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5 Daily Changes for Back Pain: Core Strength

You can’t flip through a fitness magazine without it touting the benefits of core strength. We lecture our patients on it every day, but why? Core strength plays a crucial role in both the occurrence and prevention of countless injuries. The injury spectrum is vast, ranging from the low back to pain at the foot and ankle. Research has supported the link between diminished core strength and low back pain.1 Most people correlate a six-pack and washboard abs with core strength, but don’t fool yourself. While a chiseled mid-section may be great for washing your clothes on, it doesn’t necessarily correlate with a stronger, more stable spine. In reality, the method of doing hundreds of sit-ups to develop rock-hard abs can actually increases you’re likelihood of experiencing back pain.

Your core is comprised of multiple muscle groups, some you’ve heard of and some you may have not. These muscles are responsible for movement and most importantly spine stabilization. Our muscles pull from multiple angles, stabilizing the spine from 360 degrees. We compromise stability when we develop weakness or muscle imbalance. We require strong back and abdominal muscles to pull equal and opposite. Overdeveloped low back muscles paired with a weak abdominal wall can cause unequal and uneven pulls on your spine. Uneven contractions on the spine are damaging for both short and long term spine health.

A stable spine allows for better movement of our extremities, neck, and pelvis. Our spine alone is not stable. Lucas and Bresler were the first to reports this, as the found a cadaveric spine buckles under only 20 pounds of force.2 Certainly the spine needs to gain stability from somewhere or we would all be crumbled on the floor. Where does this stability come from? You guessed it–Your core muscles.

How our spine gains stability:

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Imagine balancing a fishing rod vertically on the ground. Alone, the rod is very unstable and even a slight pressure to the tip will cause the rod to buckle—much like your spine without support from the muscles. Now imagine staking guy wires from the top of the rod into the ground. With each additional guy wire the rod becomes more stable and willing to accept compressive force. This is a simple example of how our core muscles add stability. As you snip each wire (muscle) the rod (spine) loses stability and the ability to accept compressive forces.

We ask you shift your thoughts from core strength to core endurance. Core Endurance allows you to function throughout the day without compromising your spine stability. Before you commit to hammering off sit ups, think about exercises that stabilize the spine, not move it. Stability exercises like planks and bridges can trigger muscles around the spine without moving it. This sets the platform for us to perform more powerful movements (if needed).

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The two exercises listed above have been found to effectively target the transverse abdominus, an extremely important core muscle. The transverse abdominus activates in all directions of spinal movement, while being the first to contract before we move an arm or leg.3

Achieving spine stability with core endurance is only the beginning. Exercise then progresses to more functional movements. Squats, for example, are a great exercise to engage both the core and the gluteus muscles in an activity that occurs throughout the day.

Progressing to advanced core exercises takes time and a keen eye. You can’t go wrong beginning with said exercises. Exercises that emphasize stability without movement are a priority, which means no crunches! For a more individualized and expanded program contact a physical therapist.

References

1. Vezina MJ, Hubley-Kozey CL. Muscle activation in therapeutic exercises to improve trunk stability. Arch Phys Med Rehabil 2000; 81 (10): 1370-9
2. D. Lucas, B. Bresler, Stability of the ligamentous spine, in: Tech report no 40, Biomechaics Laboratory, University of California, San Francisco, 1961.
3. Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther 1999; 4 (2): 74-86

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