Getting to the “CORE” of your back problem

You’re at the doctor’s office with back pain.  You get a prescription for exercise and/or physical therapy that says you need to strengthen your “CORE”.  Sound familiar?

So what is this four-letter letter word the “core”?  And why would strengthening it help with lower back problems?

Technically, the “core” is a group of 29 (yes that’s right, 29!) muscles that make up what is called the lumbo-pelvic and hip complex.  The “core” muscles include your thigh muscles (quadriceps on the front of the thigh, hamstrings on the back of the thigh), abductors and adductors (inner and outer thigh muscles), gluteals (buttock muscles), hip flexors, abdominals, paraspinal muscles (along the length of the spine) and the lattisimus dorsi (the big fanlike muscle in the back that looks like an upside down “V”). Their function is to stabilize, produce movements and reduce movements. 

Current research shows that most low back pain clients have weak lower abdominal, oblique and paraspinal muscles.  These weak muscles have decreased “neuro-muscular” signals that cause postural changes and loss of balance.  Research also shows that pain or injury in joints above or below the lower back can significantly impact the control of these “core” muscles.  Clients who have had pain in a shoulder or twisted ankle can present with lower back discomfort months sometimes years later as a result of the musculo-skeletal postural changes that result from the pain or injury.

To properly address my clients who come to me with low back pain, I first make sure that there is not a medical issue that would compromise our exercise program.  This includes getting a medical release from the physician, physical therapist or chiropractor indicating the client can participate in my “core” strengthening program.  Next, I perform a series of assessment looking  at posture, muscle strength, muscle balance and flexibility. 

We’re now ready to begin addressing those muscles of the CORE that need to be “REBOOTED” and strengthened.  Remember unless the current back problem is acute most lower back problems are a result of pain or injury to areas  above or below the lower back such as the shoulders, hips, knees, ankles or feet.  Unless these areas are addressed as part of the exercise paradigm the lower back will continue to express its displeasure through pain and dysfunction.

During   the initial assessment with my client I often find that the possible cause of lower back problems are related to weak upper back or “postural” muscles, tight chest, thigh and calf muscles.  So while this is just a four letter word, its implication is powerful and includes more than doing some “AB” crunches or sit ups!

Next time, we explore no more than 10 exercises and stretches that will stabilize and strengthen your lower back and “core”.

In Health, Marsha Mann, M.E.S., C.C.S