“Core stability” The facts

Have you been given “abdominal hollowing” or “bracing” exercises for your lower back pain?

Often the blame for lower back pain is “a lack of core stability”, but is this theory now becoming out-dated?

Core stability is often referred to as the strength and endurance of your deep abdominal muscles. The two most common muscles practitioners tend to identify are the transversus abdominus and the multifidus, which can sometimes be “diagnosed” as being weak under ultrasound.

But did you know that the level of activation of these muscles when moving is minimal!

While walking, the abdominal muscles are estimated to be around 1% active. Whilst bending and lifting a 15 kg weight, muscle contraction is only at 1.5%. So then why would we prescribe strength for muscles that are minimally active?

Generally, core stability exercises aim to isolate and tense the deep abdominal muscles, however it is very unlikely that there exists an isolated group of muscles that act independent from all other muscles in the trunk during sports and activity.

Further, it is well researched that we need 70% of maximal muscle contraction to achieve any significant strength improvements, but realistically, this is far from achieved from simple abdominal hollowing exercises.

Core stability training is often used for diastasis recti following pregnancy to reduce abdominal separation.

So then what exercises if not core stability?

One study has compared the difference in core strengthening exercise to general exercise for the treatment of chronic lower back pain and found that there was no difference in improvements between exercise groups. Therefore, any exercise that gets you moving and does not aggravate your pain, is the key. Here at Lilyfield Physio, it is not just about moving, but the quality of your movement that really helps your back recover. We aim to teach you to move confidently without the fear of  pain, finding strategies to get you moving safely and efficiently.

So, will core stability training be detrimental to me?

No, core stability training will not be detrimental to you, however there are a few things to consider:

• The spine is made to move and bend and the idea of core stability can prevent this.
• It has been researched that those with chronic lower back pain have increased muscle contraction when bending and lifting. Further contraction could increase spinal loading when lifting by bracing.
• The theory of core stability could promote fearful behaviour and cause some to become over-protective of their back pain.

Exercise is a really important tool to help manage low back pain. Book an Appointment to see one of our experienced physios to get you moving more efficiently, reducing stress on your spine.