Transversus Abdominis Retraining
- The patient is lying on their back with the hips and knees flexed and feet flat on the table.
- Have the patient place their hands on both sides of the lower rib cage.
- Ask the patient to find a neutral lumbar spine by rolling the pelvis towards 6 and 12 o’clock and finding the midpoint in the range.
- Instruct the patient to draw the belly in without flattening their lower back maintaining a neutral lumbar spine. The patient monitors the ASISs to make sure that they remain level throughout this exercise.
- Instruct the patient to slowly inhale through the nose allowing their lungs to fill with air as the rib cage expands out to the sides as they draw the navel in. Their chest and shoulders should remain relaxed and they should not feel that their belly pushes out or that the lower ribs are pulled down and medially by the obliques which can often substitute with transversus abdominis dysfunction.
- The patient exhales through pursed lips and allows the ribs to fall down and in. Their upper chest should continue to remain relaxed.
- If they are having difficulty recruiting the transversus have them blow out as much air as possible during exhalation using their abdominal muscles to assist and hold for 3-5 seconds. Then have them slowly inhale while continuing to draw the belly in and hold for 10 seconds.
- Have them repeat up to 10 times holding for 10 seconds each time.
