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Back Pain Secrets & Why Having A Strong Core Is Not Enough

Written by: Nick Jack
Category: 2014
on 09 December 2015
Hits: 2379

Back pain has reached epidemic proportions in the Western world. Our sedentary lifestyle, combined with our allopathic approach of merely treating symptoms, has led this injury to reach a point where 9 out of 10 adults now experience back pain at some point in their life. Only colds and flu beat low back problems for Doctor visits. It is not limited to people who don’t exercise and can cut down even the fittest people. When a serious episode hits it can send some people into panic mode which is where treatments like pain medications and getting a therapist to “fix you” are born. Surgery would be the next step if solutions are not found. For over 10 years we have been working with hundreds of clients with all types of different conditions, (see testimonials) and we have been able to assist them in getting on top of their conditions by teaching basic movement skills, increasing stability and strength and improving posture. These methods are far less expensive, less invasive, without side effects of medications and very successful if implemented correctly. And unfortunately with so much information now available on the internet people are designing their own programs. Even trainers with a poor knowledge base and experience are designing programs for people that will exacerbate pain, not prevent it. There is a lot more to this injury than taking a pill, getting a massage and doing a few random stretches. This is where people first hear the words, "if you improve your core strength your back pain will go away". And this may be true for some, but as I will explain, trying to do endless core strengthening exercises can actually cause you more harm.

How Common Is Back Pain?

Back pain does not limit itself to unfit or untrained people. It affects elite athletes as much as the 65 year old retired office worker! It does not always happen when lifting heavy objects either. Simple tasks such as tying your shoelaces or picking up a pen are often how many disc bulges occur!

To paint a picture of how bad back pain really is here are some stats:

Statistics

  • In 2009 1 in 7 Australians (13.6%) reported having serious back problems—that’s 3 million people!
  • Over 2 in 5 people with back problems (44%) have difficulty in tasks and activities associated with mobility, communication or self-care
  • 1st according to the Global Burden of Disease estimates, low back pain is ranked 1st  in Australasia (including Australia and New Zealand), compared to 6th  in the world

How do back problems affect quality of life? Compared to those without the condition, people with back problems are:

  • 2.4 times as likely to report poor health
  • 2.6 times as likely to report very high levels of psychological distress
  • 2.5 times as likely to report severe and very severe pain
  • 3.4 times as likely to report a core activity limitation (for example, self-care or mobility).

As you can see this is a big problem, and even if you don't have back pain it is a good idea to be completing exercises and stretches that will help prevent it. This is where the popularity of Pilates and Core Strength exercises have taken a hold of the Fitness world and the Rehabilitation field by informing people that having a strong core is the secret to keeping pain away. However the understanding of what constitutes Core Strength Training, in particular for preventing back pain is completely misunderstood and what you will see the exercise selection is not often based on correcting or preventing the injury but more to do with just doing isolated abdominal exercises.

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Strengthening Your Abdominal Muscles Is Not "TRUE" Core Training

Yes you did read that right. And no I am not going crazy. What you must understand is that the core is not just the muscles around the abdominal area. The Core is a complex integration of small stabilizer muscles (the inner unit) working together with large prime moving muscles (the outer unit) to produce movement. These inner unit muscles attach to the body at the spine only, meaning that when they activate they generate little or no movement. They can only stabilize not move you. These muscles, TVA, Pelvic Floor, Diaphragm and Multifidus are often the focus of clinical Pilates training as there theory is that the back is in pain due to the lack of stability provided. This is often true with back pain. In fact the TVA is classified as an anticipatory muscle meaning it is programmed to fire when it senses you are about to move, in order to stabilize the body. A bit like a construction crane being bolted to the ground before it goes to pick something up. Often with back pain this automatic sensory program is either delayed or does not occur at all leaving the person's spine vulnerable to problems. So you can see how people would come to the conclusion - "all I need to do is work these muscles to become stronger and everything is fixed!

But as you will see there is a massive problem here! Usually the body is hurt in a standing position, not a lying on your back position. Meaning that it is also using the outer unit muscles within complex motor programs all within a split second. But even more important than all of this is one huge player - The Brain!

