The answer to this question is, “it could help!”. This week we’ve been talking all things back pain from the false positives recorded by MRIs to hip flexibility. Today the question about the effectiveness “core stability” will be answered. If you search online for “core exercises” you will be presented with a limitless array of exercise routines. But what are the most effective ways to prevent or treat back pain?
The research shows that when implemented correctly, core exercises (strength and stability) are effective ways to manage low back pain. However, there is a difference between strength and stability. Strength is actually a universal term to define the ability to produce force, and that force can either produce movement or limit movement. There is some open endedness when it comes to strength. Stability however, is the ability to resist movement and it does require force. In order to be stable, you need to be strong; however, being strong does not equate to being stable.
Signs indicating that you would benefit from core strengthening would include: back pain that resolves over time, but then comes back for no reason; back pain that is not specific and can pop up unpredictably; and back pain that occurs with ballistic/high impact movements such as running, jumping, cutting (sudden change in direction). Note that high impact exercises are explosive movements, performed at high velocity, and can present a ‘jarring’ effect on the body. The categorization of weightlifting (squats and deadlifts) as high impact exercises is a misnomer, as those movements are slow and controlled.
The three most common (and they’re common for their effectiveness) stability exercises that are often poorly executed are the: 1) Transversus abdominus activation; 2) Plank 3) Superman Hold
The transervus abdominus (aka TrA) is one of the deepest muscles in the core. It’s a very thin layer that is located between our ribs and pelvis. Improper activitation of this muscle can result in instability and pain. You can activate the TrA by laying on your back and drawing in your stomach. This can often be hard to do and can be easily messed up. We find that most of our clients start off by having the inability to fully contract the core to maintain full stability (also known as bracing). A way we can address this and activate the TrA at the same time is using a foam roller and squeezing it (longways) between the knee and elbow. Take a look at this video for a demo. Try out 3 sets of 5s contractions with maximal effort. If you shake, that is motor control trying to learn this position!
The plank is probably one of the most butchered core exercises (second to the situp). If you ever search the “world record plank hold”, you’ll see what I’m talking about. It is important that you keep the hips off the floor, however, it is also very important to keep the shape of the spine consistent. This means that the spine stays neutral, or slightly flexed, with full quad and glute squeezing. You’ll know that the plan is working if your whole body is fatigued and your back feels great. Here is a video on how to fix it. Try out 3 sets of 15 seconds of maximal effort squeeze. It should be pain free and 15 seconds is all you need!
The last common exercise that is often misused to increase low back stability is the super (wo)man hold. This exercise is often thought of as a way to strengthen the low back extensors, however, when used correctly this hold can activate way more. Rather than just trying to lift the chest up the floor and activate the low back; focus on trying to squeeze the glutes together, and pull the shoulder blades down to the pelvis, and squeeze the quads as tight as you can. As a result, you’ll feel the hamstrings activate as well as your lower traps. Again holds like this can be completed for 3 sets of 15 seconds for maximal contractions.
Increasing core stability is going to be helpful to improving low back pain and prevention. However, exercises like these do have their limitations. One of the biggest arguments is that these movements occur on the floor, and it’s application to real world activities (in standing). Try out the exercises above to establish a good solid foundation, but then apply the bracing technique when you lift. It might be hard and awkward, but the more you practice, the more normal it will be.
Anything involved with resolving or preventing pain should be done within the available range of motion and strength. None of the techniques above should produce any pain. If you know of anyone who would benefit from this information, feel free to share it with them. No one has to live in pain or in fear of it.
We are just barely scratching the surface with this subject. Tomorrow we are going to talk about what I believe is the hardest part to resolving back issues, coordination. Stay tuned for more.
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