Massage Myth #4 - Core strength for back pain

This idea has been with us for a while.  Goes like this…

The spine is an inherently unstable structure and we must take great care.  We need to strengthen our core to brace it.  We lift everything with a straight back, otherwise we risk permanent or even catastrophic injury. 

Narrative like this are really entrenched in our culture but it is rooted in many assumptions and misunderstandings that ultimately give us a collective fear of our backs.  And that is highly damaging.

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Have we evolved an unstable spine? 

No.  The spine is a mega-strong structure.  It’s built to bend and twist any way you want.  You can even make it stronger by picking up really heavy things over and over.   It wants to move and be used, just like the rest of you.  Yes, from time to time it hurts and this can for due to a host of reasons, but not because it's weak or unstable.

Hurty Backs

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Watch someone who has had low back pain for a long time they tend to move in an unnatural way, like John Wayne with extra starchy jeans and a rod in the bottom.  Cautious, careful and usually rigid, they are scared of hurting themselves, understandably.  They brace their trunk to act like a corset to feel safe.  In fact, electromyography tests show that people with chronic back pain have more muscle activity around the spine, than pain-free people.  So here's the big question, why are they always told they need to strengthen their core?  It makes no sense. 

Core doesn’t need to get stronger, core needs to calm down and relax.  Let the spine start to move in a natural normal way.  Having back pain for years is like clenching a fist for years, it hurts, needs to let go man, not get stronger.  With a careful plan of graded exposure to movements, a bit of understanding about the pain and how to manage it, we can calm things down and build you up again.

core needs to calm down and relax

Learn to trust your spine, let it bend when you pick things up (unless it’s really, really heavy), have a good, comfy slouch in a chair.  You don’t need to worry about your core, it knows what to do, and when to do it.

When it comes to chronic back pain the evidence shows core strengthening seems to help… about as much as running, cycling, walking, pilates, weight lifting…  Pretty much any exercise seems to help because it’s moving and moving is good.  But more than that, it’s overcoming fear of movement – a key factor in chronic back pain.

 Say, that's a nice plank

Say, that's a nice plank

Chronic back pain is complicated and multifactorial.  A ‘weak core’ is not a predictor of low back pain, strengthening it does not solve it. 

 

If you like to do the plank exercise then do it, just not for back pain.

 

Tris