Core Muscle exercise and Chiropractic:
Preventing Back Pain
If you're following the trends in exercise and fitness, you've probably heard the phrase "core strength" or "core stability."
The chiropractic profession has always been involved in rehabilitation exercise. And core-muscle training is something all our patients get coached to do.
The terms "core strength" or "core stability" refer to the muscles of your stomach and back and their ability to support your spine and keep your body stable and balanced.
The core muscles
The lumbar core muscles lie deep within the trunk of the body. They generally attach to the spine, pelvis and muscles that support the shoulder blade (scapula).
(There are core muscles in the mid-back and the neck too, but this page will mainly discuss the lumbar core muscles.)
They stabilise these areas to create a firm foundation for co-ordinated movement of the legs and arms.
Two muscles in particular have been shown to be weak in those who have or have had low back pain:
- The transverse abdominus (TA) -The deepest of the abdominal muscles, this lies under the obliques (muscles of your waist). It acts like a weight belt, wrapping around your spine for protection and stability.
- The multifidus muscles (MF) are small muscles close in to the spine. You can't contract these muscles directly, they respond to movement and action of the TA. They also atrophy in a first episode of back pain.
These muscles are deep in your low back and stomach. You can't readily feel them from the skin.
Core stability training
Rises in back pain incidence have been linked to the sedentary lifestyle that many of us lead and as chiropractors we always try to motivate our patients to exercise.
Core-stability training begins with learning to co-contract the transverse abdominus (TA) and multifidus (MF) muscles effectively as this has been identified as key to the lumbar-support mechanism.
Abdominal hollowing
We recommend all our chiropractic patients to start this exercise as early as possible.
To perform the TA and ME co-contraction, you must perform the "abdominal hollowing" technique with the spine in the neutral position.
To do this use the following guidelines:
- Start by lying on your back with knees bent
- Your lumbar spine should be neither arched up nor flattened against the floor, but aligned normally with a small gap between the floor and your lower back. This is the "neutral" lumbar position you should learn to achieve.
- Breathe in deeply and relax all your stomach muscles.
- Breathe out and, as you do so, draw your lower abdomen inwards as if your belly button is going back towards the floor. Pilates teachers describe this as "zipping up", as if you are fastening up a tight pair of jeans.
- Hold the contraction for 10 seconds and stay relaxed, allowing yourself to breathe in and out as you hold the tension in your lower stomach area.
- Repeat 5-10 times. It is absolutely vital that you perform this abdominal hollowing exercise correctly otherwise you will not recruit the TA and MF effectively.
Pitfalls in core stability training
Don’t get tempted to progress to quickly. The biggest mistake anyone can do in core-muscle training is to do exercises that are too advanced and loosing control of the core.
If the core muscles are not able to stabilise properly, other muscles will be recruited to enable you to do the exercise. The telltale sign of weak core-muscles is the inability to keep the abdomen hollowed, the spine deviating to one side and/or the spine ‘sinking’ inwards (especially noticeable during back extension).
It pays to do it properly
It can be harder than you think to this exercise properly, but when you got the hang of it, it is definitely worth it. So, don’t give up even if it seems impossible to start with.
Chiropractic treatment and core-muscle training is such a powerful combination to beat back pain. Don't loose out by only using one or the other!
