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How to Start an Exercise Ball Program

Many treatment programs for low back pain or sciatica incorporate use of an exercise ball to strengthen the core muscles in the stomach and back that support the spine.

Using an exercise ball for strengthening is clearly an effective way for people with lower back pain problems to rehabilitate the spine.

Exercise ball program

An exercise ball program helps to strengthen and develop the core body muscles that help to stabilize the spine. Read: Exercise Ball Therapy for Lower Back Pain Relief

For many, however, it is difficult to get started using an exercise ball. This article provides several simple steps to get familiar with an exercise ball and benefit from using it on a regular basis. Once the following activities have become routine, more sophisticated exercises can be incorporated into the exercise ball program.

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Sitting on an Exercise Ball

Simply sitting still on an exercise ball is an exercise as it requires the core body muscles to work to hold the body upright and balanced on the ball. It can be easier to get started sitting on an exercise ball if it is not fully inflated — a slightly deflated exercise ball is more stable.

Here’s how to sit on an exercise ball:

  • Sit in the center of the ball with both feet firmly on the ground about shoulder width apart. If it is difficult to balance on the ball, use a wider stance.
  • The knees should be at a 90-degree angle and in line over the ankles.
  • Shoulders should be in line over the body (not hunching forward) and the head squarely over the neck (not leaning forward)

One can easily sit on the exercise ball while working at a desk or computer workstation and use it as an alternative to a traditional office chair. Others prefer to sit on it while watching television. Whatever the use, sitting on an exercise ball at some point of the day is helpful to strengthen the core muscles that support the spine.

See Office Chair: Ergonomic Chair Alternatives to Traditional Office Chairs

Once sitting upright on the ball becomes comfortable, it is time to try some activity on it.

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Bouncing on the Exercise Ball

A common beginning exercise is bouncing on the ball. This exercise sounds easier than it is. The challenges are keeping the body’s muscles engaged and maintaining one’s balance.

Here are a few points to keep in mind during this exercise:

  • Try doing some light bounces on the ball, moving up and down about one inch.
  • Keep the core muscles engaged by pulling the belly button inward towards the spine when moving up and down.
  • People new to exercise ball strengthening should begin by learning simple stretching and movement in order to get comfortable on the ball.

Beginning Exercise Ball Stretches

There are several stretches that are easy to do when starting to use an exercise ball. Importantly, these stretching exercises help with proprioception, or the sense of the position or parts of the body relative to the rest of the body, and with balance.

See Stretching for Back Pain Relief

Move the hips from side-to-side:

  • Keep the knees still and place hands on the knees.
  • Move the hips gently from side-to-side.
  • Pause for a second at the end of each sideways movement to allow for a gentle stretch.

Move hips from front-to-back:

  • Sit on the exercise ball, with feet flat on the ground and shoulder-width apart. Bend knees bent at a right angle and align above the feet.
  • Keep the knees still and place the hands on the knees.
  • Rotate the hips forward by tucking the buttocks under the pelvis, and then push the buttocks out behind the pelvis.

The motion for the above stretches should be limited to the hip area, not the knees or chest.

Each of these stretches should be done slowly 8 to 12 times.

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Beginning Exercise Ball Routines

The following two simple exercises are examples of how to use the exercise ball to help strengthen the stomach and low back muscles. Both are simple to do and are gentle on the back.

Ball Marching

Marching on the ball is a great beginner’s exercise ball routine.


  • Sit on the exercise ball, as described above.
  • Lift the heel of one foot off of the floor.
  • Move onto the toe, eventually lifting the whole foot up in the air.
  • Hold this position for one second, and place the foot back onto the floor.
  • Repeat this exercise on the other side.

Notice how the stomach muscles contract to lift the foot off the floor.

Ball Squat

The exercise ball squat is a safe, effective way to start an exercise ball routine.

Exercise ball squat

  • Stand with the feet shoulder-width apart.
  • Place the exercise ball against a wall and aligned with the lower back. Press the ball between the lower back and the wall.
  • Move both feet out so they are slightly in front of the hips.
  • Bend the knees down slightly, then up.
  • Start with a small movement and hold for one or two seconds in the down position and up position.

Each of these stretches should be done slowly 8 to 12 times.

Remember, for beginners, using a slightly deflated exercise ball provides more stability than a fully inflated ball and may be more comfortable.

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Work with a Physical Therapist or Other Qualified Professional

Before getting started with exercise therapy, it is recommended to work with a qualified professional, such as a physical therapist, a doctor or an exercise physiologist.

A professional can help:

    • Determine an appropriate workout out routine. A professional can tailor exercise ball stretches and exercises to fit an individual’s condition and abilities. For example, an athlete may be able to perform more challenging exercises or higher repetitions of exercises than an adult who is new to exercising and has just had an epidural steroid injection for sciatica.

See Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica

    • Perform the exercises correctly. It is surprisingly difficult to develop and maintain the correct form during these exercises, and strengthening exercises need to be done correctly in order to be effective.

See Strengthening Exercise Program for Low Back Pain Relief

    • Keep a person motivated to maintain the therapy. In order to reap the benefits of these strengthening exercises, it is necessary to do them regularly over time. Working with a professional makes the individual feel accountable.
    • Determine the correct size ball. Exercise balls vary in size, typically ranging between 45cm to 85cm in height.1 Using the correct size ball is important for the exercises to be beneficial and to help prevent injury.

See Choosing the Right Exercise Ball

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