If you have a problem with pain in your back, you may have been told to do exercises to make your core muscles stronger. Performing a quick search for the correlation between weak core muscles and back pain turns up a long list of possible solutions, most involving exercise to improve stability around the midsection. However, this advice may not be as helpful as it sounds.
Where did the idea of a weak core causing pain in your back come from? Eyal Lederman examined the assumptions driving this idea in a review in the Journal of Bodywork and Movement Therapies. He discovered a disproportionate focus on the strength of the transverse abdominis, spurred on by an assumed correlation between back pain and weak muscles deep in the abdomen. Lederman’s review suggested the core muscles are seen as more important than any other muscle in regards to stability and pain prevention.
The transverse muscles are situated deep inside your abdominal area, but there doesn’t seem to be any direct correlation between transverse abdominis strength and the presence of pain in the back. Pregnant women, mentioning a study in which their ability to do a sit-up was measured as a sign of transverse abdominis function and strength. Those unable to perform the exercise didn’t necessarily suffer from back pain. Other findings show individuals with back pain tend to wait to engage their transverse muscles, but this shows an adaptation rather than direct causation.
Narrow focus on core strength in treating back pain. Stripping treatment down to one group of muscles may prevent proper diagnosis and rehabilitation, and it can leave patients with the fear of a “weak back” for life. This fear can cause the body to react in ways it normally wouldn’t, contacting muscles at the wrong times or overcompensating with other muscle groups to avoid anticipated discomfort. Focusing too much on core stability and abdominal strengthening can intensify the psychological factor by making individuals already suffering from back pain think about their problems even more and become fixated on doing whatever they can to prevent symptoms from worsening.
Learning to move without fear of hurting yourself may actually be a better way to prevent back pain than doing a series of core-specific exercises. True back problems are best addressed by a doctor or physical therapist, but using common sense and paying attention to your personal patterns of movement can help prevent pain in the first place. Lederman notes everyone learns different patterns of movement and has different levels of motor skill development, and variations between individuals aren’t indicative of back pain prevalence.
Having a strong and stable core does help with daily movement and can prevent you from hurting yourself during routine tasks. Core stability also reduces the chance of falling so that you don’t wind up in pain from an injury, but it may not be the best solution if you already have pain in your back. While strengthening your core in general is never a bad idea, talk with your doctor before assuming a “bad back” is the cause of your discomfort.
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