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Swiss Ball - Truth or Hype

Swiss Balls - A Brief History

The Exercise Ball or the more popular termed “Swiss” Ball was invented in the 1960s by Italian Aquilino Cosani and was originally used by physiotherapists in Switzerland on newborns, infants and those with neuromuscular deficits or musculoskeletal injury. For the past 2 or so decades however, the Swiss Ball has gained popularity and notoriety among personal trainers, coaches and athletes as well as the recreational exercising community as a tool which can offer amazing benefits through its supposed ability to alter exercise performance through providing an unstable surface. However, is the hype surrounding its use justified?

Swiss Balls & Instability

The idea behind how the Swiss Ball works lies in its ability to provide an unstable base in which exercises are performed. The common belief is that this unstable surface is able to activate the core muscles, which consists of the pelvic floor muscles (transversus abdominis, multifidus, internal and external obliques), rectus abdominis, the lower erector spinae, and the diaphragm. Some other minor muscles also make up what is known as the core. The core muscles, when contracted are able to provide extra trunk and spine stability (commonly termed core stability) during times of movement or in different postural positions. By building up the strength and endurance of the core, it is thought that this would translate to more efficient, powerful movements with less chance of injury. Sports specific skills are often performed on a fairly unstable base (running tennis forehand, baseball pitch, etc). It has been shown that unilateral body movements such as pitching activates the transversus abdominis first and foremost before the limb muscles are activated.

Swiss Ball Research

Unfortunately, there aren’t any conclusive articles regarding the overall effectiveness of use of an unstable surface (Swiss Balls) on exercise and sports performance. However, let’s examine what is available to see if we can come to preliminary conclusion.

Swiss Balls & Core Muscle Activation

Many studies have been able to show increased activity of the core musculature during exercises performed on an unstable base such as a Swiss Ball. For example, Cosio-Lima et al (2003)1 and Vera-Garcia et al (2000)2 were both able to show increased core and abdominal activity in untrained men and women with exercises performed on a Swiss Ball over floor or bench exercises. Stanton et al (2004)3 used Swiss Ball training exercises on basketball and rugby athletes and found that while markers for core stability was improved, it did not translate to improved sports specific (running) performance. Escamilla et al (2010)4 tested core muscle activation of 8 different Swiss Ball exercises and 2 traditional abdominal exercises. The study found only 2 Swiss Ball exercises were able to significantly increase core muscle activation over the other exercises.

Swiss Balls & Muscle Activation

A few studies have also looked at whether exercising on a Swiss Ball will increase agonist muscle activation. That is, does exercising on an unstable surface cause increased activation of muscles that are specifically targeted by the exercise? (eg. chest and shoulder muscles with the bench/chest press) Some studies showed no significant difference in activation (Uribe et al (2010)5, Lehman et al (2005)6 and Wahl et al (2008)7). The latter study showed no significant differences in agonist muscle activity when performing exercises on moderately unstable surfaces such as on a Dyna Disc or BOSU Ball. However, it also showed that standing on a Swiss Ball compared to stable surface standing increased all muscle activation. Other studies have shown that agonist muscle activity is actually decreased when performing the same exercise on a stable vs. an unstable base (Kohler et al (2010)8 and Behm et al (2002)9). Lehman et al (2007)10 looked at the non core stabilising muscles when performing push ups on the floor vs. on the Swiss Ball. The study found no significant difference in shoulder girdle stabilisers activation between the two bases. On the other hand, Marshall et al (2006)11 concluded in his study that muscle activity can be changed and even increased when an unstable surface is your primary base of support. This idea was also supported by Lehman et al (2005)6 who showed changes in trunk muscle activity during body weight static exercises.

Swiss Balls For Strength, Endurance, Power

Can Swiss Ball or unstable surface training lead to overall muscular adaptations? The most positive study found was one by Sekendiz et al (2010)12 which was able to demonstrate improved strength, endurance, flexibility and balance in sedentary women with 12 weeks of Swiss Ball core strength training. Other studies however showed conflicting results ranging from no significant changes to strength (Goodman et al (2008)13) to decreases in isometric strength, power and force production (Koshida et al (2008)14 and Behm et al (2002)9 and (2004)15).

Swiss Balls & Core Stability

Basically, the evidence out there seems to be all over the place. It pays to understand though that there are several issues with many of the studies showing positive effects in that many of them were performed on sedentary, untrained or recreationally trained individuals. It is also important to realise that because of the unstable surface of the Swiss Ball and other devices which increase instability, there will be a reduction in the weight that you can lift. As such, it may not be able to offer the resistance necessary for many muscular changes such as growth or strength. Relating Swiss Ball training to sports performance, while core training is crucial to stability, Swiss Ball/unstable surface training may not provide the same type of environment as specific sports as the training is static in nature, whereas sports require a more dynamic balance and stability.

