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Chiropractic and Preventing Back Pain

If you’re following the trends in exercise and fitness, you’ve probably heard the phrase “core strength” or “core stability.” Core-muscle training is something all our patients get coached to do here at the Isis Chiropractic Centres.

The terms “core strength” or “core stability” refer to the muscles of your stomach and back and their ability to support your spine and keep your body stable, safe and balanced, which is fundamental in any physical activity, if you want to stay injury-free and perform to your potential in sport.

Pitfalls in core stability training

Don’t get tempted to progress to quickly. The biggest mistake anyone can do in core-muscle training is to do exercises that are too advanced and loosing control of the core.

If the core muscles are not able to stabilise your spine properly, other muscles will be recruited to enable you to do the exercise.

The telltale sign of weak core-muscles is the inability to keep the abdomen hollowed, the spine deviating to one side and/or the spine ‘sinking’ inwards (especially noticeable during back extension).

It pays to do it properly

It can be harder than you think to this exercise properly, but when you got the hang of it, it is definitely worth it. So, don’t give up even if it seems impossible to start with.

Chiropractic treatment and core-muscle training is such a powerful combination to beat back pain. Don’t loose out by only using one or the other!

The core muscles

The lumbar core muscles lie deep within the trunk of the body. They generally attach to the spine, pelvis and muscles that support the shoulder blade (scapula).

(There are core muscles in the mid-back and the neck too, but this page will mainly discuss the lumbar core muscles.)

They stabilise these areas to create a firm foundation for co-ordinated movement of the legs and arms.

Two muscles in particular have been shown to be weak in those who have or have had low back pain:

  • The transverse abdominus (TA) -The deepest of the abdominal muscles, this lies under the obliques (muscles of your waist). It acts like a weight belt, wrapping around your spine for protection and stability.
  • The multifidus muscles (MF) are small muscles close in to the spine. You can’t contract these muscles directly, they respond to movement and action of the TA. They also atrophy in a first episode of back pain.

These muscles are deep in your low back and stomach. You can’t readily feel them from the surface.

Who needs core stability?

Because good balance and overall muscular strength are involved in most sports, core stability is helpful for all athletes. However, there are some sports where good core stability is especially important.

These include sports where you need very good balance, contact or collision sports, such as:

  • downhill-mountain biking and snowboarding.
  • hockey, football or rugby also benefit from core strength.

Core stability is also needed in everyday life: helping to keep you fit and to prevent injury when you are lugging those heavy shopping bags or doing the ironing.

Core stability training

Rises in back pain incidence have been linked to the sedentary lifestyle that many of us lead and as chiropractors we always try to motivate our patients to exercise.

Core-stability training begins with learning to co-contract the transverse abdominus (TA) and multifidus (MF) muscles effectively as this has been identified as key to the lumbar-support mechanism.

Abdominal hollowing

We recommend all our chiropractic patients to start this exercise as early as possible.

To perform the TA and ME co-contraction, you must perform the “abdominal hollowing” technique with the spine in the neutral position.

To do this use the following guidelines:

  • Start by lying on your back with knees bent
  • Your lumbar spine should be neither arched up nor flattened against the floor, but aligned normally with a small gap between the floor and your lower back. This is the “neutral” lumbar position you should learn to achieve.
  • Breathe in deeply and relax all your stomach muscles.
  • Breathe out and, as you do so, draw your lower abdomen inwards as if your belly button is going back towards the floor. Pilates teachers describe this as “zipping up”, as if you are fastening up a tight pair of jeans.
  • Hold the contraction for 10 seconds and stay relaxed, allowing yourself to breathe in and out as you hold the tension in your lower stomach area.
  • Repeat 5-10 times. It is absolutely vital that you perform this abdominal hollowing exercise correctly otherwise you will not recruit the TA and MF effectively.

Bear in mind the following points:

  • Do not let the whole stomach tense up or your upper abdominals bulge outwards, as this means you have cheated by using the large rectus abdominus muscle (the six-pack) instead of TA.
  • Do not brace your TA muscle too hard; just a gentle contraction is enough. Remember it’s endurance not max strength your are trying to improve.
  • Do not tilt your pelvis nor flatten your back, as this means you have lost the neutral position you are trying to learn to stabilise.
  • Do not hold your breath, as this means you are not relaxed. You must learn to breathe normally and maintain the co-contraction of TA and MR.
  • Use your fingers for biofeedback on either side of your lower abdomen to feel the tension in the TA muscle.
  • Once you have mastered the abdominal hollowing lying on your back, practise it lying on your front, four-point kneeling, sitting and standing.

In each position get your lumbar spine into neutral before you perform the hollowing movement.

Once you start to feel that you have good control of this exercise you can start to do other core-stability exercises.

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