. Your body should stay in its original position and not move with the ball. Roll forwards and backwards 10-12 times for a set. Fun twist: Move the ball in a circular pattern, clockwise and counter-clockwise.

Push-up:

In a prone position, roll out on the ball until it is somewhere between your knees and feet. Think of the ball as a fulcrum: the further it is from the center of your body, the more challenging it is to do push-ups. Just as with conventional push-ups, it's important to keep your head, shoulders, back, hips and legs in alignment.

Start with one set of ten and work your way up to two-or-three sets.

Ball wall squat:

Start by leaning with your back against the ball, and the ball positioned in the small of your back. Your legs should be straight and feet slightly forward, so that your knees don't move forward of your toes when you squat. Slowly squat down until your knees form a ninety-degree angle, then return to a standing position. Start with one set of ten and work your way up to two-to-three sets.

To make this exercise more challenging, hold a medicine ball straight above your head when you squat. Doing so creates a longer lever, requiring you to use more muscles. It will also remind you not to bend forward when you squat, maintaining proper form.

Seated Ball Twists:

Sitting on the ball with feet shoulder width apart slowly rotate the torso to the left. Pause for a few seconds and then rotate toward the right, pausing at the end range of motion. These exercises can be made more difficult by moving your feet closer together or holding a weight in your hands. Eventually the weight can be held in front of the torso during the movements.

Seated Ball Chop:

A variation of the medicine ball woodchopper exercise, sitting on the ball with hands in front. Reach up and to the right with arms extended, and then reach down to the left. A medicine ball or small weight can be used for added difficulty. Perform this exercises both directions.

Moderate Hard Exercises

The foundation of exercises have to be mastered to move onto these exercises. Skipping steps will cost you later.

Single leg ball wall squats

Next, perform single leg squats. Once again, try and move slowly and controlled through the exercise while pausing at the bottom of the squat. Another form of the exercise is to squat and hold the position for 30 seconds before standing.

Split squats

Take a large forward step and keep your legs apart. Keeping your back straight, lower your waist toward the ground. Stop as it becomes too difficult to keep the back straight or maintain balance. Your knees should continue to point forward, and your waist should not rotate or wobble.

These squats are used as a transition to build strength and endurance toward a forward and backward lunge. For added difficulty, place a piece of foam or towel under one leg to make it more unstable.

Around the world

Around the world teaches you to stabilize your hips and knees while bending and twisting. Begin by marking three spots on the floor: one directly in front of you, one to the left (about 60-degrees from the front mark), and one to the right (also 60 degrees from the front mark). Stand on one leg and using an exercise ball, bend and reach for the left mark. Touch the ball to the left mark, middle mark and right mark, returning to a standing position between each ball touch.

You should touch each mark 3-4 times before switching legs and repeating the exercise. Performing the exercise on both legs constitutes one set.

Single leg squats

Standing on one leg with the other knee bent, keep your back straight as you squat downward, until the point where you want to hinge forward. Over time, you will be able to squat lower before hinging. Start squatting on the ground, then add unstable surfaces to increase the challenge.

Hamstring ball curl

Laying on your back with two feet on an exercise ball, lift your waist into the air. Next, pull your feet into the ball and roll it toward your waist. The harder you pull into the ball, the more stress will be applied to the hamstring muscles. After you pull the ball as far as you can, extend your legs as you maintain pressure into the ball. The exercise can be performed with two feet or a single leg.

Mountain climber

We do this exercise using the treatment tables, but you can do it at home using your bed (if the mattress is relatively firm) or a table. You can also do it at the gym using a flat weight bench. Begin in the plank position. If you do the plank correctly, your head, shoulders, hips and knees should form a straight line. It's important not to sag in the middle or raise your hips up too high so that you are angled at the waist. Drive one knee towards the table and move it back to the original position, then drive forward with the opposite knee. This exercise is about building power and strength, so move quickly, just as if you were climbing an actual mountain. Drive each knee forward ten times to complete a set.

Mountain climber on exercise ball

Before you attempt the mountain climber, you should feel comfortable performing the mountain climber on a bench or table as well as being able to hold a plank on an exercise ball for 30 seconds. To perform the mountain climber, get into the plank position on the ball. Kick one knee forward until it touches the ball, then move it back into place and kick with the other knee. Kick the ball 10 times with each knee for one complete set.

