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So how do we contract the Transversus & Multifidus muscles?
The most effective ways to learn how to contract these muscles is to kneel on all fours. Once in position, relax and allow the stomach to sag down with gravity. To contract Transversus Abdominus now, all you need to do is very gently pull in your tummy so that your belly button moves closer to your spine.
It is important not to contract too hard, otherwise you will be using muscles other than the ones we are concerned with - don't contract your 'six pack' muscles. Also, don't confuse this exercise with breathing in and sucking your tummy in - you should be able to hold the contraction while continuing to breath and have a conversation.
It is difficult at first but once you have mastered the technique it should become second nature. The Stabiliser Pressure BioFeedback Device is a great tool that allows you to see if the technique is correct. The contraction should be held for 4 seconds and repeated 20 times. Then, as your technique improves, increase the contraction hold to 10 seconds. Eventually you should be able to hold the contraction indefinitely.
At this stage you should be able to move to different positions, such as sitting in a chair or standing up, and still be able to contract the deep stabilising muscles. Although it seems strange at first, once the muscles have been recruited, you will not have to concentrate on them and they will contract automatically, thus improving your posture and lumbo-pelvic stability.
As a progression from the core stability exercises, core strength should be addressed. These form a part of the conservative rehabilitation phase, so the patient should be familiar with these exercises. The individual exercises and their progression are described later in the post operative phase.
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