After a recent presentation on low back pain, a few people approached me and asked, “So what core exercises won’t hurt me?” and “Which core exercises should I do?” These are fair questions, so I thought I’d write an article about them.
I have nothing against core exercises—even the really hard ones. Core exercises are great—if executed correctly. Ironically many people dive head first into core exercise in an effort to alleviate back pain. However, if you start experiencing pain in your lower back during these types of exercises, you are likely not using the right muscles.
Research has shown that low back pain can cause the brain to “shut down” access to the deep core system—that is, the group of muscles that are tasked specifically with stabilizing the lower back. When this happens, the body compensates by recruiting your outer “movement” muscles, like hip flexor and lower back muscles—sometimes even hamstrings, to maintain posture and protect that painful low back. These movement muscles are poorly equipped for the job—they are designed to move you through your environment, not maintain your posture all day. Here’s where the problem arises. Those movement muscles fatigue easily, and then ache, increasing your discomfort and adding to your back problem. In the attempt to alleviate back pain, you begin a “core strengthening program,” thereby bending, side-bending and twisting your trunk to fatigue, challenging the already fatigued and painful low back, hip flexor, hamstrings, and outer core muscles, and driving yourself into more back pain.
So is core strengthening wrong? No. It’s just a bad place to start when you have back pain.
A second problem lies in the notion of a strong core being the full solution to back pain. It’s really only a partial solution. The other big players are the pelvic stabilizers, including your “butt” muscles. It makes sense that most of us are walking around with a “dead butt,” given the fact that as modern humans, we sit more than we stand. The very position of sitting shortens the hip flexor muscles in the front of the hips, which can partially or fully contribute to shutting down the butt muscles on the back of the hips. Butt muscles are big muscles, and meant to support the weight of your trunk in standing, and act as your “motor” in walking and running. Without them on-line, the body must rely on the same usual suspects: hip flexors, lower back muscles, and hamstrings- none of which are in a great position to hold up the weight of the trunk. So the muscles fatigue…then ache…then ultimately leave you with back pain.
The good news:
In my experience, this cascade of weakened or inhibited muscles leading to increased compensation and pain can be stopped and reversed. You can learn how to use those muscles properly again, and incorporate them into exercises that challenge the entire system. That’s a big part of what we do at Re-Kinect every day.
Even better news:
Once those deep stabilizers of the lower back and pelvis are active and in use, you can crunch, plank, rotate, and knee-lift until your heart’s content. And that “new and improved” strong body (and core) will help ward off future back pain for months and years to come so you can ultimately return to the activities you love to do!