ARTICLE IN PRESS

Journal of Bodywork and Movement Therapies (2009) 13, 112–113

Journal of Bodywork and Movement Therapies

www.elsevier.com/jbmt PREVENTION & REHABILITATION Self-management: Patient section The New Abds$

Petra Valouchova´, P.T., Craig Liebenson, D.C.Ã

L.A. Sports & Spine, 10474 Santa Monica Blvd., #304, Los Angeles, CA 90025, USA

Received 10 September 2008; accepted 11 September 2008

Introduction abdominal muscles. This is important since in daily life—e.g. bending, lifting, pushing, or pulling People have always been infatuated with abdom- activities—we do not isolate our abdominal mus- inal . Not only amongst the fitness elite, cles from the rest of our body, but instead we but even sedentary people want a flatter tummy! integrate the abdominals, arms and legs. Whether it is for cosmetic purposes or to protect This integrated function is even more evident against back pain abdominal exercises have prob- when we perform sports like volleyball, skiing, ably drawn more attention than any other ex- European football, or tennis where the core keeps ercises. the torso rigid and stable so the arms or legs can One abdominal in particular, the sit-up, push or pull to generate power or absorb force. has become the most famous. Unfortunately, with When the abdominal muscles keep the torso rigid all the attention and effort a common complaint and stable this is called an ‘‘isometric’’ contraction heard in spine care centers is ‘‘I don’t understand because the trunk is not moving, but being held why my back hurts. I do a hundred sit-ups every stiff. The exercise shown here trains this isometric morning.’’ function of the abdominal muscles which is so A major problem with this common exercise is important to prevent back injury during activities that the sit-up places a high level of stress on the as well as to enhance sport performance. discs of the low back. Additionally, the morning is a vulnerable time for the back since the discs are normally a little swollen after being recumbent all Procedure night. Finally, the spine may not be warmed-up first thing in the morning.  Lie on your back with your head about one foot A safe alternative to sit-ups is shown here. This is from the wall a functional in that the arms J If necessary put a small pillow or folded towel and legs are active at the same time as the under your head for slight support  Place your palms against the wall while being sure your elbows are slightly bent $This paper may be photocopied for educational use. ÃCorresponding author.  Lift one leg up at a time until both feet are E-mail addresses: [email protected] ( Petra Valouchova´), in the air with your knees bent as pictured [email protected] ( Craig Liebenson). (see Figure 1)

1360-8592/$ - see front matter & 2008 Published by Elsevier Ltd. doi:10.1016/j.jbmt.2008.09.002 PREVENTION & REHABILITATION ARTICLE IN PRESS

Self-management: Patient section 113

Figure 1 Functional abdominal exercise—start position.

Figure 2 Functional abdominal exercise—alternate heel tapping.

 Next, push away from the wall with your hands your breath in or exhale vigorously. Just continue (don’t actually move your body as this will be to breath normally what is called an ‘‘isometric’’ effort’’  Finally, while continuing to push away from the J You should instantly feel your abdominals wall, feeling your ribs move down, and main- tighten in the front and sides along with your taining a normal breathing pattern begin lightly back muscles so that you have 360 1 of support tapping the floor with one heel at a time (see or tension Figure 2). J Notice how when you do this your lower ribs above your belly move down towards your Repetitions: Perform this until you have alter- – This is an isometric version of the famous nated tapping the floor with each heel between 8 ‘‘’’ exercise and 12 times.  While pushing away from the wall and feeling Sets: Rest for a few seconds and then perform your ribs move downward be sure to maintain a 2–3 additional sets. normal in and out breathing pattern. Do not hold Frequency: This should be performed 1–2 Â /day. PREVENTION & REHABILITATION