Core Strength Training may aggravate back pain

Posted by Helen Potter Subiaco on 16 February 2017 | Filed under About Acute Back Pain, Back Treatment, Pain, Physiotherapy

Core strength exercises could make chronic back pain worse Article by: AAP | Last Updated: 11-11-2016

Backs are not weak

Back pain is very common; most people will have it once in their lifetime. With one in six Australians suffering from chronic back pain needs to be managed properly, say Prof Hodges and Prof O’Sullivan. The idea that back pain is a result of a weak “core” is wrong and needs correction to manage the complaint affecting thousands.

The fitness industry’s obsession with Core Strength Training causes unnecessary fear about our spines. Core Strength Training may add to the problem of chronic back pain. Our spines like to move, not be stiff, and the problem is too many core building exercises require no movement at all.

Impact of Core Strength Training

Years of Core Strength Training may make a person’s chronic back pain worse, says musculoskeletal physiotherapist Professor Peter O’Sullivan (Curtin University). He says “people with back pain are already too rigid. Their muscles tense as a protective response to the pain.

Core Strength Training can be counterproductive. People with back pain require individual assessment by a professional as unique movement signature patterns need specific treatment. If someone’s got pain just doing a conventional program may not be the right thing. You need to change it.

Core Strength Training misunderstanding

“The common belief around tensing up a structure that’s already tense doesn’t make sense,” Prof O’Sullivan said. Relaxing your muscles around your trunk when you have back pain is more helpful. Professor Paul Hodges, from The University of Queensland, agrees. We need to correct the myth that core stability equals a stiff spine to better back care.

He says too many people “wrongly” believe that a weak core leads to back pain. Those in the fitness industry who heavily advocate core building exercises as a way of managing the common pain complaint, fuel fear of moving. While core stability exercises are easy to teach, they involve little movement of the spine, says Hodges.

“The common assumption in gyms is that people assume core stability means that you stop the spine from moving.” “The Plank” exercise, for example, involves a person on their elbows and toes while holding their body stiff. Many Pilates studios have people lying still on a reformer bed while holding their spine rigidly in place.

This blanket idea that exercise should just be about stopping people from moving their spine is only half of the story. Prof Hodges says some people do move too much and need core control, and vice versa. However different functions need different solutions and “one-size fits all” approach isn’t appropriate.

Treatment Outcomes rely on thorough assessment of impairments. Treatment is about getting the balance between movement and stiffness right. “If you think about most functions, they need the spine to move.”

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