Straighten your spine with ACT

Longterm and incorrect sitting at work or an unending journey in a car to a dream holiday means excessive load for our musculoskeletal system and reduced strength of unevenly used parts of the spine. Together with increasing muscular imbalance, which directly impacts neurophysiology (physical and chemical processes in the neural system) and biomechanics (mechanical properties of biological materials) of the musculoskeletal system, it closes the vicious circle of pain.

Using suitable methods, we will explain the foundation and crucial principles of exercise of the ACT concept.


The ACT - Acral Coactivation Therapy according to PhDr. Ingrid Palaščáková Špringerová, Ph.D utilizes positions of children’s motor development with motor learning. The method is used as prevention, as functional rehabilitation exercise and in the treatment of patients from a wide spectrum of clinical fields, especially patients with musculoskeletal system disorders. ACT activates motor patterns using press exercises against acral (end) parts of extremities - the heel and the heel of the hand, which are support points helping keep the spine straight. This improves posture and motor control. Regular exercise using the ACT method can lead to straightening and stabilization of the spine and limbs, changes in muscle tension and improved coordination, attention and concentration.


The learning process in ACT is called “training movement patterns based on pressure” against acral (end) parts of the body in different positions; with repetition, these become motion stereotypes. In other words, the body will adopt the correct motion patterns and begin to use them automatically. The aim of ACT is to straighten the spine and keep it straight when applying the pressure. You will notice the effects by the straightening of your spine, lowering/disappearance of pain and strengthening of muscles of the torso and the limbs. The exercises can be included among routine daily activities. A part of this neuromuscular physiotherapy is improving physical condition and concentration. This requires motivation, namely the activation of the limbic system in the brain responsible for it. It is followed by checking and directing the sight at the acra (ends of limbs), which helps to be aware of posture and contact with the floor. Only in the end, after this procedure, comes the actual push-out. You are aware of the quality of the push-out and whether the spine is being straightened or you need to change the angle of the limbs.


ACT exercise is useful for anyone without limitation, from children, through adults to seniors, or for professional athletes.


  • Back or spine ache
  • Pains in upper or lower extremities
  • In case of improper movement habits at home or at work
  • To improve physical condition and motor skills
  • To strengthen the torso and limbs
  • As part of pre-sport preparation
  • As part of preventive exercises


Starting position

  • Sit on a chair
  • Straighten your spine so that your back is straight
  • Keep your head as an extension of your spine
  • Push your chin back towards your neck
  • Rest your feet on their heels and raise the toes above the floor
  • Rest your arms on your thighs with the heels of your palms
  • Keep your hands arched (imagine holding a ball and pressing it back with your wrists)

Instructions for exercise

  • Start by pressing the heels of your palms against your thighs
  • Press down with your heels
  • Expand your shoulders by the so-called feeling of distancing lungs from ears
  • Keep your shoulder blades slightly down and outwards
  • Slightly pull in your stomach (pull your navel into the “inner belly” and slightly upwards)
  • Stretch your head upwards in a straight line

The most important thing is the correct positioning of the acra (end parts) of lower and upper extremities and keeping it throughout the coactivation push-out exercise.

Functional positioning of feet during push-out

  • The angle between the foot and the shin should be 90 degrees
  • The toes should be relaxed, not contracted or extended

Correct breathing during exercise

Breathing is “free” during the whole exercise to keep the natural rhythm of breathing

  • BREATHE IN while activating the muscles (press into the support points: hand - thigh, foot - floor)
  • Breathe normally and hold this position for about 30 seconds
  • Breathe in once again with muscles still activated
  • BREATHE OUT gently and relax the muscles

The spine is straightened and the pelvis is in neutral position during the push-out.

You should feel the muscles activate against pressure: hand - thigh, foot (toe in the air) - floor.

The length of activation should be equal to the time at rest.

Common mistakes

  • Failing to keep active straight back
  • Failing to keep active pressure against heels
  • The angle between the foot and the shin is not 90 degrees
  • The toes are contracted or too extended

How often to exercise

  • Every day
  • The exercise can be incorporated into daily activities

FYZIOklinika physiotherapy Ltd, Prague, Czech Republic

Source: I. P. Špringrová, 2011, Akrální koaktivační terapie, rehaspring, ISBN 978-80260-0912-2

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