How To Safely Activate Your Core With A Herniated Disc

If you’ve got a herniated disc in the lumbar spine, frequently L4,L5 or L5,S1, one of the biggest challenges can be that you know you need to activate your core and learn to control the spine, but there seems to be a lot of conflicting information out there. The hope is that today, we can ease some of this confusion and perhaps join two areas of the “core bracing” or “core activating” spaces by explaining things a little better.

It is also worth mentioning right at the outset, that while many of you struggling to recover from low back pain will go on to get back into more advanced strength training. This is not meant for those of you without back injury or sciatica. The trained and uninjured individual is very different to the individual who’s recovering from a bout of sciatica or a bulging lumbar disc.

Teaching how to activate the core

The way we have always taught to engage the core is through the activation of it by contracting the midsection musculature to create a firm ring of support for the spine. Others in spaces such as the bodybuilding or strength building space teach it quite differently, they talk about pushing out in what amounts to a valsalva maneuver – a fancy way of simply “straining”. This apparent contradiction creates a tremendous amount of confusion for many and so it was a fantastic opportunity to have a chat with a strong Australian strength coach at a seminar this weekend, Sean Mcinroy. We had a good conversation about this to help bridge the gap and generate an understanding which will hopefully help you all better understand the interplay between these two seemingly opposite approaches. 

Why are we activating the core?

The region between the bottom of the rib cage above, and the pelvic floor below, with the lumbar spine running though it is a potentially vulnerable space, with two large centers of mass at either end, perhaps like a loaded barbell stood on its side. Therefore the only thing that creates rigidity here is the ability to create pressure in this space enough to provide stability and force transfer up or down through the trunk region.

Think of the core as a tin can:

• The spine of course runs through the middle.
• The diaphragm makes up the lid of this “tin can”
• The abdominal region/trunk muscles make up the sides of this “tin can” wrapping around.
• The pelvic floor make up, the base of the same “tin can”

When these parts contract in balance, pressure rises inside the “can,” creating stiffness so the spine doesn’t buckle as you move. The greater the off balancing force, the greater the required force from these muscles to preserve stability. 

Thinking about stability of a joint

At its root we are trying to stabilise a joint from moving. Taking the example of the elbow joint, if we just contract the bicep or the tricep, the joint will move one way or another, flexing or extending the elbow. However, if we contract both with equal and opposite force, we are able to create a fixation of the joint at a chosen position. For example, with the elbow at 120 degrees. The stability is similar in the spine, the interplay between these different muscles on different margins of the tin can allow us to provide control over the pressure and the exact position of fixation.

Understanding the role of these muscles in breathing

This section might be a little more detailed than necessary but it should help you get a deeper insight into how this all works through breathing. The diaphragm is the primary driver of the way in which humans breathe. It contracts to pull the lungs down and as a result creates a negative pressure in the rib cage or thorax. If we think of the “body” as having two halves, the top being the thorax and the bottom being the abdomen, the diaphragm is the separator. And so when it decreases the pressure in the thorax to draw air in, the abdomen pressure either increases or in the relaxed state, the tummy bulges – this is normal diaphragmatic breathing. If the abdominal wall did not stay relaxed in this case, the tummy would not move and pressure in the abdomen would increase – think spine stability here.  

For certain activities where more oxygen is needed, we use some extra “accessory muscles”. These come into two categories: inspiration and expiration. The former meaning they help get extra air in during a deep breath, think muscles like the scalenes and SCM. The latter are the ones we’re interested in, the transverse abdominus for example, the “core muscles” these help force extra air out so we can get a full deep breath to fill the lungs with air for more oxygen to meet our needs. 

Our interest lies in the accessory muscles of EXPIRATION – the core and trunk muscles. When they squeeze as the diaphragm relaxes they help increase the pressure in the abdomen such that the relaxing diaphragm is aided and pushed upwards like a champagne cork forcing air out of the thoracic cavity. If we closed our mouth and nose, this would eventually create a pressure and perhaps our ears would pop…You’ll be pleased that I won’t go into the excruciating anatomical detail to explain this more. 

It is these accessory muscles of expiration, the core, that so many struggle to utilise. More on this next.