Forward ball tuck

Begin by rolling yourself forward on the exercise ball until the ball is under your feet and your arms are fully extended to the floor. This is similar to the position you would assume for push ups on the exercise ball. Move your knees to your chest: the exercise ball should roll forward under your legs and in the full-tuck position, be close to your hands. Extend your knees and roll the ball back to its original position. Repeat for a total of 10 tucks for a set.

Reverse ball tuck

This is a more challenging exercise for those who have mastered the ball tuck. Sit on an exercise mat and position the exercise ball under your feet. Your knees should be bent to about 90 degrees. Position your arms by your side so your hands are on the floor right next to your hips. Your hands should be slightly angled out from your body. Extend your arms fully so your hips are off the floor. Use your feet to roll the ball away from you until your legs are almost fully extended, then roll the ball backwards towards your hips. Roll the ball back and forth ten times, then lower your hips back slowly to the floor to complete a set.

Dips on the ball

This is a fun challenge for anyone who has mastered dips off of an exercise bench. By using an exercise ball, you need to work much harder to stabilize your hips and knees. Start by sitting on the exercise ball with your legs extended slightly out in front of your knees. Position your hands next to your hips with fingers facing forward. Carefully lift, push your hips up off the ball, move forward, and lower your hips towards the floor. Then push your hips up and back onto the ball. Complete 10 dips for a full set.

Anterior Plank

Lay on your stomach with your forearms underneath your chest. With your tip toes firmly on the ground, lift your waist and body off the ground. Keep your back straight as you create a straight line from your shoulders through the waist, knees and to the ankles. The tendency is to drop the pelvis or lift the butt in the air as you get tired. Hold the position to fatigue at first, then build up to 3 sets of 2 minutes.

Anterior plank exercises can be performed on your forearms or hands with elbows straight, like the top of a push up position. Moving the hands closer together makes the exercise harder, as does moving the feet closer together. Eventually you can perform a plank on one foot or hand. You can also place an exercise ball or BOSU ball under your hands or toes for added difficulty.

Lateral planks

Start by laying on your right side with forearm perpendicular to your torso. Lift your waist of the ground while keeping the side of your right foot on the ground. Your left foot will be on top of the right. Focus on keeping your body perpendicular to the ground, and not rocking forward or bending at the waist.

Start by holding the position to fatigue and then switching to the left side. Build up to three sets of 1 minute on each side.

Once again, the exercise can be made more difficult by placing an unstable surface under the hands or feet. Or add a weight to the free hand.

Push-up:

In a prone position, roll out on the ball until it is somewhere between your knees and feet. Think of the ball as a fulcrum: the further it is from the center of your body, the more challenging it is to do push-ups. Just as with conventional push-ups, it's important to keep your head, shoulders, back, hips and legs in alignment.

Clock exercise

Think of the face of a watch, not a digital clock. Standing on one foot with the raised foot held behind you, rotate as far as you can counter clockwise. Keeping your hands at your chest and your back straight, squat down as far as you can, maintaining form and balance. Like the hands of a clock, you are probably at the 8 or 9 o'clock position.

Slowly rotate clockwise one position and squat again. Work through all the positions of a clock dial that you can, and then repeat going counter clockwise.

Steps ups and downs

Early on we practiced stepping up on and down from a step or box. Increase the height of the box or make it a small jump. One of my favorites is to step as slowly as possible off the vibration platform, really focusing on trying not to touch the ground until it is absolutely necessary. Likewise, you can practice stepping up on the vibration unit backwards, trying to go as slowly as possible off the ground.

Medicine ball woodchopper:

Begin standing with feet shoulder width apart, holding the medicine ball straight out in front of you. Reach up and to the right with your arms extended, then bring the ball down and to the left, bending your knees for a full range-of-motion. Your back should remain straight and flexed slightly forward. Keeping the arms straight, bring the ball up on the left-hand side and fully extend your arms, now swing it down and to the right, bending the knees as you go. Ten "chops" in each direction is one set.

Rear medicine ball raise:

Grab the medicine ball behind your back. With your arms straight, lift the ball up towards the ceiling. Repeat for a total of ten lifts in a set.

