The core & low back pain... a hot topic!
Let's dive in.
Do you have or have you had low back pain? If so, have been told that you have a weak core or that you need to strengthen your core? Or maybe you know someone who has low back pain and has been given a bunch of core exercises to "fix" the pain?
Even if neither of the above things apply to you, this is an interesting topic to discuss for many reasons, two of which are:
It is believed that having a strong core will prevent injury (heads up, it doesn't!)
Weak abdominals = low back pain (heads up, you should change that "=" sign to a "≠" sign!)
Just because you have or have had low back pain, does not mean that you have a weak core or that strengthening your core is the fix for your back pain.
Before we continue, I want to reference an excellent paper on the subject of core stability and low back pain by Professor Eyal Lederman titled, "The Myth of Core Stability." This paper came out in 2007 and examines if performing core stability exercises and strengthening the core can prevent, reduce, or improve low back pain.
Now let's continue with some more proof in this core pudding...
There was a study (check it out here) that tracked over 400 people who were considered to have weak abdominal strength, yet they did not have low back pain.
Cool, right? This makes sense because we know from pain science that pain is multifactorial and involves a host of things from psychosocial to psychological factors.
Ultimately the research has shown that performing core stability exercises is not more effective than performing any other type of exercise in preventing, improving, or reducing low back pain.
Some things that influence pain and how you feel and perceive your body include:
Your stress levels
Your nutrition
How much you exercise & move throughout the day
Your sleep
How hydrated you are
The quality of your relationships
Your work life
Your home life
...the list goes on.
As you can see, the answer to what is causing the low back pain is NOT as simple as having a weak core.
To illustrate the above point:
In 2006 (check out the study here) postpartum women who had low back pain were studied and the results found that cognitive behavioral therapy was more effective in reducing and improving their low back pain than core stability exercises were! The worries of the women were a major source of the back pain!
Another note on having weak abdominals or a weak core...
We all have muscle imbalances. They are normal and are not necessarily the cause of pain OR mean that we will develop pain. We are able to function just fine with a lot of asymmetry and imbalance. For example, you have two lungs that are different sizes. You have a big liver on one side of your abdominal cavity and not on the other. Your bones and joints on the right and left side of the body can be of different lengths, variations, and orientations. Also, life takes you out of alignment and out of being stable and neutral... all the time!
I do want to note here that there is nothing inherently wrong with doing core stability exercises! I absolutely love some dead bugs, planks, and bird/dogs. What is potentially harmful are the bold (and false) claims that are made about these exercises, including that a strong core will prevent injury and that weak abdominals lead to back pain.
IN CONCLUSION:
If you have low back pain, keep moving and move in the ways that you enjoy and that you can, and remember that pain is multifactorial. We are complex beings and it is not one size fits all when it comes to treatment and dealing with or getting out of pain.