Remember the crane scenario. Well by training abs on their own and doing nothing to teach your brain how to move correctly is like forgetting to teach the crane driver how to use the crane, and just making modifications to the base of the crane. If the driver is not well skilled or trained to use the crane it does not matter how good the stabilizers are, disaster is always just a small step away. Also forgetting to maintain and strengthen the the crane arm and hook (the outer unit) is ensure strong enough to lift the loads is also a recipe for disaster.

The outer unit controls the range of motion, generates movement and provides stability on a much bigger scale. However these muscles do a very poor job of stabilizing the pelvis and spine. Poor training technique and abuse of bad exercises however teaches them to do the role of the inner unit setting you up for problems. The key here is one cannot work without the other. The stabilizer muscles are not designed or know how to produce movement. And the large global muscles are not designed to create stability. To focus solely on only one area is a waste of time and potentially could ruin you. This is where the trick is, identifying which one is the main contributor to your problem, and secondly working out how to correct it WITHIN A MOVEMENT! And usually the movement that creates your pain is the one you need to work with the most!

"True core strength can only be developed using both inner unit and outer unit together in a standing position" This is where you will now be training the inner unit, the outer unit but more importantly the Brain and the Nervous System who drive the crane!

How Do You Train The Brain & Why You Must Change How You Move?

Above is a great video to watch about how easily back pain can be created from simple daily movements we think nothing of. It is easy to see how we fall into the trap of thinking well if there is a problem with my stabilizers I will fix that and it should all be okay. The question you should be asking is, "why are my stabilizers broken?" When you find the answer to this question is when you really make some progress and some significant changes that will last forever! I give many ideas on how to do this in the article look for the cause. Bones and muscles are like idiots, they just do whatever they are told to do. They don't question if it is wrong or right, they just do what they are told by the brain and nervous system. If the brain and nervous system only know dysfunctional movement then this is all it will use, even if it creates pain and more harm because it knows no other way! It is up to you to find out what is the optimal movement and develop that skill enough times that the brain takes this new pattern and makes it automatic! The more complex it is, the more brain involvement there will be. Which is why exercises like crunches, planks, machines and endless isolated abdominal exercises do very little to change the brain. Plus they are nearly always performed lying, sitting or kneeling.

We start by teaching the foundation movements of bending, squatting, lunge, pushing, pulling, twisting and gait, otherwise known as walking or running. (I highly suggest you read the article Movement Not Muscle to get a good understanding of this concept). All of these movements require activation of both the inner unit and outer unit, also needing multiple skills and abilities such as balance, flexibility and coordination which force your brain into heavily concentrating on what is going on in order to coordinate the most efficient form of movement. Because of this huge brain involvement it can make many modifications in a split second in order to move efficiently. Sitting on a machine or lying on the floor will not require much brain at all. It will delegate the responsibility of these movements to the automatic programs it already has, and it does not care if it is right or wrong. Remember I said earlier that muscles and bones are idiots? Well they will continue to use the only movements they know until someone teaches them a new one. Exercises that challenge the brain the most and are mastered will make the most significant changes in terms of flexibility, strength, stability and most importantly how you move!

The exercises that I like to use that encourage great activation of everything we just spoke about also utilize what is known as the slings of the body. I suggest reading our article on Core Strength Training here to see a full explanation. But basically there is 4 slings within the body that tie all of the muscles together. Using exercises to encourage better timing, strength and coordination of these slings is what will not only prevent back pain but will significantly make you move better, just like an elite athlete!

There is so many examples of great ways to train the brain but here is 4 of my favorite movement patterns for my back pain clients to learn. Remember if you have back pain right now, you cannot go straight into doing this. You need to start at the beginning and work on stretches and basic skills. All of this is covered in our Back Pain Secrets Education Program which you can get at the bottom of the page or in our FREE Report that you can get by clicking here.

Single Arm Cable Press

This exercise utilizes what is known as the anterior sling. Read this article about Myofascial slings for more information.  Critical for developing strength for throwing actions, running and even walking. Again it uses a standing position with huge integration of stabilizers before movers, rotation is critical, posture must be maintained and we also see opposite sides of the body being used simultaneously. The amount of activation you feel around the abdominal muscles is massive! A very underused and underestimated exercise by many. Something like 150 muscles are activated within this exercise!
Click here or the image to see the video of how to do it.

