A medicine ball is a great tool to use to improve muscular control and coordination. It also helps to improve balance and dynamic flexibility, two attributes that are important in preventing injury if you have to "catch yourself" from a potential trip-and-fall situation. Furthermore, medicine ball training is a great option for those individuals who want to build strength but have physical limitations/conditions, such as rheumatoid arthritis, that make it difficult to grasp hand held weights or resistance bands. Below are some exercises that will help you to build upper body strength and overall core stability. The weight of the ball that you choose should be heavy enough to challenge your muscles, but not so heavy that form and technique are compromised.

Overhead Lunge - works shoulder, triceps, abdominal, back, hip, buttocks, and thigh muscles

Step One: Stand with feet shoulder width apart and ball level with your navel.

Step Two: Lunge forward with your right leg, making sure to keep your abdominal muscles tight. At the same time, extend your arms above your head. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions per side.

Reverse Wood Chop - works shoulder, obliques, abdominal, hip, thigh, buttocks, and back muscles

Step One: Stand with feet shoulder width apart, knees bent, and torso twisted to the left with the ball slightly behind your left hip.

Step Two: In a quick, but controlled, motion raise the ball diagonally upward toward the right while extending the legs to assume an upright position. The motion should end with your arms extended over your right shoulder. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions per side.

Lateral Raises - works shoulder and triceps muscles; challenges core muscles

Step One: Stand with feet shoulder width apart, knees slightly bent, and ball slightly below your navel.

Step Two: While keeping your abdominal muscles tight and your back straight, extend your arms until you have raised the ball to shoulder level. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions.

Triceps Extension - works triceps muscles; challenges core muscles

Step One: Stand with feet shoulder width apart, knees slightly bent, and the ball held behind your head.

Step Two: While keeping your abdominal muscles tight and your back straight, extend your arms upward until the ball is above your head. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions.

Helpful Hints

• The reverse wood chop, lateral raise and triceps extension exercises can be performed while in the seated position.
• Remember to breathe when performing the exercises, exhaling as you lift the ball.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

The use of medicine balls (weighted balls) originated in Europe where they were used to improve muscular function in older rehabilitation patients. Their use in the United States became prevalent when Admiral Joel Boone, the White House physician for President Hoover, developed a game known as Hoover Ball to maintain the President's fitness. The medicine ball lost some of its popularity as interest in weight training with machine and free weights increased. In recent years, medicine ball training has made a come back in school, home, rehabilitation, and fitness center settings due to its versatility and adaptability. A countless number of exercises of varying degrees of difficulty can be performed by individuals of all ages and fitness/skill levels. Medicine balls come in different sizes (baseball to basketball) and weights (1-30 pounds). They can be "lifted" to improve strength and stability or thrown to improve power.

Benefits of Medicine Ball Training

• Develops functional fitness, muscle coordination, and core strength. To perform the exercises, your body must perform as a unit. Therefore, the effects of this type of training can be carried over to improve performance of activities of daily living.
• Increases muscular strength and endurance.
• Improves balance.
• Improves flexibility and range of motion.
• In the athletic setting, drills can be performed that mimic movements during a particular sport to help increase power and agility. For example, a drill that involves chest passes with a weighted ball can increase the force with which the athlete passes the basketball during a game.
• Exercises can be designed to be performed alone (e.g., walking lunge) or with a partner (e.g., chest pass).
• Exercises can be modified to account for functional capacity of the individual (e.g., performed seated in a chair rather than in an upright position).

For a change of pace in your workout, try these medicine ball exercises:

Walking Lunge - develops abdominal, thigh, hip, back, shoulder, and triceps muscles

Step One: Stand with your feet shoulder width apart and the ball level with your navel.

Step Two: Lunge forward with your right leg while twisting your upper body to the right, bringing the ball to the right and slightly behind your right hip. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions per side.

Lateral Flexion - targets obliques and works lower back and shoulder muscles

Step One: Stand with feet shoulder width apart. Hold ball above your head.

