Another week, another lower back pain client. But what was different this time was that the client was young, with no history of back pain or trauma. They just suddenly woke up one morning with a stiff and painful lower back.
After some investigation (literally delving into the muscles and pressing on some joints), observing movement form, and conducting tests in the lower back and hip area, the issue seemed to stem from their core/stomach.
The client's core was weak, causing their back to overcompensate when sitting upright or lifting items. There was barely any core activation or front trunk control around the hips.
It's funny how the stomach can affect the back; who would've known?
The research and gold standard show:
"The core muscles in the body, which help stabilize the spine, can be divided into deep and shallow muscles.
This study reviewed different core strength training strategies to see which ones were most effective for alleviating CLBP.
Four types of core strength training exercises were analyzed: trunk balance, stabilization, segmental stabilization, and motor control exercises. These exercises focus on improving the strength and control of deep core muscles. The study found that these exercises helped reduce pain and improve disability levels in CLBP patients.
Evaluation methods used in the study included pain assessment, disability questionnaires, and objective measures like ultrasound. Results showed that core strength training led to significant improvements in pain levels and disability, as measured by various assessment tools.
Overall, core strength training, particularly exercises targeting deep core muscles, can be an effective way to manage CLBP. Using objective evaluation methods can provide clearer insights into the effectiveness of these exercises."
(Luo et al., 2015, p. 619)
What's my opinion?
Most of the time when we are sitting on a chair or reclined, there's really no weight being pushed through our core; it's all just being supported by the back or the chair. For the average person, our core isn't activated unless we're holding some shopping, picking things up, or walking.
I believe we should actively do some type of extra core work. If you're at the gym squatting, doing shoulder presses, playing a sport, doing Pilates or Yoga, or just running daily (you guys are the top-notch athletes), then you're doing just fine and won't need anything extra for your core.
But for the rest of us, some sit-ups, good old dead bugs, and some balance/walking exercises (like standing on one leg for 30 seconds, step-ups) are really the simplest yet most effective exercises.
Let's see what the next week entails for me and hopefully some more discoveries.
Luo, J., Song, W., Huang, L., Liu, M., Li, M., Gong, L., ... Liu, W. (2015). Effectiveness of core strength training for chronic low back pain. Journal of Physical Therapy Science, 27(3), 619–622. https://doi.org/10.1589/jpts.27.619
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