How Do You Strengthen Your Core To Fix Lower Back Pain?
When it comes to back pain, sciatica and the diagnoses that are at the root cause of these, for example, disc herniations, the understanding that your core should be improved is something that is agreed upon by everyone. However, there are common mistakes when it comes to training and rebuilding the core region. If we can better understand what it means to have a resilient trunk region, we will have much more success in the short, medium and long term. Let’s face it, core training is simply not enough if we are to fully recover from back pain, and quite frankly it can end up being counter productive, even worsening your back health when done improperly.
Your core is part of your abdominal region
Firstly, we should identify the region of the body that we’re referring to and what is included. We have the central load bearing strut, the lumbar spine. This is bounded top and bottom by the pelvis and the rib cage. These two points create, with the spine, strong bony anchor points for the musculature to attach to.
The musculature of the region would include, rather obviously, the oblique muscles and transverse abdominus, muscles which run around the side of the body. Imagine the way in which you might squeeze a coke can, that’s how these muscles work if your abdominal region was the coke can and your hand these muscles. They also, when working selectively, help with bending and twisting. We have the 6-pack (rectus abdominis) on the front, and then the erector spinae muscles on the back running parallel to the spine alongside muscles like quadratus lumborum, with our psoas muscle running on the front of your lumbar spine into the hip region. Then over the top of the back, we have the large latissimus dorsi muscle which extends up to the shoulder region.
Finally this is all supported further by various fibrous sheets, like the thoracolumbar fascia, A sheet of fibrous tissue which is like a sheet that can be pulled on all sides by tension in muscles above and below the abdominal region.
You see, there is a huge degree of complexity to this region, and this is not even discussing the degree to which we have muscles outside the region, which exert their influence on the abdominal region and core in general to provide stability. All of these muscles then work to provide muscular tension that supports the central strut, the spine.
The complexities of how your core is stabilized in the real world.
If you want to get good at sit ups, then do sit ups. If leg raises are your goal, do them. But don’t think that this is appropriate core training, and in both cases these are problematic for back injuries for reasons we discuss elsewhere. Hopefully you can see in the previous section that the core region is a very complex region, you cannot possibly hope to “isolate” those muscles without others partaking in the movement. In reality, why would you even want to?
The coordinated effort of this system to maintain stability to the spine is vital to the effective functioning of your lower back and body in general. In the real world, aspects of this system will be more involved in certain “exercise” movements, however, when it comes to us living without back pain in the real world, all these structures and many more not mentioned will be working in concert, like an orchestra, to produce safe and effective, fluid motion.
For example, when you’re carrying the shopping and putting it in the car or on the kitchen table, your core is working to provide stability to your spine, your back muscles are holding you tall, your leg muscles then acting to stabilize the one leg more while you shift your weight as you lift the bags with your shoulder and arm muscles to put it on the table. There are periods in this action where every single one of these muscles will be engaged to a greater and lesser degree, where weight shifts from some muscles on the left, to some on the right, some on the front, to some on the back. Some will provide stability statically holding their position, while others shorten to move a limb at the same time their counterparts are slowly lengthening.
This might sound all rather complex and make the whole thing sound overwhelming! It is a great system and the simple fact of the matter is that you don’t spend any conscious brain power on any of this happening at all!
Because your body is marvelous!
When back injuries create instability in your back
The simple fact of a back injury is that it disrupts the stability of the central strut, mentioned earlier, it creates a weak point, and with reactive muscle spasm, you can see how the concert we mentioned earlier is disrupted by some fool banging a symbol out of turn – that’s your muscle reactions messing the whole thing up by the way!
Over time this dysfunction and injury, leads to a lack of activity and then from there the muscles decondition and get out of practice working together. Quite often we can see this in an inability to perform normal activities correctly, perhaps the legs are weak, the hips don’t move properly, as a result the “core” muscles aren’t working right either, and then there is the pain too that influences things. It’s a mess.
The right way to rebuild your core – Step 1: Floor Core Exercises
It’s only natural that when we start out, working on providing that stability to the spine is of primary concern, in the safest possible way. Most of the activities of daily life involve load bearing and having to stabilize the core. So we begin by removing load bearing, reducing the stakes so to speak. If things go wrong when we’re doing our core work standing, we have our whole body weight to negotiate, if we’re lying down on the floor we have less forces at play. This approach is borne out in our Phase 1 and most of the Phase 2 exercises that we choose, helping you build the core’s ability to maintain a neutral spine and stability as the limbs of the body move.
In the example earlier in this piece, we see the way the core works. We want stability in the region defined as the core, so that the upper body and the legs have a solid base on which to act. For example, imagine when trying to close a door in your house, if the doors hinges were attached to a floppy piece of rubber and not a solid wall, the mobile hinge would have a poor base on which it can act, meaning when you close the door it doesn’t work smoothly. You need to have a strong central point which can act as an anchor. The early core training is teaching this because that’s how we work in real life!