Step Two: Slightly bend at your waist to the left while keeping the ball above your head. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions per side.

Squats - works entire core, thigh and upper arm muscles

Step One: Stand with your feet shoulder width apart and knees slightly flexed. Your arms should be bent with the ball at chest level.

Step Two: While tightening your abdominal muscles and keeping your back straight, bend at the knees to assume a squatting position. At the same time, push the ball out in front of you. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions.

Russian Twist - works entire core

Step One: Stand with feet shoulder width apart. Hold the ball at waist level, slightly behind your left hip.

Step Two: Swing the ball across your body to just behind your right hip. Then, swing back to the left side. Perform 2-3 sets of 10 repetitions (one full repetition includes swinging to the left and right). Your abdominal muscles should be tight throughout the exercise. Rotating your back foot will increase your range of motion.

Helpful Hints

• Lateral flexion and russian twists can be performed in a seated position.
• Do a 5 minute warm-up prior to training with a medicine ball.
• Start with a lightweight ball. As fitness improves heavier balls can be used.
• Perform medicine ball exercises on 2-3 nonconsecutive days of the week.
• Focus on technique while performing the movements in a slow controlled manner.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

ACSM's Health & Fitness Journal, Vol. 12, No. 3; pp.7-12. "Medicine Ball Training For Kids: Benefits, Concerns, and Program Design Considerations," Faigenbaum, A.D. and Mediate, P.

     It is important to perform core strength and balance exercises in positions other than an upright stance.  Positions such as kneeling alter your center of gravity.  This challenges your brain to adapt to a different pattern of weight distribution.  Practicing the exercises below will help you to participate in physical activities that require a kneeling position, such as gardening.

Pushup Plank/Two Point Balance - works glutes, shoulders, upper arms, and lower and upper back muscles; engages core stabilizers

Step One:  Keeping your back straight and your head in line with your spine, assume the pushup position on the disc.  Your hands should be slightly wider than shoulder width apart.

Step Two:  Tighten your abdominal muscles and extend one leg behind you.  Concentrate on contracting your glutes as you lift your leg.  Your lower back should not be arched.  Hold for a count of two.  Slowly bring your leg back to the starting position.  Repeat.  Perform 2-3 sets of 10 repetitions per leg.

Kneeling on all Fours - works glutes, back extensors, and shoulder extensors; engages core stabilizers

Step One:  Kneel on the disc with your knees shoulder width apart and placed at its center.  Your hands should be flat on the floor in front of you.

Step Two:  While tightening  your abdominal muscles and contracting  your glutes, extend one leg behind you.  Hold for a count of two.  Slowly return to the starting position.  Repeat.  Perform 2-3 sets of 10 repetitions per leg.

Alternate/Challenge:  Follow the instructions for Step Two, but extend your opposite arm as you extend your leg.  Hold for a count of two.  Repeat.  Perform 2-3 sets of 10 repetitions per arm/leg combination.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

     Everyone can benefit from incorporating core and balance training into their exercise routine.  These exercises can be performed on alternate days and/or on rest days from your aerobic activity.

Seated Balance - works abdominal, obliques, hip flexors, and lower back muscles

Step One:  Sit on the center of the disc.  Your knees should be bent with your feet flat on the floor.  Your arms should be raised out in front of you.

Step Two:  While tightening your abdominal muscles, slowly lean back raising your feet off of the floor.  Hold for a count of two.  Slowly return to starting position.  Repeat.  Perform 2-3 sets of 8-10 repetitions.

Stepping - engages all stabilizers.  The purpose of this exercise is to train your body to make adjustments when you transfer from one medium to the next (e.g., from solid floor to unstable balance disc; sidewalk to grass).

Step One:  Stand in front of the disc with your eyes fixed straight ahead.

Step Two:  Step onto the disc with your right foot, placing it just to the right of the center. 

