LOW BACK PAIN and an INEFFICIENT CORE

Researchers have found that individuals with chronic low back pain (85% of U.S. adults) have decreased activation of certain muscles including tranversus abdominis, internal obliques, pelvic floor muscles, multifidus, diaphragm, and deep erector spinae.

Performing traditional abdominal exercises without proper lumbo-pelvic-hip stabilization has been shown to increase pressure on the discs and cause compressive forces in the lumbar spine.  Furthermore, performing traditional low back hyperextension exercises without proper lumbo-pelvic-hip stabilization has been shown to increase pressure on the discs to dangerous levels.  These unsupported exercises can cause damage to the ligaments supporting the vertebrae.

The CORE is defined as the lumbo-pelvic-hip complex, and the thoracic and cervical spine.  The core is where the center of gravity is located and where all movement begins.  It consists of 29 muscles and 2 systems:  the stabilization system and the movement system.  These interdependent systems must be trained appropriately to allow the kinetic chain to function efficiently during dynamic activities.  This means that we must work from the inside (stabilization system) out (movement system).  Training the muscles of the movement system before training the muscles of the stabilization system would not make structural, biomechanical, or logical sense.  This would be analogous to building a house without a foundation.  The foundation must be developed first to provide a stable platform for the remaining components of a house to be built on.  One must be stable first to move efficiently.

A weak core is a fundamental problem that causes inefficient movement and can lead to predictable patterns of injury.  Many people have a strong rectus abdominis, external obliques, and erector spinae, but weak stabilizing muscles.  This results in a lack of stabilization and unwanted motion of the individual vertebrae, thus increasing forces throughout the lumbo-pelvic-hip complex that may result in low back pain and injury.

I do the exercise below with all my beginning clients.  This is a great at-home exercise.  With advanced clients, I make sure to add some type of pelvic floor exercise weekly.        -Sara

CORE – STABILIZATION EXERCISE

To activate your deep stabilizing muscles, perform the drawing-in maneuver.

  1. Lie on floor face up, with knees bent at a 90-degree angle, feet flat on floor.
  2. Head, neck, shoulders, and arms are on ground, relaxed at all times.
  3. As you inhale, arch your back (your belly will rise up).
  4. As you exhale, completely contract your belly into the floor.  *Pull in the region just below the navel toward the spine.  You can feel these muscles working if you take your fingers and touch both sides just below your navel.
  5. Repeat for total of 10 repetitions.
  6. Do 2 more sets for a total of 3.  Repeat 6 times a week.  As you get stronger you can increase repetitions to 20 or 30 and go at a more rapid pace.

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