I like to begin by strengthening the transverse abdominis by using two Paul Chek moves, the TVAT and the HORSE stance.
In the TVAT, have the client on the floor on all fours. Make sure the head and neck stay in line with the spine and the spine remains neutral. Have the client take a deep breath and then completely exhale. As the client exhales also draw the navel in towards the spine. Once all air has been exhaled, hold the breath and hold the navel in as tight as possible for ten seconds. Repeat this move ten times for one set. This is a very effective way to train the client to engage the transverse abdominis.
The HORSE stance is similar but a little more challenging. Begin on all fours again. Completely exhale and draw the navel in towards the spine as in the TVAT. As the client does this have her lift the right hand and left knee slightly off the floor. Lift the hand and knee only high enough so you could slide a piece of paper underneath. As she does this tell her to keep the shoulders and hips level. Hold this position for ten seconds and then repeat by lifting the left hand and right knee. I usually have a client perform five reps on each side. If core strength is limited you may notice as the client fatigues she will begin to wobble from side to side as she tries to hold the position. If the client begins to wobble stop the exercise because she is too fatigued to perform the move properly.
I have had obese clients who did not like to get down and up from the floor. In that case, I had the client straddle a bench, bend at the waist, and place their hands on the bench. I might even incline the bench slightly to make the client more comfortable.
Once I notice improvement in the client’s core strength, I progress to planks and crunches on a Swiss ball.