Core stability for back pain
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Here are examples of core stability exercises that I use for patients who present with low back pain.
1️⃣Bird dog
2️⃣Side plank
3️⃣McGill Curl up
4️⃣RKC plank. I often will replace the curl up for the plank as I find it is easier for patients to perform without cueing / compensatory spinal movements.
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Generally these are performed for 10 seconds with 4-6 repetitions on each side. Once you can perform 8-9 sets without compensations I would progress to more advanced exercises. Generally the advanced exercises include upper and/or lower limb movement while remaining stable. Athletically you are never in a perfect spine position, but if you cannot maintain an isolated spinal position how can you expect to maintain a braced spine in a dynamic movement?
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Unfortunately on social media people will post exercises without an explanation of WHY they are chosen. Why do I use these exercises?
1️⃣Patients with lumbopelvic deficits respond well to volitional core stabilization.
2️⃣Core musculature are designed to resist movement, therefore should be INITIALLY trained isometrically.
3️⃣Combined these 3 exercises hit anterior, lateral and posterior core musculture.
4️⃣Dr. Stu McGill, @backfitpro , expert of spinal biomechanics, studied a variety of core stability exercises. The McGILL big 3 exercises provided maximum core muscle activation with minimal spinal shear forces. The sit-up is an example of having high rectus abdominis activation but moderate lumbar shear, therefore may not be the best exercise for a patient with back pain.
5️⃣Easy to do at home and does not require equipment.
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Since I have back pain, should I do these exercises? MAYBE. Not all patients with low back pain will benefit from these exercises. These are examples of exercises that I would use if a patient presented with lumbopelvic stability deficits and what I believed was the cause for their symptoms. I do not give ALL patients with low back pain these exercises. I would encourage you to see a healthcare provider to give you a better understanding of your symptoms.
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Reference:
McGill, S. M. (2015). Low Back Disorders, 3E. Human Kinetics.