Swiss Balls Safety

As you all know, all exercise and sports has its risks. Using a Swiss Ball or other instability devices can be dangerous to both you and the people around you, especially if you are new to the exercise. The risk for injury increases and the consequences of such become more severe for specific populations such as pregnant women and the elderly. While use of Swiss Balls and other unstable devices are safe when used properly and with proper supervision, extra caution needs to be demonstrated if you fit into those specific populations.

Swiss Balls Recommendations

Swiss Balls, BOSU Balls and other unstable surfaces are a novel way to train, but may not be all it’s cracked up to be.

  • If you’re sedentary, untrained or recovering from an injury it may be more beneficial to incorporate exercises on an unstable surface.
  • If you’re a regular trainer or a well trained sportsperson or athlete, training on unstable surfaces may not provide you with the sufficient challenge you need to improve. But of course this depends on your goals.

It is vital to know that lifting heavier loads on a stable base is able to work the core stabilising muscles and as with any muscles, it takes extra resistance to cause further gains, which may be difficult with unstable surface exercises. In this author’s opinion, depending on your goals and stage of training, Swiss Ball and other unstable surface exercises can be a great supplement to your regular training. Relying on it as a sole source of training however is not recommended as it does have several restrictions as stated above.

1 Cosio-Lima L.M., K.L. Reynolds, C. Winter, V. Paolone, and M.T. Jones. ‘Effects of physioball and conventional floor exercise on early phase adaptations in back and abdominal core stability and balance in women.’ Journal of Strength and Conditioning Research.17(4):721-725. 2003.
2 Vera-Garcia, F.J., S.G. Grenier, and S.M. McGill. ‘Abdominal muscle response during curlups on both stable and labile surfaces.’ Physical Therapy. 80:564-569. 2000.
3 Stanton, R., P.R. Reaburn, and B. Humphries. ‘The effect of short-term Swiss ball training on core stability and running economy.’ Journal of Strength and Conditioning Research.18(3):522-528. 2004.
4 Escamilla RF, Lewis C, Bell D, et al. ‘Core muscle activation during Swiss ball and traditional abdominal exercises.’ J Orthop Sports Phys Ther 2010 May; 40(5):265-76.
5 Uribe BP, Coburn JW, Brown LE, et al. ‘Muscle activation when performing the chest press and shoulder press on a stable bench vs. a Swiss ball.’ J Strength Cond Res 2010 Apr; 24(4):1028-33.
6 Lehman GJ, Gordon T, Langley J, et al. ‘Replacing a Swiss ball for an exercise bench causes variable changes in trunk muscle activity during upper limb strength exercises.’ Dyn Med 2005 Jun 3.:6.
7 Wahl MJ, Behm DG. ‘Not All Instability Training Devices Enhance Muscle Activation in Highly Resistance-Trained Individuals.’ J Strength Cond Res 2008 Jun 9.
8 Kohler JM, Flanagan SP, Whiting WC. ‘Muscle activation patterns while lifting stable and unstable loads on stable and unstable surfaces.’ J Strength Cond Res 2010 Feb; 24(2):313-21.
9 Behm DG, Anderson K, Curnew RS. ‘Muscle force and activation under stable and unstable conditions.’ J Strength Cond Res 2002 Aug; 16(3):416-22.
10 Lehman GJ, Gilas D, Patel U. ‘An unstable support surface does not increase scapulothoracic stabilizing muscle activity during push up and push up plus exercises.’ Man Ther 2007 Jul 19.
11 Marshall P, Murphy B. ‘Changes in muscle activity and perceived exertion during exercises performed on a swiss ball.’ Appl Physiol Nutr Metab 2006 Aug; 31(4):376-83.
12 Sekendiz B, Cuğ M, Korkusuz F. ‘Effects of Swiss-Ball Core Strength Training on Strength, Endurance, Flexibility, and Balance in Sedentary Women.J Strength Cond Res 2010 Oct 9.
13 Goodman CA, Pearce AJ, Nicholes CJ, et al. ‘No Difference in 1RM Strength and Muscle Activation During the Barbell Chest Press on a Stable and Unstable Surface.’
J Strength Cond Res 2008 Jan; 22(1):88-94.
14 Koshida S, Urabe Y, Miyashita K, et al. ‘Muscular outputs during dynamic bench press under stable versus unstable conditions.J Strength Cond Res 2008 Sep; 22(5):1584-8.
15 Anderson, K.G., and D.G. Behm. ‘Maintenance of EMG activity and loss of force output with instability.’ Journal of Strength and Conditioning Research. 18(3): 637-640. 2004.

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