Man are there a lot of people out there with some type of low back pain. I over hear it at the gym, and I’m told it during my initial meeting with clients on a daily basis. There is often the consensus that just by strengthening the core, pain will decrease or go away. Because obviously the pain is coming from some type of weakness right? No way!! In most cases, the pain at the lower back is not because there was originally something wrong with the lumbar spine itself, but other areas were not functioning properly and symptoms are displayed there. The first thing I think when I hear low back pain is thoracic spine and hips. How is motion at these joints? If the hips or thoracic spine are hypomobile, the lumbar spine needs to go through additional ranges of motion to make up for the lack of motion in the other areas. If motion is fine, it could possibly be a stability issue. No, I’m not talking about strength, but core stability. Do the intrinsic core muscles such as the multifidi, transverse abdominis, and intertransversarii group stabilize each segment properly? Or maybe they don’t display the reflex stabilization that core stabilizers should have. Notice I didn’t say they aren’t strong enough? Reflex stabilization is the ability for these muscles to turn on without us telling them. This is essential in the core for proper function and stability.
After all that do you still think it’s a strength issue? Stuart McGill, in his book Low Back Disorders, tests the lumbar spine musculature for endurance, not strength. These muscles need to contract for long periods of time throughout the day to maintain the body’s upright posture. So if you have low back pain, what is your issue? Could it be mobility, stability, or reflex stabilization? Stop thinking about strength as your cure and look at the whole picture. It could even be those crunches/sit-ups you do on a daily basis, but we won’t even go there!