Will strengthening my abs prevent lower back pain?

Hi there,

There are a few ways to tackle lower back pain. I'll assume you have an increased arch in your lower back which is the main cause of the pain. Weak core muscles can contribute to the problem, as can tight hip flexor muscles which are pulling your pelvis down which is leading the curve. A tight back can also be part of back pain. 

I don't like giving sit up's or crunches to people with lower back pain, as in order to do the movement you have to turn your hip flexors on which, in turn, is going to cause them to become tight if not stretched regularly and make the pain worse.

I would suggest the following things:

1. Stretch your hip flexors - I have a stretch for that on my website here http://www.jtwellbeing.com/p/stretches.html (stretch #8)

2. Stretch your lat muscle -  I have a stretch for that on my website here http://www.jtwellbeing.com/p/stretches.html (stretch #1)

3. Work on transversus abdominis activation. This is the main core muscle that offers stability and one I would try and activate then strengthen. There are different levels of progression this but the first one is to:

1. Lay down on a bed
2. Feel for the sides of your hip bones and move in 1-2cm and keep a finger there
3. Breathe in and squeeze your pelvic floor muscles
3. Breathe out but keep your pelvic floor muscles drawn and stomach squeezed/tensed. Hold for 10-15 seconds initially or until you feel the muscle stop working/tensing.

There is research to say that if your abdominal muscles are switched on then the transversus muscle is likely to be also, but I think it's good to focus on it specifically. 

Here is a good video that might help if you're stuck feeling for the muscle as it isn't the easiest muscle to feel for. http://www.youtube.com/watch?v=dgIhzlp474A

I wont go into detail about working other muscles that are weak because I think that the stretching and core activation is a great place to start. 

If you do feel severe pain or it doesn't get better I think it would be good to see a physio so they can assess it.

I hope this helps!

Jason

Hi,

Low back pain can be a difficult problem to treat. Low back pain is a very personal and individualised problem… thus an individualised management program is advisable! Assessment and management with a physiotherapist is advised.

People with low back pain need to consider and work on two things… spinal mobility and spinal muscular conditioning (control, endurance, strength).

If spinal mobility has not been suffiecently assessed and managed, spinal muscular conditioning will be more difficult and slower to progress. So just working on abdominal strength is not enough to help prevent low back pain episodes.

With regard to spinal mobility, people often display a direction preference for movement. When moving in the preferred direction (usually lumbar extension with and without a bias) the spine moves freer and local and other pains are often improved. When moving in the non-preferred direction (often lumbar flexion) the spine stiffens and local and other pains are worse. So finding your preferred direction is very important for spinal mobility and management of low back pain. A credentialled McKenzie physiotherapist is advised for this aspect of managing low back pain. Check out www.mckenziemdt.org.au for a therapist near you.

With regard to spinal muscle conditioning, transverse abdominis and lumbar multifidus are two very important muscles to activate. Once you know how to activate transverse abdominis and lumbar multifidus, challenging these muscles with low intensity functional exercises is important. When transverse abdominis and lumbar multifidus are functioning well, continued exercise management with a personal trainer (fortnightly sessions) is advised to monitor form and technique.

Any questions, I am happy to discuss.

Regards, Neil

 

Many physiotherapists, Exercise Physiologist and other Allied Health Practitioners place a strong emphasis on strength and rehabilitation programs. They recognize that core stability and muscle retraining can be important, especially when the nature of your job or sport involves heavy or repetitive loading.One of the Frequently Asked Questions by patients who come to our clinic for the first time is “Why am I not better?? I have been taught a strength program or core stability program for my back by another health professional and my back is just the same or worse”There are 2 critical things that make all the difference with Rehabilitation Programs that are frequently not well done by many health professionals.

• The underlying joint problem (eg disc in the lower back, or labrum in the shoulder or hip) is not resolved first
  
• The exercises are not specific for your particular problem
  

With the McKenzie Method we first correct the underlying joint issue. This instantly improves muscle function even before strengthening takes place! Failure to correct the underlying joint issue does not allow normal functioning of the joint, causing pain inhibition and alters muscle function. Retraining the muscle in this instances leads to poor results and a failure to improve pain!With the underlying joint issue sorted out (within 2-3 sessions) the muscle function often rapidly and dramatically improves. The key then is ensuring exercises are performed in the direction your problem needs, which is central to the McKenzie exercises.eg. Doing crunches for the low back (with a reasonable view of strengthening the core) causes repeated flexion to occur, the most common direction that worsens disc problems in the low back!Specific Rehabilitation Programs also need to befunctional, as research clearly shows that exercises need to be performed in positions that replicate your work or sporting environment for best results!

Joel makes very good points.  You need to do pain relieving exercises first.  Once the pain is releived with that then strengthening the area allow you to get back to what you love to do.

Unfortunately, I also see lots of people who “think” they are doing the right thing, but in fact it is not helping matters.  Like Joel mentioned, doing crunches is strengthening the abs but it is a felxion exercise - the exercises or movement that does the most harm.

The McKenzie Method is a targeted assessment and treatment tool that can be used for any musculoskeletal problem.

The ‘Ab’ muscles are just one part of the entire ‘core’ group of muscles. The ‘core’ muscles form a wall around the abdominal cavity that help stabilize and protect not only the lower back and spine, but also all the abdominal organs. I will also include some of the hip and upper back muscles in the core muscles group as there are muscle in these regions which reinforce the lower spine and pelvis, the foundation of the core.
I suggest you speak to a qualified physical therapist to specifically diagnose your condition, and prescribe exercises for you that are suitable to your condition, as you have mentioned, there may be some exercise that are not suited for you. Sit-ups and crunches have been thought to be more damaging for the spine than beneficial if performed incorrectly.

Back pain is multifactorial and hugely variable. Each individual needs a program matched to his or her signs and symptoms. Some backs need movement and minimising slump sitting. Some need stability training or reduction of postural standing stress.

If your pain is ongoing then learning about persistent pain and how you feel about it can be a start. There is growing evidence that your thoughts and beliefs, what we call "thought Viruses", can be powerful in prolonging or controlling your pain. Finding a reliable source of accurate information is vital.

To find the optimal treatment for your back pain it is better to have a clear diagnosis or categorisation of your problem before embarking on random trials of this or that.

My Web site www.intouchphysio.com.au has a summary on the latest approaches to chronic pain based on Butler and Moseley’s Pain Approach. www.PAINhealth.csse.uwa.edu.au offers a wide range of evidence based information