Is “Core” Strength The Answer To Low Back Pain?

"Man can no more see the world than a fish can see the river bank." - Remy de Gourmont

Through the lens of low back pain I learned to move. It forced me to pay attention, to have a plan, to celebrate the wins no matter how small. I’m stronger and more confident in my body’s ability to adapt because of my experience with pain and injury. 

I tend to tackle problems with information and one of the first things anyone comes across when plugging “low back pain” into a search engine is core strength. This seemingly simple topic is a minefield of misinformation and false claims interspersed among truth and real answers. The truth is that strength, activation and timing of your “core” matters a lot in situations of low back pain, but it is not a magic bullet and is only one part of a multi-factorial solution. There will be work to do on multiple fronts if you really want a lifelong solution to this problem. But if you get this core thing worked out, you will be well along the road to a healthier spine. 

For the purposes of this blog post I want to focus on the “How” and “Why” of a few core exercises with exceptionally high return for your time and energy investment. We will not discuss breathing, posture, repetitive strain or psychosocial considerations to any degree. These are all worthy paths of exploration that I encourage everyone to go down but for the here and now, we will keep it simple and discuss my big bang for your buck “core” exercises that significantly reduced my low back pain. I chose these particular exercises for a few reasons: 

1) They offer both a strength training effect and awareness of proper positioning.
2) They are all dynamic and will reflexively activate the right stuff.
3) They are non competing exercises and could be paired together in a circuit to get both a training and corrective benefit.

Reverse Curl
Video Demonstration

The How: Choose any object to squeeze behind your knees. It can be a pillow, a foam roller or a weighted object like a medball. Then without momentum, slowly and progressively curl your pelvis and subsequent lumbar vertebrae in sequence and slowly lower down in reverse order. The key point is that your entire back should sequentially peel off the ground and segmentally lower to the ground rather than moving as one piece. 

The Why: People experiencing low back pain often guard the lumbar spine area and have difficulty disassociating the pelvis and lumbar vertebrae. Unlocking this area takes time, patience and a concerted effort, but it is well worth the investment as fluid and dynamic movement requires flexion and extension in this area. 

Side Plank Abduction
Video Demonstration

The How: This move is often performed with the bottom leg straight but I prefer a bent knee as it really allows you to focus on the movement path of the top leg. You want that leg to move straight up and straight down without flexing or rotating at the hip. When these details are paid attention, the range of motion will be reduced but that is OK because it is the truth! And all we want is the truth that allows us to focus on the right stuff to get better. 

The Why: Obliques and Glute Medius for days. The bottom glute med and obliques (among other things) are doing work creating stability while the side hip “stuff” on top is producing high quality movement.

Rack + Suitcase Carry
Video Demonstration

The How: Pick up the two heaviest objects you can carry and take a walk. That’s it. Don’t overthink it but do try to focus on staying balanced on your feet. If you notice that weight is being displaced off to one side of the foot or is disproportionately loaded onto one foot over the other, then attempt to balance things out. If you don’t have kettlebells, then two objects carried at your side is effective as well.

The Why: This is what you are designed for. Carrying heavy loads for distance is a huge part of what shaped your current physiology and is something we as humans have tried to get away from. The load at your side (Suitcase) challenges the frontal plane much like a walking side plank. The load at your chest (rack) challenges the entire midline to stabilize as it wants to pull your trunk forward. You also get tons of grip and shoulder strength. This is easily one of the biggest bang for your buck exercises anyone can do. 

Low Bear Crawl
Video Demonstration

The How: Stay low! Knees hover just above the ground as you move in all directions. Don’t just go forward, challenge your shoulders and midline stability by moving sideways and backwards as well. Keep the movement cross body by moving your opposite foot and opposite hand at the same time. Create and maintain a pelvic tuck the entire time. 

The Why: This really speaks to the deep core stuff. Since the pelvis is tucked and the spine is slightly rounded, we can’t cheat the movement as easily as we could in a traditional plank. There is a dynamic multiplanar challenge that reflexively activates all the right things and provides good transfer of energy through the midline from opposite shoulder to opposite hip.

Did I use the right words?!

Have I convinced you of the value of these movements? Just as a side note, I’m always fascinated by the selection of words, these mutually agreed upon mouth noises, that effectively jolt our target audience into action. I hope to have chosen the right ones. These exercises have been tremendously valuable for my low back pain. I still have the occasional flare but for all intents and purposes, I’m completely pain free the vast majority of the time. I hope to inspire the same in you.

Move often and move well. Don’t get too dogmatic on any one modality. Experiment and explore. Myopic movement is not the answer.