Rebuild Your Core

Whether you’re post-surgery, postpartum, lacking pelvic floor strength or struggling with weak abdominals and lower-back pain, this mat series, created by two-time cancer survivor and Pilates pro Emilee Garfield, will give you the tools to safely restore strength to your deepest muscles. By Emilee Garfield • Edited by Amanda Altman

By Emilee Garfield  • Edited by Amanda Altman

After major abdominal and pelvic surgery from stage IIIC ovarian cancer, I didn’t even recognize my body. I had to get used to a new ileostomy (colon bag) on my tummy.

Being a Pilates teacher, I was determined to get my body back in shape. At first, I didn’t care how my body looked, I just wanted it to function without it hurting. (Scar tissue inside the surgical site was painful.)


“This was me at home for a few months. I carried all this on me and even to the studio if I felt good enough to work,” recalls Emilee.

It didn’t take long to realize that healing my body was going to be a process. After radiation damaged and weakened the tissues in my abdomen and pelvis, I lost sensation inside my core. I had to slow down, listen to my body and let it teach me.

I created this routine for myself because of my limited range of movement due to the ileostomy. If I tried to do a regular workout, it just didn’t happen, and I got frustrated. I also developed body image issues, and the last thing I wanted to do was to judge myself.

The Pilates balls used here supported me so that I wasn’t in pain. At the same time, I was able to find a deeper part of my core by using them. I was amazed how the slower and smaller my movements were, the more I felt the work on a deeper level.

While doing this series, be mindful and concentrate on slow, micro movements to teach your core muscles—the transverse abdominis, multifidus, diaphragm and pelvic floor—to work together to produce maximum stability in the abdominals and lower back. This is what makes these exercises so unique and perfect for anyone who needs to rebuild their middle.

I learned that there is no one right way. Do what works best for you. Above all, slow down and work deeper, not bigger.


The purpose of these movements is to reconnect to your core and nervous systems, as well as to create more strength and stability in your core. Working with the ball between your knees activates the nerves that run through your lower-back and pelvic region, and behind your sacrum and upper back. Concentrate on slow, small movements and sinking your feet into the floor to home in on your deep, abdominal wall.


Props: 1–2 (10-inch) stability balls
Reps: 5–10 (unless otherwise indicated)
• Timing and coordination are the most important steps in these exercises. Move in slow counts of 4.
• It doesn’t matter what the movement is—always move slowly and stay more connected to your body. Less is more. Go deeper, not bigger!
• Sink your feet into the floor prior to each movement to help activate your core. This is very important. Your feet are connected to your core and nervous system!
• Maintain a constant squeeze on the ball between your knees. This helps activate muscles deep inside your pelvis.
• Avoid gripping or bearing down with your abdominals. Don’t allow your belly to protrude.
• Don’t overinflate the balls. They work best when a little air is released.

Upper-Back Stretch

Purpose: stretches the abdominals (and scar tissue if you had surgery), chest and shoulders; enhances spinal mobility
Setup: Lie on your back with your knees bent and feet flat on the floor. Place one ball under your upper-mid back and another between your knees, squeezing the ball with your inner thighs. Interlace your fingers behind your head, resting your head in your hands with your elbows wide.

1. Allow your chest to open over the ball, stretching your belly. Take a few deep breaths, relaxing into the stretch.


Tip: Breathe into your abdomen, and allow your pelvis to relax. If your shoulders are tight or your fingers get numb, bring your elbows closer together, in line with your armpits.
Modification: If your neck is tight, place the second ball behind your head for support.

Chest Lift

Purpose: strengthens the abdominals with a focus on the rectus abdominis (“six-pack” muscles)
Setup: Same as Upper-Back Stretch.

1. Exhale in a slow 4 count, pressing your upper back into the ball and lifting your chest to activate your upper abdominals. Imagine that your elbows are reaching toward your knees and that your rib cage is narrowing. Pause, inhaling for 4 counts, drawing your lower abdominals in and up under your rib cage while pressing your head into your hands to further activate your abdominals.


2. Exhale, slowly lowering your chest over the ball.

Tip: Keep your pelvis neutral and gaze forward.

Single-Arm Reach

Purpose: strengthens the abdominals and pelvic floor
Setup: Same as Upper-Back Stretch.

1. Exhale, pressing your upper back into the ball, and lift your chest, until you feel a strong connection across the front of your abdominals.


2. Inhale, reaching your arms forward to touch your knees. Squeeze the ball between your knees.

3. Exhale, sinking your feet into the floor, and in a slow count of 4, curl your tailbone toward your pubic bone, until you feel your lower back sink into the floor. Don’t rush this—it’s the most important action. Inhale.
4. Exhale, lifting one arm by your ear. Pause for 4 counts, scooping and lifting your lower abdominals in and up under your rib cage.

5. Inhale, slowly returning your hand to your knee for 4 counts.
6. Alternate arms for 5–10 reps.
7. Inhale, interlacing your hands behind your head, and slowly stretch over the ball.

Tips: Use your opposite hand as a force to create traction and help deepen your core awareness. Keep your tailbone curling toward your pubic bone at all times, focusing on pulling in and up with the muscles inside your pelvic region.
Modification: If you feel any strain in your neck, place the ball higher behind your back.
Advanced: Do Double-Arm Reach instead of lifting one arm at a time, lift both together.

Single-Side Oblique Reach

Purpose: strengthens the abdominals, especially the obliques; strengthens the neck
Setup: Same as Upper-Back Stretch.

1. Repeat steps 1–2 of Single-Arm Reach.
2. Inhale, reaching both hands to your left knee with your right hand on top.
3. Press your left hand into your leg, and reach your right arm back on a diagonal by your right ear. Hold for 4 counts, drawing your abdominals in and up under your rib cage, then return your hand to your knee. Do 5–10 reps.

4. Interlace your fingers behind your head, and relax over the ball.
5. Repeat the sequence on your other side.

Tip: Pressing your hand into your leg while you sink your feet into the floor creates a force that allows you to go deeper into your core.

Get the rest of this article and more exercises like this in our current issue, available on newstands and on Magzter now!

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