Best core exercises for back pain
We all hear that we should strengthen our core to improve back pain. The first image that probably comes to mind is old fashioned sit-ups, crunches, or pilates type leg lifts while directed to flatten the lumbar curve. In fact, when lying down to address core work, the number one question new students who come to me with back pain ask me is, “Should I flatten my lower back to the floor?” The answer is NO! NEVER!
What these exercises have in common is a shortening of the front body. Anyone who: sits, or walks in a slouched position; carries a baby with their hips swayed forward; spends a long time on a computer with their arms out in front of them; or who has text neck, is already too short in the front body and overly long in the back body (which includes a flattening in the lower back and back of neck). The above exercises would only increase that pattern.
More than that, if core strength is prescribed for lower back pain, and the pain is stemming from nerve pain, degenerative discs, herniated discs, stenosis, spondylolisthesis, or excessive lumbar lordosis, these exercises could be very dangerous, as lumbar flexion is contraindicated for all of these conditions.
For safety, keep your spine neutral
It is valuable to have MRI imaging to have an exact diagnosis, but, especially for the adult body, better safe than sorry. The safest core exercises are performed with a neutral spine, one that does not flex ‘flatten’ or extend ‘arch’ the lumbar spine.
Should I use a back brace?
Don’t rely on a back brace. It is the job of our core muscles, not a back brace, to keep the lumbar spine safe and stable. It is mandatory that we learn, and grow strong enough, to hold our vertebrae in centered joint positions with a small lumbar curve intact (not a large curve or a flattened one), to be free of back pain. Exercises (with modifications for different ability levels) like leg lifts, planks, or triangle in yoga, challenge our core to hold the spine steady in varying positions.
Think of this as a bracing activity of the core to not allow the spine to bend while challenging it with the weight of the legs in leg lifts, with the weight of the pelvis and head in plank, or with the weight of the torso and head in triangle.
Relaxing and expanding the core is as important as training it to contract
We need to spend time relaxing the core and letting the muscles move through their full range of motion to be strong. As in, take off your spanx or stop sitting in front of the computer! Spend time lying on your side, or stretching out on your back with as little pillow as possible, (or better yet, hang from a pullup bar), and let the breathing muscles move your belly. If you watch a sleeping baby breathe, you will see a rise and fall in the belly. Muscles that are always held tense, tight, short, or overly long, are weaker muscles. If you watch an older person breathe who has lost the connection to their core muscles, even when they are sleeping, you may only see their chest move, rather than the belly.
Core muscles begin with your pelvic floor muscles
It also seems to be a little recognized fact that core muscles begin at the bottom of your pelvis in your pelvic floor. All the muscles in your pelvic bowl, in fact, not just your waistline muscles, need to support your spine.
Pelvic muscles assist with lifting and bearing down core activities
Bracing is not the only job of the core. There is the responsibility while standing, bending, and picking up objects, to lift and hold some weight off the lumbar spine… to share the workload.
Another lifting activity, is preventing the bladder contents from leaking until a bathroom is available.
Bearing down strength is also required. Think about childbirth, or going to the bathroom, where muscles are required to push out.
Pelvic floor dysfunction
Things that can cause the pelvic bowl muscles to underperform or become dysfunctional, are pelvic position, whether sitting or standing, and head/shoulder position. Stand up, sway your hips slightly forward toward your toes, and feel the pelvic bowl muscles turn off. Now draw your hips slightly back just above your ankles, and feel the subtle support from the pelvic bowl muscles. Similarly, notice the difference forward head and shoulder positions, versus upright posture, have on the pelvic bowl muscles.
Relaxation and expansion are also especially important for pelvic muscles as many people are chronically tense which is another aspect of pelvic floor dysfunction. Yoga positions that allow a relaxed expansion of the pelvis such as supta baddha konasana, side lying, or gentle inverted positions are exceeding useful for this purpose.
Please contact me if you need help with core strength for back pain, or pelvic floor dysfunction!
The author, Jane DoCampo, M.A., E-RYT 500, C-IAYT, is a yoga therapist certified by the International Association of Yoga Therapists, and specializes in improving back pain, scoliosis, and postural problems.
She works with students privately (in person or online), and in small groups teaching Backcare Essentials, Backcare Essentials and the Pelvic Floor, and Backcare Essentials and Scoliosis classes at her studio, My Back and Body Clinic, in Woodcliff Lake, NJ.
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