Ask the experts
Can you suggest some safe core exercises for someone with an enlarged spleen?
Doctor's response
Check with your doctor before you do any of these exercises. An enlarged spleen can be serious, and your doctor should give you the okay before you start any exercise program.
"Core" exercises have been the buzzword for some time. Although humans have been using their core muscles since the beginning of time, exercise scientists, physical therapists, fitness trainers, and others have recently been pushing the virtues of exercising the core. What is the core? The core is loosely defined as the spine, abdomen, pelvis, and hips, and the muscles that support these structures for posture and movement. More than 30 different muscles may be involved. Some of the main core muscles are the erector spinae (located in your back along your spine), the internal and external obliques (the sides of your abdomen), the transverse abdominis (located deep in your gut, this muscle pulls your belly button in toward your spine), the rectus abdominis (the "six-pack"), and hip flexors (in your pelvis and upper leg). These and many other muscles team up to support and stabilize your body when you walk, run, and do many other activities. Although there isn't a large body of research at this time, the evidence that exists suggests that a strong core can help control movement, improve posture, protect the low back, hips, and even knees from injury, and provide a more stable center of gravity and base for movement.
Importantly, core muscles work best when they work together. For example, a golfer who has a strong core may swing the club better if all the muscles in his abdomen, low back, and hips, work synergistically. If his low back muscles don't work in unison with his abs and hips, then the swing might be off. The same holds true for all other sports movements, recreational exercise, and even activities of daily living like pushing a grocery cart, opening a heavy door, or carrying a package.
How do you get the core muscles to work together? Here are some tips:
- Identify effective core exercises that work the muscles together.
- Do the exercises slowly, focusing on the muscles as you do them.
- Don't hold your breath while doing them. Instead, breathe slowly in and out through your nose and mouth. There is no reason to breathe just through your nose.
- Work hard on each exercise, and then move on to the next exercise when you are tired or lose your concentration. You want to maintain focus throughout the exercise to maximize the benefit.
Below are 10 of the best core exercises starting with gentle to more intense. In all of them, take your time and focus on your core muscles: the abdomen, hips, and back. Do them slowly so you can feel the core muscles working, and hold each for five to six seconds unless instructed otherwise. Do eight to 12 repetitions and one to three sets for each exercise.
1. Crunch:
- a. Lie on your back with feet on a chair or the wall.
- b. Keep your knees at 90 degrees.
- c. Put your hands across your chest.
- d. Pull your belly button in to activate the deep abdominal muscles.
- e. Raise your head and shoulders slowly off the floor, pause one to two seconds, then return to the floor.
2. Quadruped (sometimes called Bird Dog):
- a. Start on your hands and knees.
- b. Lift your left leg straight back, then your right leg.
- c. Now try lifting your left leg and right arm at the same time, then switch.
3. Superman (You've done this if you practice Hatha Yoga.):
- a. Lie on your belly (you can use a small pillow or rolled-up towel under your hips for support).
- b. Lift your right arm and left leg off the floor.
- c. For a more advanced exercise, lift both arms and both legs off the floor simultaneously. You can start with arms at your sides and then progress to the arms overhead.
4. Plank (primary muscles are back, abs, and legs):
- a. Lie on your belly with your forearms flat on the floor alongside your shoulders.
- b. Lift your hips off the floor with your back straight so that you are resting on just your forearms and your toes.
- c. Focus on the muscles in your hips, abs, and low back (those are your core muscles working).
- d. Hold for five to six seconds.
5. Modified Plank (If you can't do the plank in #4 above, try this modified version.):
- a. Start in the same position as the plank.
- b. Lift only your torso off the floor so you are resting on your forearms and your knees.
- c. Hold for five to six seconds, again focusing on the core muscles.
6. Side Bridge (Primary muscles are obliques in the abdomen and spinal muscles.):
- a. Lie on your side, leaning on your elbow and forearm.
- b. Lift your body off the floor so you are resting on your forearm and side of your foot.
- c. Hold for five to six seconds.
- d. Repeat on the other side.
- e. You can make this harder by lifting up on your hand instead of your forearm.
7. Side Bridge Advanced:
- a. Repeat the side bridge as above but lift the upper leg (the one on top) straight up.
8. Glute Hold or Wrestler's Bridge:
- a. Lie on your back with hands at your side or across your chest.
- b. Put a rolled-up towel under your neck if you need support.
- c. Squeeze your gluteals (buttocks) and abs and then lift your hips off the floor.
- d. You should be holding your body up with your shoulders and heels on the floor.
- e. Stop the exercise and stretch your hamstrings if the back of your legs cramp.
9. Alternating Crunch:
- a. Lie on your back with knees bent, hands along side your head.
- b. Crunch your torso up slowly, and lift your legs off the floor.
- c. Twist your torso so that your right elbow moves toward your left knee while you pull your left knee toward the right elbow. You are attempting to touch the left elbow to the right knee. Then repeat the other way.
- d. For an easier version, you can do these while sitting on the end of a bench.
10. One-Leg Balance:
- a. Stand on one leg while keeping the abdominals contracted and hands behind back.
- b. Bend forward until your torso is parallel to the floor.
- c. Return to starting position.
- d. Remain still while doing this and feel the muscles throughout the abdomen, sides, and back.
Core exercises can also be done with a physioball (those big colored balls you see in all the gyms). Here are some terrific core exercises with a ball.
1. Knee Drops:
- a. Lie on your back.
- b. Lift your legs with the ball between your feet, knees bent.
- c. Drop your knees slowly to one side trying to keep your shoulders flat on the floor.
- d. Engage the abdominal muscles and lift the knees back up and over to the other side.
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REFERENCE:
"Approach to the adult patient with splenomegaly and other splenic disorders"
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