Step Three:  Step onto the disc with your left foot, placing it just to the left of the center, so that your feet are shoulder width apart.  Hold for a count of two.

Step Four:  To dismount, step back with your right foot then with your left foot.  Repeat.  Perform 2-3 sets of 10 repetitions per lead foot (e.g., 10 reps stepping with right foot first, then 10 reps stepping with left foot first).

Knee to Chest - works glutes and hip extensors; engages all stabilizers

Step One:  Stand in front of the disc with your arms extended in front and your knees slightly flexed.

Step Two:  Step onto the disc with your right foot.

Step Three:  While slightly flexing at the hips, bring your left knee up toward your chest.

Step Four:  Bring left leg back behind you, stepping onto the floor.  Then step back off of the disc with your right foot.  Repeat.  Perform 2-3 sets of 10 repetitions per lead leg (e.g., perform 10 reps with stepping with your right leg first, then 10 reps stepping with your left leg first).

Alternate Style:  When lifting your knee toward your chest, bring your arms down to your sides.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

     Developing core strength and improving your balance are key to being functionally fit.  You may recall from my article, "Are you Fit to Function?," that the goal of a functional fitness exercise program is to train your body for the routine and customary movements of daily life situations.  A key element of functional fitness training is that it concentrates on developing muscle integration throughout the body during an activity.  Performing core strength and balance exercises on a balance disc or BOSU balance trainer, such as the ones demonstrated below, will help you to achieve functional fitness.  If this is your first attempt at incorporating core strength and balance exercises into your routine, you may find it easier to do these exercises without the balance disc.  You can incorporate the disc as your balance improves.  These exercises can also be performed using a step aerobics step/platform instead of a balance disc.

Single Leg Squat - works glutes, hamstrings, quadriceps, hip adductors, and spinal extensors; engages core stabilizers (abdominal muscles)

Step One:  With your arms out to the side to maintain balance, stand with one foot on the disc.  Your opposite leg should be slightly flexed at the knee.

Step Two:  Tighten your abdominal muscles (to stabilize spine).  While bringing your arms out to the front, slowly lower yourself into a one-legged squatting position by flexing at the hips, knee, and ankle.  Hold for a count of two.  Slowly return to starting position.  Repeat with opposite leg.  Perform 2-3 sets of 10 repetitions per leg.

Side Lunge Toe Tap - works glutes, quadriceps, hip adductors and abductors; engages core stabilizers (abdominal and lower back muscles)

Step One:  Stand on the disc with feet shoulder width apart and arms out in front of your body, flexed at the elbow.

Step Two:  Slightly flex at the hips while you lunge to one side and tap your toes to the floor.  Step back onto the disc.  Repeat with other leg.  Perform 2-3 sets of 10 repetitions per leg.

Single Leg Balance - works glutes, hip adductors and abductors; engages core stabilizers (abdominal and lower back muscles)

Step One:  Stand with one foot at the center of the disc and one off to the side.  Arms should be raised to the sides to form a T.

Step Two:  Tighten your abdomen (to stabilize the spine) and raise your leg to the side.  Hold for a count of two.  Slowly return to starting position.  Repeat.  Perform 2-3 sets of 10 repetitions per leg.

Squat - works glutes, hamstrings, quadriceps, hip adductors, and spinal extensors; engages core stabilizers (abdominal muscles)

Step One:  Stand on the balance disc with feet shoulder width apart.  Knees and hips should be slightly flexed.

Step Two:  Tighten abdominal muscles (stabilizes spine) and lower into a squatting position by flexing at the hips, knees, and ankles.  Raise arms forward to maintain balance.  Hold for a count of two.  Return to starting position.  Repeat.  Perform 2-3 sets of 10 repetitions.