Advanced Exercises

Many of the beginner and intermediate exercises can be made more difficult by adding an unstable surface. You can also hold a 5-10-pound weight during the exercises to further challenge the stabilizer muscles.

Vibration platforms make any of the standing exercises harder by knocking you continually off balance. The body has to work harder to maintain balance along with moving through the activity. At our office, we slowly incorporate most standing and squatting exercises onto the vibration plate. Most people are surprised how much harder the exercises become on the vibration plate.

BOSU & vibration single leg stance

Perform single leg stance exercises on the vibration plate. Maintaining balance on one leg while squatting is significantly harder on unstable surfaces. Start with standing on the rubber portion of the BOSU before turning it upside down. Then transition to squatting on the vibration plate.

Square dance vibration unit

Instead of just reaching forward, backward and to the side, this time you will reach as far as you can in all directions and squat at the same time. Squatting further challenges the hip and knee stabilizers, and the vibration plate magnifies the difficulty. This exercise will really expose your hip and knee stability weakness.

Rotational Movements on Ball or Vibration Plate

Standing with either two feet or one foot, squat downward while maintaining an erect posture; no hinging at the low back. With your hands in front of you, rotate to one side and then the other side. Once you get the hang of it, add a weight to your hands. The further you can hold the weight from your body, the harder the exercise becomes, especially on one foot.

Medicine ball wall squat:

In a knees-bent, squat position, push your back against the wall. Hold a medicine ball in your hands, With- your arms straight, raise the medicine ball up so it is in front of your chest. Hold the position for thirty seconds, working your way up to two sixty-second holds.

Jumping onto unstable surfaces

Landing on a variety of unstable surfaces further challenges the body's proprioceptive system. Jumping from and onto foam, wobble boards, rocker boards, vibration plates, and elevated surfaces is the next step in the progression. Click to read and see more examples.

Square jumps

Visualize a box six inches by six inches on the ground. With two feet together, jump from corner to corner. Start going clockwise and then switch to a counter clockwise direction. If you are stable and under control, begin jumping diagonally across the box. Over time, the box can get bigger and bigger. Transition from two-foot jumps to single leg.

Skier jumps

Standing on your right leg, jump laterally to your left and land on your left leg only. After establishing your balance, laterally jump to the right. Start jumping slowly and establish your balance before jumping the other direction. With improvement, jump further and faster.

Single leg jumps onto vibration plate

Standing on your right leg, jump forward onto the vibration plate. Land and regain your balance before jumping forward off the vibration plate and then quickly jumping forward again. After improving on the forward jumps, stand on the right side of the plate on jump laterally to your left, landing on the plate. Once again, regain full control before jumping laterally off the plate and onto the ground, quickly jumping to the left upon impact. Repeat the exercise jumping to the right. Once comfortable, you can attempt jumping backwards onto the plate and off.

Medicine ball woodchopper:

Begin standing with feet shoulder width apart, holding the medicine ball straight out in front of you. Reach up and to the right with your arms extended, then bring the ball down and to the left, bending your knees for a full range-of-motion. Your back should remain straight and flexed slightly forward. Keeping the arms straight, bring the ball up on the left-hand side and fully extend your arms, now swing it down and to the right, bending the knees as you go. Ten "chops" in each direction is one set.

Rear medicine ball raise:

Grab the medicine ball behind your back. With your arms straight, lift the ball up towards the ceiling. Repeat for a total of ten lifts in a set.

Lunge with medicine ball twist:

Stand with your feet slightly apart, holding the medicine ball in front of you. Lunge forward with the left leg, while swinging the medicine ball to the right. Return to the standing position while moving the ball back to midline. Repeat for a total of ten lunges and twists on each side.

Russian twist:

Start in a supine position (lying on your back) with your knees bent and feet on the floor. Grab the medicine ball between your hands and lift your feet off the floor. Curl up and twist to one side, then come back to neutral and twist to the other side. Twisting to each side ten times is a set.

Medicine ball pull-over:

Roll the ball out so you are supine with the exercise ball supporting your upper back. Hold the medicine ball between your hands and extend your arms straight up so the ball is above your chest. Keeping the arms straight, extend the ball so it is slightly in back of your head. Then move the ball back to the starting position keeping the arms straight. Repeat nine more times for a set.

