Back pain is one of the most common and debilitating conditions that strikes the population today. In this day and age we put more stress on our backs by sitting at desks for hours on end, standing in jobs, lifting, bending and various sports where we push our bodies to the limit. It costs the community as a whole, hundreds and thousands of dollars per year in lost income, treatment and insurance payouts to name a few. It can haunt us forever if not properly managed by both the therapist and the individual involved. It is the therapist’s job to not only mobilise and massage but to give the patient the tools to treat themselves by a series of home exercises. While sit-ups will make us look good on the beach in our swimmers and maybe attract a few from the opposite sex, it does nothing to protect our backs from pain and dysfunction. It is the deep stabilising or “core” muscles that are important in treating low back pain. It is almost guaranteed that these muscles are not working properly in someone with back pain. Pain causes the inhibition of these muscles until eventually they “switch off”. The exercises need to be progressed in stages. Firstly, the exercises need to be given in a “basic” position such as lying down. It is important to activate the muscles and learn the pattern of movement. Then the exercises need to be progressed to activate the muscles in a standing or sitting position. Finally, the exercises need to be progressed to a “functional” level. As your muscles being working better they need to be challenged to work in ‘normal’ conditions such as walking or running. They also need to be ‘specific’ for example during gardening or lifting; which are two activities that may cause back pain. These muscles need to be trained for the specific environment or sports undertaken. There is no point being able to activate your ‘core’ while sitting on a Swiss ball unless you are involved in a seated sport such as motor racing or paddling. For example, golf, tennis and football are three activities which require different demands on our muscular system. Therefore, we need to train our ‘core’ specifically in these environments. By lying on a Swiss ball or Pilates reformer it will only partially improve the control and may not fully treat the problem.