STRENGTHEN YOUR CORE TO EASE PAIN
Core muscles are the foundation for pain-free movement. Start by strengthening the deep core muscles.
Everyone can benefit from building strength in their core, meaning the group of muscles in the abdomen, back, hips and pelvis. Having a strong core takes pressure off nearby joints and helps the body to maintain good posture.
“The most important thing our core musculature does is give us a brace with movement,” says Cleveland Clinic physical therapist Jennifer Smith, PT, DPT, OCS. We need this stability for greater mobility.
When Evaluating patients with low back pain or pain in their lower extremities, Smith examines their core strength. Many people with back pain have weakness in the stabilizing muscles of the core. “If I notice a patient demonstrating poor posture while sitting or standing, I know their core strength may also be affected,” she says.
Â Start with the Inner Core
The core muscles of the spine are made up of multiple layers. The deep ones, which form the inner musculature of the spine, often don’t get as much attention as the more global core muscles, such as the rectus abdominis (also known as the abdominals) and the obliques (the outermost muscles of the abdomen).
“Those are the glamour muscles of the spine,” says Smith. “But we need to start activating the deeper core muscles first, as they provide segmental stabilization to the spine.” The main deep core musculature on the front of our bodies are the transverses abdominis muscles and at the back is the multifidi musculature.
Smith starts patients with exercises to strengthen these deep core muscles. The first is transverses adbominis bracing. “I start them in a hook-lying position, and eventually progress the exercise to sitting and standing,” says Smith. “The ultimate goal is to have them activating this muscle throughout the day without knowing it.”
“Once patients can activate those muscles, I add dynamic movements,” says Smith. For example, while lying on your back with knees bent and feet flat on the ground, tighten your abdomen and then slowly lift each leg up one at a time like you’re marching in place. Once the inner core muscles are strengthened, you want to activate muscles surrounding the core. Such as the gluteal (the muscles in the buttocks). This can be done with the bridge exercise.
More Advanced Moves
More advanced exercises, such as the standing diagonal chop, keep core muscles strong and are good for prevention if you don’t have acute pain. Once you know the basics of any exercise you can progress it to make it more challenging.
There are many exercises that can challenge your abdominal muscles. You want to make sure you are not hurting your spine or other joints while performing them. “Always start core strengthening with your spine in a neutral position because exercises such as sit-ups can put too much stress on the back,” says Smith.