It may seem strange or counterintuitive that you have to strengthen your front in order to strengthen your back, but it’s true. I may be simplifying things a little to make a point, but the abdominal muscles are incredibly important in keeping your lower back safe and pain-free.
Lower back pain is one of the most common causes of disability in the U.S. and the world. People with chronic low back pain are more frequently depressed, sleep poorly and are more likely to be unemployed or on disability, according to data from the National Health and Nutrition Examination Survey.
So what can you do to reduce your risk of becoming one of the millions with low back pain? Strengthening your core is a great start.
What Is the Core?
The muscles of the core help move the torso forward and backward (extension and flexion), side to side (lateral flexion) and twist to the right and left (rotation). While we just talked about the core including the back as well as the front of the torso, the muscles of the core can be divided into two groups: the deep core—also known as local stabilizing muscles—and the shallow core, or global stabilizing muscles.
The deep core includes:
- Internal obliques
- Lumbar multifidus
- Quadratus lumborum
- Transversus abdominis
The shallow core includes:
- Erector spinae (back muscles near the spine)
- External and internal obliques (on the sides of the torso)
- Quadratus lumborum
- Rectus abdominis (the classic “six-pack”)
Some of these muscles are in both groups and some, such as the erector spinae, are actually groups of muscles. The point, however, is that the core is more than just abs. In fact, many back muscles are part of the core, and spine stabilization is one of the main functions of the core.
Don’t Neglect Your Back
One problem I see over and over again is when people say they exercise their core, what they’re really talking about exercising their abs. They do sit-ups, crunches and other exercises that they think will give them a washboard stomach (which, by the way, is more a function of diet and low body fat than it is musculature) and neglect the back. The result? Strong abs, weak back—muscle imbalance.
Muscle imbalances can lead to injury, poor posture and chronic pain. It’s important to train the core muscles of the back as much—if not more—than the ab muscles, and the deep core muscles are just as important as the shallower muscles. Weak core muscles—no matter where they are—will always be a contributor to back pain.
Core Exercises for a Healthy Back
Sit-ups aren’t going to cut it. You need exercises that work your whole core, not just the “mirror muscles” of your abs. Working these muscles is perfectly fine and, in fact, encouraged. However, it’s important to have a complete core training regimen, which may mean you need to mix and match exercises so you’re targeting all the muscles in both the deep and shallow core.
Here are some of the best exercises for core training:
Plank. The plank may just be the king of core exercises. There are a number of variations, but the basic plank works like this:
- Get into the top of a pushup position.
- Keep a straight line from your head to your heels.
- Squeeze your glutes and your abs.
- Stay for as long as you can in this position and repeat three to five times.
As a variation, you can do your plank on your forearms instead of the palms of your hands. You can also put your knees on the ground if you need to make it easier.
Side planks. This exercise really targets the obliques.
- Get into the plank position, then move your right hand in toward the center line of your body.
- Open up so that your left shoulder is pointed to the ceiling. You should be balanced on your right hand and your right foot, with your left leg laying on top of your right.
- Stay as long as you can, and repeat three to five times.
Like the standard plank, you can do this on your forearm or with your knee on the ground. You can also put your left foot on the ground in front of you to help you balance.
Superman. This exercise works the core muscles of the lower back very well.
- Lay on your stomach with your arms outstretched over your head.
- Squeeze your glutes and hamstrings and lift your legs off the ground, then lift your hands and arms off the ground.
- Hold the position for as long as you can and repeat three to five times.
These three exercises will work all of your core muscles. Aim for two or three times a week at first, but you may be able to increase the frequency if you feel you are recovering well. You should consult with a healthcare practitioner before starting a fitness regimen. Additionally, you may want to consider hiring a personal trainer or other fitness professional to help you develop a more complete fitness routine and to make sure you practice good form.
If you, like so many others, are experiencing lower back pain, I can help. I am board-certified in pain medicine as well as physical medicine and rehabilitation. Request an appointment with me or one of my colleagues today to talk about your treatment options for back pain.