     When performing these exercises, it may help to focus on an object straight ahead to help you with maintaining your balance.  Remember to breath during the activity, exhaling as you contract your muscles and inhaling as you return to the starting position.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

     Functional fitness has once again been named as one of the top trends in the fitness industry by an international survey published in the November/December 2008 issue of ACSM's Health & Fitness Journal.  Functional fitness workouts are designed to help you perform everyday movements and tasks such as lifting a laundry basket or carrying your luggage with greater ease and efficiency.  A key element of functional fitness training, and one that differentiates it from traditional machine-based muscle conditioning exercises, is that it concentrates on developing muscle integration throughout the body during an activity.  That is, it strengthens and trains various muscle groups of your body to work together to carry out a task.  

     Traditional machine-based muscle training isolates a muscle group through a fixed range of motion.  It doesn't "teach" the muscle to work with other muscles in the body.  Consider the tasks you perform throughout the day and the muscles involved in carrying them out.  How often do you use one muscle group or bend at one joint to perform a daily task?  Although traditional methods build muscular endurance and strength, the carryover into everyday activities, which require different muscle groups to work together, is not as great as it is with functional fitness training.  Think in terms of a seated biceps curl machine. Your torso and arms are stabilized against pads, your lower body is inactive and the only joint being used is that of the elbow.  Contrast this against lifting a bag of groceries in which you not only need to recruit your biceps muscles to lift the bag, but you need to activate your leg muscles by squatting and engage your abdomen and back muscles to stabilize your spine while performing the lift.  All of these movements need to be coordinated in order to prevent strain and injury.

     The goal of a functional fitness exercise program is to train your body for the routine and customary movements of daily life situations.  To serve this purpose, these types of exercises consist of multi-joint/multi-muscle activities that involve coordination of upper- and lower-body movements.  Disciplines such as Pilates and Yoga fall under the functional fitness category.  A variety of equipment can be used to develop functional fitness as well such as weighted balls (medicine/kettle balls); balance discs, boards, and balls; resistance bands and tubing; and step boards.  However, you do not need special equipment to improve your functional fitness. 

     Using one's own body weight, especially if you are starting a functional fitness program for the first time, can improve your ability to perform everyday tasks with ease.  Examples of exercises that teach your body to support its own weight include push-ups (can be done against the wall or countertop if unable to do "traditional" push-ups), squats, and lunges.  Activities such as balancing on one foot, performing one-legged squats, and standing leg abductions and adductions can promote balance and muscle coordination needed in everyday life.

     Does this mean you should eliminate all forms of traditional exercise in your quest to achieve functional fitness?  No.  Traditional means of gaining and maintaining fitness have their place, and a very important one at that.  Aerobic activities such as walking and biking help to build cardiovascular endurance and weight lifting with machines can lay a solid foundation of strength upon which to build.  

     As stated by Shelley Rubinstein, Co-coordinator of the Optimal Aging Program - a medically-based program promoting fitness in healthy adults 60 years of age and older - at William Beaumont Hospital's Beaumont Health Center in Royal Oak, "Exercise in general improves function".  What do we need to function independently?  The ability to "reach, bend, carry and lift" according to Rubinstein.  "Simulating those moves [in your exercise routine] helps to strengthen muscle memory" explains Rubinstein.  Muscle memory, also known as motor memory, involves performing a particular activity repeatedly over time so that your muscles "learn" the movement and it becomes automatic.  Performing the above movements in your exercise routine will carry over into your day-to-day activities improving your ability to function in real-life situations.  An ideal exercise program is one that incorporates a variety of modes and methods to develop a body that is capable of meeting the demands placed on it throughout life.

Resources:

ACSM Fit Society Page Summer 2006 pp. 3-4, "Exercising for Functional Fitness". Yoke, M.

ACSM's Health & Fitness Journal VOL .12/NO. 6, pp. 7-14. "Worldwide Survey Reveals Fitness Trends for 2009". Thompson, W.R.

www.webmd.com WebMD Feature Article "Working out for Real Life Functions". Shaw, G.

William Beaumont Hospital's Optimal Aging Program; Beaumont Health Center, 4949 Coolidge Highway, Royal Oak, MI 48073; (248) 655-5034.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.