“THE LINK BETWEEN LOW-BACK PAIN AND CORE STRENGTH”
According to the NSCA (National Strength and Conditioning Association, USA) low back pain can be acute or chronic and can be caused by either a strain (injury to a muscle), a sprain (injury to a ligament), tight muscles or trigger points, hypomobility and hypermobility just to name a few. One of the most common complaints I encounter as a pharmacist and to some degree as a trainer is back pain. Those clients with chronic back pain are no strangers to strong prescription-only opioid (codeine/morphine-based) pain-killers or strong prescription-only anti-inflammatories such as high-strength diclofenac (trade name: “Voltaren”) and celecoxib (trade name: “Celebrex”). Unfortunately, many of these clients have ‘slipped through the cracks’ in terms of rehabilitation – i.e. just an ongoing cycle of GP (General Practitioner) visits and prescription-only pain-killers/anti-inflammatories. This is further emphasised in NSCA literature – “low back pain can cause a vicious cycle of pain, decreased function and loss of muscular support that, if not properly regained, can reappear frequently”.
The low back or trunk is commonly referred to as the ‘core’, which is crucial to everyday movements and performance. Hence, much of this low back pain can be attributed to poor core strength. As a trainer, I usually address low back pain through torso/trunk stability exercises (I must mention that the torso consists of the spine, pelvis, hips, abdomen and the rib cage). These exercises involve the abdominal muscles, the diaphragm and the pelvic floor muscles. By contracting these muscle groups, the rib cage and pelvis are supported.
Stabilisation of the spinal column is brought about by a combination of strength and balance training. This seeks to re-establish appropriate torso strength and stability. Generally, for FFS (Fusion Fitness Solutions) clients with low back pain, providing they have a GP’s medical clearance, I incorporate balance exercises into their programs.
For any torso/core stability exercises, I highly recommend, as well as use for FFS clients, the stability/exercise ball. Stability balls are an integral piece of equipment for core stability. Two stability ball exercises may include: (1) Kneeling on an exercise ball – whereby the client should maintain a straight back, push the hips forward, and stare straight ahead. (2) Pushing side-ways with an exercise ball – whereby the client should stand with legs positioned pelvis-width apart and with flexed knees, then rotate the torso to push the ball against the wall. When the ball contacts the wall, the elbows are held still, transferring the energy to the torso. Both these exercises increase upper body stability and muscle responsiveness.
Low back pain is a very prevalent condition in today’s society and the importance of core stability exercises in gym program design cannot be overlooked; not only in the rehabilitation of a client but also in general program design – whatever the goal(s) of the client. The ‘humble’ stability ball therefore makes for an excellent starting point for anyone who wants/needs to incorporate core stability exercises into their training.
Ref: National Strength and Conditioning Association, USA, 2012