Training the Core and Low Back Pain

I started training others in 1999 and over the course of 15 years, I’ve seen lots of trends in abdominal training come and go. Back then, if someone told me they wanted a six-pack (which was just about every client), I told them to clean up their eating and we would hammer their abs for 15-20 minutes at the end of each session with sit-ups, 374 different crunch variations, side crunches, hanging leg raises, and anything else I could dream up. I even created a group class called “Hard Core” which would challenge your balance, endurance, and abdominal strength in any way I could dream up (I used Swiss balls in every class). During the past 5-7 years however, through lots of reading articles, books, and research publications from people much smarter than me, and coaching hundreds more people I’ve changed my approach. I understand more about the true role of our core musculature and some of the mechanisms of pain and injury.

Low back pain (LBP) is the most common complaint I hear from people who come to me interested in training. I’d imagine than anyone reading this knows several people who have suffered through LBP or required some type of medical treatment to resolve it. Much of this can be attributed to the fact that as a population, we sit more than ever and we adopt faulty sitting, standing, and breathing patterns. Unfortunately though we all want six-pack abs and think that the best way to achieve them is to do lots of sit-ups, crunches, side crunches, hanging leg raises, etc. There are many other “ab” exercises that I have neither the time nor interest to type which you might be performing and might be detrimental to your spine health resulting in low back pain in the future. I’ll discuss some of them and if possible, I’ll post videos of them at some point.

    Some of the common culprits

  • The sit-up – If you’re doing sit-ups, you should probably stop. The sit-up imposes approximately 3300 N (730 lbs) of compression on the spine (Axler and McGill 1997). The National Institute for Occupational Safety and Health set the action limit for low back compression at 3300 N, yet every time you do a sit-up you are subjecting your spine to this high compression with each repetition. In his book, Low Back Disorders, 2nd Edition, world-renowned spine specialist Stuart McGill says, “Those who are training for health never need to perform a sit-up; those who are training for performance may get better results by judiciously incorporating them in to their routine.” Essentially, the risk isn’t worth the reward.
  • Straight Leg Raises or straight leg holds – Most people have performed a straight leg raise at least once in their lives. Our high school soccer coach would make us hold them for maximum time at the end of practice to see if our abs were in shape. I vaguely remember my longest hold being somewhere in the neighborhood of five minutes. Did we use good form? I think not. The straight leg raise with feet a few inches off the floor (or hold) engages the hip flexors which forces the pelvis in to anterior tilt thus pulling the lumbar spine in to extension and compressing the spinous processes and nerve roots. Most of the clients I work with or see in our gym “live” in extension and training them in a way which exacerbates this pattern isn’t a good idea. As you raise your legs (mainly a hip flexor action) your lumbar spine will tend to flatten or even flex, right before returning to an extended position. And during the Straight Leg Raise the flexion / extension cycle is repeated often until exhaustion. The problem is that the overwhelming majority of people lack the core control to pull off the Straight Leg Raise.
  • The crunch – Crunches came about as a way to alleviate the problems created by the sit up, yet still “feel the burn” of abdominal training but crunches have created an entirely new set of problems because of our excessive thoracic kyphosis (hunched over) and neck posture namely; anterior head carriage and cervical spine extension. I see some pretty bad crunch technique, most of which includes pulling forward on the head and using the arms to help perform the exercise. So yes your abs will burn from doing 100 crunches, but at what cost? You could further damage your already hunched-over upper back and shoulders and create problems in the neck and head. (The number of people who come to me complaining about neck pain and headaches is almost as many as those who come to me with low back pain.)
  • Planks – I know what you’re thinking, “Wait, planks are supposed to be safe for your back and good for the core, and I can hold a plank for 17 minutes!” First of all, planks CAN BE good for your core and safe for your spine, but they are more often than not performed with less than optimal technique. Secondly, if you can hold a plank for more than a couple minutes, I’d venture to say that you’re doing something wrong. As we fatigue, our bodies compensate. And when we compenate, we make alterations to proper movement / position. For example: try to stay up a couple nights straight and don’t take naps during the day then see what happens. Chances are, you will start making silly mistakes, dozing off, or hallucinating. THAT is your body’s way of compensating for your lack of sleep. It’s shutting down the systems that should be running properly in favor of simply keeping you alive. (Why do you think the FAA has time-out regulations for flight crews?)

So what CAN you do for your core that will not hurt your low back, upper back, neck, etc?

It starts with the ability to control your core with very subtle but important breathing and bracing technique. Fundamental exercises that allow you to control spine position while moving are first.
Hip extensions (glute bridge) – This a great warm-up exercise that can serve as a primer for the rest of your workout or if you have poor core control, it may constitute part of your workout. Most people get this wrong by driving their low back up in to greater extension (remember most people live in extension) rather than driving from the glutes while keeping the lumbar spine neutral. Lie on your back with your feet 12 inches from your butt. Brace your core and pull your low back to the floor. Press your heels to the floor and drive through your glutes lifting your hips. Hold for one full breath, lower and repeat. Perform 10-15 reps.

Plank – I test the plank for all my new clients to determine if they tend to fall in to one or more of these faulty positions (low back sags, head falls forward, hips up too high). As you can see, this client sets up with a couple positions which need correction. A plank should look like a plank of wood. Straight.

Bad Plank

If you cannot hold a good posture in the plank, you have no business moving on to more advanced exercises. Sorry. I know you saw this crazy cool exercise on Youtube, but you’re not ready for it. Don’t put the cart before the horse. It’s easy to tell you how to fix it, but it’s better to teach you. Essentially, I would like the hips lower (by actively turning on the glutes) and posteriorly tilting the pelvis which will bring the lumbar spine to neutral. Then we want the chin tucked in and back to created a more neutral cervical spine as well. All this is easier said than done however, because some people whose hip flexors dominate their pelvis cannot effectively activate their glutes (distance runners and desk jockeys).

Side Plank – A side plank should look like a plank…on your side. Hips extended with glutes squeezed, lumbar spine neutral, and head in line with the spine. I usually start with a kneeling side plank or a side plank up on the wall to master the position before going to a full side plank.

This is only a very basic introduction to this idea and I will have many more posts, pictures, and videos to follow which will take us deeper down the rabbit hole. But until then, remember this. The function of the core is to control movement of the spine and to transfer power from lower to upper extremity and vice versa. Train it accordingly, and you will feel better, move better, and be stronger.

Published by wattsperformance

I'm a strength and conditioning coach who helps people of all ages move better, feel better, and look better.

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