Cable Wood Chop

Quite often the twisting movement is difficult for the person with back pain. It could in fact be the movement that creates serious pain. We often get told by clients, "my doctor said rotation is bad for the spine and I should never do exercises that rotate". This evolves from the information that you will wear out your discs from excessive rotation which is true. However this is usually when the rotation is repetitively completed in the same position and without use of the legs. You must understand without rotation you are now a robot! You cannot eve walk correctly because you need rotation to create torque for all movement. Out of all the foundation movements this one is the most important, it is also the first movement you ever learned (see our article on infant development exercises). The key here is to LEARN HOW TO DO IT CORRECTLY. This exercise encourages movement from the legs in a standing position with massive recruitment of stabilizer abdominal muscles in conjunction with prime movers. It encourages mobility and athletic developments and if done correctly promotes awesome posture! Click here or on the image below to see the video of how to do it.

Single Arm Cable Pull With Single Leg Balance

This is a classic case of using a complex movement to create brain activity. This particular movement is very similar to a bending movement to pick something up off the ground. Think of how a golfer picks up a ball on one leg after sinking a putt. This is actually a very safe way to teach a bending action and by using an exercise in the gym environment to become even stronger and better balanced will reap huge rewards for the back pain sufferer as the bending action is often the hardest to do. Weak glutes combined with a poor movement pattern is how you ruin a good healthy back. Almost opposite to the cable press this exercises integrates with a pulling action. This would utilize what is known as the Posterior sling. Often this sling is weaker and poses more problems to people in particular by adding the single leg movement. Very tiring exercise that requires high levels of co-ordination and stabilization. Click here to watch the video. (watch from the 5 min mark)

The Deadlift

Similar to the last movement this is also requires use of the Bending movement pattern. Learning how to become the master of this movement is ESSENTIAL! Many people avoid this due to fear of reinjury, again they are often told never to do this in the gym! I use the complete opposite approach and find ways to do this in the gym that many times that there is no fear, there is no risk! If you can do this with load in the gym, the real world where you do gardening or lift boxes is nothing. Keeping your lumbar curve and posture is the most important part of the whole movement. If you lose your lumbar curve during the movement you are at risk of suffering a herniated lumbar disk. When the lumbar spine is held in neutral position (curvature), the nucleus or center portion of the lumbar disks is in its normal safe position, held away from the spinal cord and nerve roots. However once the spine is flexed, the pressure within the lumbar disks rises, for example, when sitting in a chair the pressure within the disks is 140% - or 40% greater than when standing.So if you now do a sloppy dead lift and let your spine flex, you will force the  nucleus to be pushed backward toward the spinal cord and nerve roots which lie behind the weak areas in the disk.

I suggest reading our article How To Do The Deadlift to get a better understanding. Below is 2 videos demonstrating how closely this exercise mimics real life situations and why it is so easy to hurt your back doing everyday activities.

Does That Mean I Stop Doing All Abdominal Exercises?

No, the isolated exercises such as breathing, TVA activation, lower abdominal training and even oblique training all have their place in your rehabilitation program. They just must be looked at as a stepping stone to harder more complex movements in a standing position. If you are able to walk around, go to work, do things at home such as gardening, sports lifting shopping bags you MUST learn how to move. Just isolating your abdominal wall to feel the burn will do nothing to save your back! These exercises make up a big part of our initial assessment and we use them to establish how much coordination your body has at a basic level. Hip dominance is very common and to get rid of this takes time, and usually a combination of stretching with basic abdominal exercises is the first place to start. As long as you understand the rules of progression you can continue to use these exercises and get great results. If you are in severe pain these are the best exercises to do first. Below is pictures of TVA Tummy Vacuum and the Lower Abdominal Test and click here to see the video of our Top 7 Abdominal  exercises

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Conclusion

I hope this article shares some light on what CORE STRENGTH really means and that you grasp the concept of learning to move is more important than just trying to work your abs! The movement that is likely to hurt you is the one you must learn to master. Failure to learn this will mean you are always one small poor movement away from hurting yourself again. Surgery, pain medication and relying on health professionals to treat you is merely treating your symptoms and not addressing your real reason you are in pain. A common sense approach to designing your plan is required as you cannot go straight to lifting deadlifts with load. This is why we have created stacks of information and education programs you can get below.

If you live in Melbourne I encourage you to contact us by filling the form below and we can arrange to schedule a FREE Postural and Movement assessment to design a program to get you pain free forever!