Medicine ball "skull crusher":

Do this exercise with a spotter, since it involves lowering the medicine ball over your head. Roll out on the exercise ball supine until it is supporting your upper back. Holding the medicine ball between your hands, extend your arms so the ball is straight above your chest. Now bend your elbows and lower the ball towards your forehead. Straighten your arms until the ball is back at the starting position above your chest. Repeat nine more times for a set.

Medicine ball reverse crunch:

Lie supine on the mat, with your knees bent and feet on the mat. Grab the medicine ball between your knees and bring your knees up so that your thighs are at a 90-degree angle to your chest. Now bring the ball as close to your chest, holding it between your knees as possible. Move back to the overhead (90-degree angle) position and repeat an additional nine times for one set.

Time For Some Humility Exercises

Reverse plank:

Lie supine on the mat with your legs together and straight out in front of you. Bring your forearms and elbows to your side, and slowly raise your torso and hips off the ground so that your torso and legs form a straight line from the shoulders to the knees. Hold this position for 30-to-60 seconds. For a more challenging exercise, raise one leg off the floor while in the plank position.

Lower back strengthener:

Lie face down on the mat, with your arms straight and hands clasped behind you. Slowly raise your chest and shoulders off the floor and arch your back. Hold for a count of three and return to the starting position. Repeat nine more times for a set.

Teaser (with thanks to Greatist.com):

Start out in the supine position on the mat. Raise your head and shoulders off the mat and grab your knees. Extend your arms and legs out in a V-position. Bring your arms forward and hold them out straight in front of you so that they touch your legs. Raise and lower the legs three-to-five times, touching your hands to your legs each time.

Push-up and dips on the exercise ball:

You have already learned how to do push-ups on the ball in the basics section. To do a dip on the ball, start by sitting on the exercise ball with your hands near your hips, palms down and fingers facing forward. Slowly lift yourself up off the ball and lower your butt down towards the ground in front of it. Your knees should remain bent with your feet on the floor. Now using your arms (don't cheat with your legs), raise yourself back up onto the ball in the seated starting position.

To make this exercise challenging, do a cut-down alternating push ups and dips on the ball.

Forward and reverse tuck:

To perform the forward tuck. Start in a prone position and roll out on the exercise ball until the ball is underneath your lower legs, slightly ahead of your feet. Your body should be straight, with your head, shoulders, torso and legs in alignment. Now bend your knees and roll the ball towards your waist until you are in a tuck position.

Slowly roll the ball back out to the starting position.

The reverse tuck works opposing muscle groups. Begin by sitting on the ground with your legs straight out in front and feet resting slightly apart on the ball. Your hands should be next to your hips, palms down and fingers either to the sides or facing front. Raise your butt off the ground and slowly roll the ball towards you, bending your knees as you go. Return the ball to the starting position.

This superset is a cutdown, alternating forward and reverse tucks.

Mountain climber and glute bridge:

You will have learned about the glute bridge in the basics section.

The mountain climber on an exercise ball is a variation on the ball plank. Once in the plank position, kick one knee towards the ball, then move it back to the plank position and kick the other knee forward. You should move your legs quickly, similar to running up a hill.

Alternate the mountain climber and glute bridge for a superset that works the pelvis, abdominal and leg muscles.

Plank with leg extension; medicine ball raise and touch:

We mentioned the plank with leg extension briefly in the basics section. From the plank-on-ball position, slowly raise one leg behind you, keeping the leg straight, and then lower it back to the starting position. Alternate leg raises.

To perform the medicine ball raise and touch, start out supine on the mat. Grab the exercise ball between your feet and lower legs and raise it straight up, so that your legs (and the ball) are at a ninety-degree angle to the floor. Grab the medicine ball between your hands and curl up so the head and shoulders are off the floor. Touch the medicine ball to the exercise ball, bring it back down to the starting position and repeat.

This superset cut-down works the full body.

Plank-and-roll, rear medicine ball raise:

To learn how to perform the rear medicine ball raise, refer to the basics section. The plank-and-roll begins with the basic plank-on ball position. Once in the plank, slowly roll the ball forwards and back. Alternate this with the rear medicine ball raise to work the core and upper body muscles.