Core, Rehab

Could core strength be contributing to your back pain?

Core Strength Training:

Patients often comment on how they believe that their lack of core strength is a large contributor to their back pain. Many times this can be the situation but maybe not in the way they had originally thought. While core strength can play a role and contribute to low back pain, core activation and the timing of core activation is usually just as large of a contributor to pain. Did you know that there is a difference between working out your abs and performing dedicated core rehab training? In what I call “core rehab training” we not only look at the strength of the core muscles, but also the timing with which they turn on compared to when movement is initiated and how much they turn on with each movement. 

To get a better understanding of the difference between the core and your ‘abs’ I have laid out the anatomy of the core below.  


The Anatomy:

The abdominals are made up of the Rectus Abdominis, Internal and External Obliques and Transverse abdominis. The ‘core’ that provides stabilization of the low back also includes the Diaphragm, Pelvic Floor and Multifidus. 


When we look at the abdominals they run from the bottom of the rib cage to the top of the pelvis. In this case, the muscles contract and  pull the ribs down towards the pelvis and provide a rotational component. When we add in the muscles that make up the entire core the movements it causes evolves. The Transversus Abdominis attaches from the low back and runs around to the front of the body, attaching from the ribs down to the pelvis. The diaphragm fills the bottom of the ribcage attaching all the way around the body and the pelvic floor fills the bottom of the pelvis. When we bring in each of these elements the core attaches from the bottom of the rib cage, to the bottom of the pelvis and all the way around the abdomen. 


The Function:

This means that when you activate the core not only can it bring the ribcage and pelvis closer together, but it can also tension all the way around your abdomen and cause a corseting effect that will stabilize your low back.This means that when the core is engaged properly provides support to the entire abdomen.  It is this support, caused by the proper strength and activation of the core musculature, that can have a greater impact on preventing and eliminating low back pain. Spending time dedicated to working solely the rectus abdominis typically doesn’t correlate with decreased low back pain, and may also contribute to increased pain. 


Training the core:

  1. Umbrella breathing: 
    1. Laying on your back with a small gap between your low back and the floor
    2. Inhale through your nose
    3. Allow your ribs to expand and spread apart – reaching your ribs to the walls beside you
    4. Your stomach and pelvic floor muscles will fill up with air and relax
    5. Exhale through your mouth 
    6. Allow your ribs to draw down and your stomach and pelvic floor come in
    7. Throughout the motion you keep the spine in the same position
  2. Ski Jump:
    1. Standing with your feet hip width apart
    2. Lean forward through your ankles keeping everything else in a line
    3. Perform an umbrella breath in this position starting with inhaling through your nose
  3. DeadBug progression:
    1. Laying on your back with your knees bent and feet flat on the floor
    2. Complete 2-3 umbrella breaths 
    3. Breath in, exhale and slowly lift one leg off the ground keeping it bent
    4. Focus on keeping your pelvis stable and not letting it move while you lift your leg
    5. Repeat on the other side
  4. Plank:
    1. Laying on the floor lift yourself up onto your elbows and toes (or knees to make this exercise slightly less difficult)
    2. While on your elbows and feet, squeeze your quads (the front of your legs)
    3. Take 5-6 umbrella breaths and hold for 10 seconds
    4. Repeat 6 times 


What can proper core engagement do for you?


In short, properly engaging your core is more than just a strong abdomen. It involves activating your pelvic floor, stabilizing your low back and involves breathing more than you may have realized. Not only can increased core engagement and proper breathing decrease your chances of low back pain but it can also aid in digestion, decrease the risk of constipation and decrease stress. It’s not always about having the strongest core. In conclusion, it is more about having a core that fires in the right pattern at the right time.



Wondering if your core strength and activation are contributing to your back pain? Contact one of our Chiropractors today for more information.

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