Probably the number one mis-information I hear on a daily basis is that your low back pain is coming from a weak core. I get asked all the time about how to strengthen your core, what exercises work best etc. However, your low back injury likely didn’t develop from a “weak core.”
Let’s use me as an example. I know my way around a gym. I’ve been training in various methods for over 10 years, I have done certifications as a Strength and Conditioning Specialist, Crossfit Level 1 Coach and I’m a chiropractor! My whole MO in the gym has been to “strengthen my core” all of these years. At various stages I could deadlift 450lbs, squat more then double my body weight, and through myself up over a bar to perform a muscle up. Those movements aren’t possible with a “weak core.”
Instead, this is what I observe more often in my clinic - it’s not a weak core problem its an IMBALANCED core activation problem. You aren’t able to control or coordinate your core appropriately for the task at hand.
Let’s talk about your core. What is it? Your core is a group of muscles that surround your midline. Your abs are probably the least important here. Think more of a cylindrical tube of muscles that wrap around the space between the bottom of your rib cage and your pelvis. Also, it includes your pelvic floor muscles and your diaphragm muscle. So really your “core muscles” are like a can that are used to keep you upright. Other notable contributes are your glute muscles (butt), your diaphragm and your hip flexor muscles (front of the hip).
This is why there can’t be a cookie cutter approach to dealing with low back pain. “Strengthening your core” can literally mean 100 different things.
The more important thing we need to understand is how our muscles work. Remember, our bodies are incredible, amazing, adaptable machines. They will perfectly adapt to the ENVIRONMENT you put them in. This is advantageous to us since it allows us to do the things we want to do (i.e. hike, bike, climb, swim, sports etc.).
But what sort of demand are you putting on your muscles? If you are sitting for multiple hours a day in the same static position, your muscles, nerves and brain start to believe that this is how you want your muscles to perform. So they adapt to be strong in a sitting position. Then after you’ve trained your body to do this for years, suddenly you decide you want to stand and boom, you throw out your back. Your thoughts “well I must have a weak core, my body is failing me, I’m getting old.” This couldn’t be farther from the truth. Your body has done an amazing thing to adapt to the circumstance that YOU told it was most important and then you demanding something different and blame your body for not immediately adapting.
My point: you need to stress the tissues in your body in a way that you want them to perform constantly and consistently throughout your life. Otherwise you create an imbalance which is going to lead to injury, pain, and an inability to do the things you love over time.
Unfortunately, doing a few core exercises is not going to be the answer to correcting your low back injury. You must not oversimplify a complex problem. This is why I have developed a method for my practice members to first mobilize and regain movement, then stabilize and balance the restored movement and finally strengthen the tissue to meet your specific demands. Since everyone has different demands for their body and created different imbalances throughout their lives its going to look a little different for each individual.
My preference for most people is to do uni-lateral (one sided) exercises to activate muscles. Single sided exercises will often use less weight which means you are more in control. USE YOUR BRAIN - you need to think about what muscles you want to activate in order to develop those strong neural pathways. Always stay in control of the movement, slow it down and use the appropriate weight to accommodate the weaker side.
As always, listen to your body, trust it’s ability to adapt. Work smartly under someone’s guidance and be patient - give your body time. There is no quick fix or handful of exercises that are going to correct your neural imbalances. Let your body re-learn, then retrain and strengthen a more balanced neural pathway. Remember that your problem isn’t a “weak core” - it is an imbalanced or poorly controlled activation of your core muscles.
Dr. Alfredo is a health enthusiast who’s goal is to help people and families live healthier, happier lives. My philosophy on health is simple - our body’s have the amazing ability and potential to self-adapt, self-regulate and THRIVE in this world.