By Jerry H. Hall

There is also a significant body of work demonstrating the importance of the deep abdominal musculature in providing trunk stabilization, particularly the transverse abdominals and obliques.

Unless otherwise specified, a neutral alignment of the spine should be maintained when exercising. This is especially critical when it comes to the lumbar spine. The key is to try to prevent the core musculature from disengaging and allowing a hyperextension of the lumbar spine during compression or flexion loading.

A ‘neutral spine’ is preferred when exercising, although occasionally we will ask for a posteriorly tilted pelvis during specific movements, like a push-up or roll-out. This is done to teach preferential recruitment of specific musculature and safety. After proper core stabilization is mastered during the exercises, we no longer insist on a posterior pelvic tilt during the execution prone exercises.

Robinson defines a neutral spine as ‘a position or range of movement defined by the patient’s symptoms, pathology, and current musculoskeletal restrictions. It is a position in which a vertical force exerted through the spine allows equal weight transference to the weightbearing surfaces (e.g. in sitting – the ischial tuberosities, in standing – the feet).’ It should be noted that a neutral spine is an ideal concept, defined differently by various authorities. A neutral spine is also different from person to person, therefore don’t get too caught up the ‘exactness’ of the definition and just use the concept!

When suspended in prone positions that load flexion of the spine (e.g. push-up or roll-out position), an attempt to maintain a posterior pelvic tilt engages the lower abdominals and prevents the lumbar spine form hyper-extending. Although maintaining a ‘neutral spine’ position during such exercises will provide adequate protection to the lumbar spine, the position is ‘too close for comfort’ and can easily result in lumbar hyperextension in a fatigued state. Especially for beginners, a posterior pelvic tilt provides better stimuli to the lower abdominals and hip flexors, and affords ‘more room for error’. If you look at most of our clients exercising in a prone position, you will see a natural line at their lumbar spine.

With the exercise ball, an element of instability is introduced to the exercise that one would not normally get in a floor exercise. The body responds naturally and automatically to this instability to keep balanced on the exercise ball. Over time, the muscles used to keep in balance on the Swiss ball become stronger. In essence, individuals build strength in important back muscles and abdominal muscles without knowing it.

The exercise ball also uses what is called ‘proprioception,’ an awareness of where one’s hand, or foot, is in relationship to space. The instability of the exercise ball provides the body with constant opportunities to evaluate its orientation in space, developing and training the body’s natural awareness. Enhanced proprioception provides the body with increased balance and stability.

The exercise ball is a great tool for strengthening those hard-to-get-to muscles (such as the TVA and erector spinae), as well as improving your balance and overall coordination.

About the Author: The Balance Ball has had long-standing success in the world of clinical rehabilitation. Find out How the Balance Ball can Improve your Fitness at

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