The right way to rebuild your core – Step 2: Upright Core Exercises
Once this is mastered in the safe environment on the floor, we can start to take things to the next level and add in gravity. We can look at exercises that involve gravity and challenge our body to retain stability in the low back and core region. These activities are true to real life, integrating now more of the lower and upper body muscles to rebuild that integration between stability in the core and movement in the periphery. We often teach, like in the earlier Phases of the program, that starting out with limited ranges of motion helps you “get into” these exercises. Your core is gradually being challenged and built by more and more complex movements. Movements that are beginning to replicate the activities of daily living.
Earlier when we discussed the complex activations and engagements that take place when putting a shopping bag on the kitchen table, it might have seemed overwhelming to think about having to get all those parts working again. The reality is that you’re wired to do them, you’re just weaker than you should be, out of practice, and had an injury to the lower back that was affecting your ability to do all these things well. Perhaps there’s also an unhealthy addition of bad practices that have built up over the years too, but that’s another topic.
In truth, simply working through exercises, like a simple reverse lunge, help us rebuild this coordination from the core first. As if your core is not working correctly, you will hurt your back again, you will also likely fall over, and possibly injure your knee and ankle too! The lunge requires your core to be terribly steady. Balancing the weight your upper body above in a dynamic way, as you move through the lunge movement, you then also have to coordinate the core engagements with the action of muscles like the glutes, the psoas, and other lower body muscles as they pull on one side of your trunk more than the other. The small corrections happening in the lower leg and foot muscles create small movements that again need to be corrected for above as your “core” has to continue to maintain stability and balance. All of this happens very slowly and purposefully when doing the exercise in an exercise setting, but when you’re out in the real world goin up a step, or coming back up to standing from being knelt down to do up your shoelace, these movement patterns are being executed subconsciously. Sometimes this is done badly, and to the point it aggravates the lower back pain or sciatica.
Is doing sit ups or leg raises or some other variation, even the simple exercises we discussed in Step 1 going to even come close to the levels of stimulation of your core? No, and this is where the big misconception for many around core rehabilitation comes in.
“Abdominal Exercises” do not build a strong core or protect your low back!
Although as you can see above, there is a role to be played by the incorporation of core exercises in the more traditional sense, there is a significant misconception around strength training in general as you move forwards. Progressing on to build resilience in your lower back is done much more effectively through the incorporation of off balanced and on balanced load bearing exercises. Let us see how this compares.
People will typically think they perhaps need to do “heavy cable crunches” or “weighted leg raises” and this is the best way to build the core strength and stability. While this has a role in sectors like bodybuilding for example, this is typically not applicable to the average person trying to strengthen their core and back.
If we take the heavy cable crunches, this is essentially a weighted sit up, you could certainly increase the resistance used here to high levels, however, all you’re doing is working hard to tuck your body over into a rounded position. Think of how applicable this is to the myriad of activities you have to do on a daily basis, how useful is this strength? Note that we are not even going to discuss the negative side of doing lumbar rounding exercises if you have back pain, you can read more about that in other episodes.
Now compare this to say the split squat with a weight or resistance, in this scenario, your core has to work very hard as we discussed earlier to integrate with other muscles and maintain neutral or balance in the face of the many challenges that off-balance the body, with resistance during this movement. Not at all that it is necessary, but the scaling of this exercise can be done to the extreme with 100’s of lbs of load, to think that a simple abdominal crunch is going to provide you with the same degree of benefit to exercises like this, when it comes to “strengthening your core” to help your back health, is simply farcical.
The right way to rebuild your core – Step 3: Loaded Core Exercises
The final step to build your core would be to continue with the same principled exercises, with the addition of load carefully. There are three things happening here if you do it right. Firstly, the load helps give stimulation to your spine that it is required to bear more load and to make the necessary strengthening adaptations to the tissues. Secondarily, the muscles naturally become stronger over time as you increase the loads being used. Finally, as you increase the range of motion to incorporate “full range of motion” compound movements, using the load to off balance or challenge your core in general, you will find you continue to build resilience in your lower back.
The benefits don’t stop there however, increases in muscle competence in this way will have knock on effects beyond the back and muscles themselves. Your hips, knees and ankles, as well as other regions of the body will benefit. You will, with consistency and a little attention to your food intake, likely go through somewhat of a recompositioning, improving your body fat levels. You’ll have more energy, be more resistant to issues like diabetes, heart disease and more diseases that plague those that do not take good care of their health and wellbeing.
You’re not training your core to train your core.
You’re working out, doing the rehabilitative exercises to free yourself from back pain or sciatica, and to build resilience so you can do the things you enjoy with the people you love. When we think of the core, it is the central anchor from which all other movements take place. Building a strong core region, and slowly exposing your spine to load will allow the rebuilding of a core that can effectively hold neutral with the spine, providing that trunk stability, so the powerful leg muscles and upper body muscles can work their magic through our daily lives.
If you’re someone who’s been caught in the trap of thinking endless sit ups, planks and the like are the secret to your core strength and protecting your back, we hope this week’s episode has made you think about other avenues not yet explored that will unlock the doors to a resilient lower back and body in general. If you need any additional help and guidance, or want to follow a program that follows these principles then check out the Premium Membership below.