The technical difficulty with utilising the core muscles

One of the great nuggets from Sean’s seminar was the comment about over-estimating the individuals competence and skill level, their ability to perform the given movement. When it comes to those with lower back injury and sciatica, it is VERY common that there is often a real inability to actually control and utilise the midsection muscles, this is one of the reasons that some of the early training and tips are to hook the contraction of the core to the outbreath. These muscles play a vital role in meeting the tension of the diaphragm to create a solid stable, “pressurised core”. 

This forced work from the core muscles helps squeeze out the air from the lungs. This is why we teach the core engagement from the breathing at the most basic level, exaggerating the belly breath phenomenon, breathing deeply with the diaphragm and squeezing the air out, like in the case of the exaggerated candle drill to “accidentally” feel what it is to have the core muscles contract. For many this is a “lightbulb moment”, and for more still this is often a real hurdle that must be overcome, for how can we hope to create stability if we have little fundamental conscious control of these areas. It’s like trying to do a squat safely with no coordination of the muscles of the legs or hip – a recipe for trouble should we be foolish enough to challenge such a vulnerable and uncoordinated movement. 

Ladies who’ve had children, let alone c-sections, find this a particularly challenging feat, not least because re-establishment of core control is left to yourself to “never explicitly relearn” after giving brith. And so it is this inability to control a fundamental aspect of stability generation that needs to be re-learned. 

Hopefully you can appreciate the reason why a lot of our information about creating stability for the spine centers around the generation of this stability through learning to engage and “activate the corset of muscles” that wrap around the trunk.

Learning the core aspect first

Strengthening the core fundamentally is synonymous with creating stability and protecting the low back, and so we find that specifically for the individual struggling with lower back issues, learning this ability to control the core first is of paramount importance. Once more controlling the lower section of the core, the bit between the belly button and the pubic bone, is a vital area that is lacking in control for so many. But with thoughtful practice over time, skill develops, skill enough to work on building strength in this domain. 

A quick word on the pelvic floor

The pelvic floor is something that frequently comes up alongside learning to engage the corset of muscles and this too can perfectly reasonably be “activated” or “engaged” alongside your core engagements when performing early rehabilitation exercises to get into the habit that will help you build strength over the long term. 

The topic of belts and pelvic floor weakness for ladies in particular also came up in discussions at the seminar and ideas that were not discussed but i have reflected on afterwards might be helpful for some of you thinking about this interplay for the “lifters out there” considering the use of belts for the low back when lifting heavier weights. It seemed that such weaknesses during heavy lifting with the belts can result in a degree of temporary incontinence. Some thoughts on this would be that when training without the belt, we are always developing all aspects of that tin can together, but when we use a belt we are allowed to generate super-human strength in one of the walls so that the other non-reinforced wall (the pelvic floor) simply cannot manage, not that there is weakness there, but that it understandably not being reinforced the same way the trunk is. Perhaps if there was a way of using a support to invert this imbalance we might find herniations of the abdominal wall would be the result. 

This leads me to the conclusion, that unless you have a competitive case to do so, belts are wholly unnecessary for ladies, and quite frankly i think the same advice is there for men too – as you might have guessed from other videos on the topic of lumbar supports and belts. 

As Sean rightly said “people earn the right to use the belt when they no longer need it” and so really they are only being used to further the weight on the bar which is a competitive pursuit rather than a “health” choice.

Final thoughts on core stability, bracing and the confusion

Understand that core stability is a function of the interplay between margins of the “tin can” that is the abdomen. And that while some may preferentially talk about the “pushing down and out” and others about the “core muscles” and drawing everything “tight” both sides would agree that the purpose here is to create the equal and opposite force between all boundaries of the abdominal cavity. So there is not as much contradiction as you might initially perceive. However the most important parts of that puzzle depend, in our opinion, on the circumstances you are in, if you’re on our page, then chances are you are not a powerlifter looking to break a PR next week, you’re more likely someone struggling to get out of bed, get dressed, play with your kids. You’ve got a low back injury and are starting from ground zero. Hopefully this and many of the other videos on our page and website help you on the path to recovery. And remember if you need any more help, you can always check out the program!