Core Stabilisation for Back Pain 101
First of all what is core stabilisation?
In yoga, the term ‘core’ is used to broadly describe all of the musculature that supports and stabilises the lumbar spine, sacrum and pelvis. Stabilising muscles do not change length during movement; rather they stabilise and support the trunk during movement, which can be particularly helpful for students in the rehabilitation and prevention of lower back pain.
What muscles are involved?
Studies have shown that core stabilisation exercises which train and strengthen the deep abdominal muscle called the Transverse Abdominals (TA) and the deep spinal stabilisers called the Multifidi can be effective in helping to reduce pain and the risk of re-injury. One study, in particular, showed that people who’d been trained to strengthen their spinal stabilisers had only 30% recurrence of lower back pain after one year, versus a control group who were not given any spinal strengthening exercises and suffered an 84% recurrence rate.
The TA is the deepest layer of the abdominal muscles. Its muscle fibres wrap around the spine like a wide belt or corset, attaching at the bottom of the ribcage and at the top of the pelvis all the way around. When the TA engages it has the dual action of:
- narrowing the waist, as if you were tightening drawstring pants and;
- gently zippering the lower belly in and up as if you were doing up a tight zipper on your jeans
The Multifidi, on the other hand, are a group of tiny individidual muscles that provide stability to the spine, keeping the vertebrae in a safe position. These muscles come into play when:
- the lower back is either neutral, such as when you’re standing with good posture in Mountain Pose
- in slight back-bending or extension movements, particularly performed against gravity, such as Bird-Dog pose.
It’s important to understand that the co-contraction of TA at the front of the trunk and the Multifidi at the back of the trunk will serve to maintain a neutral curve in the lower back and pelvis. Hence core stablisation techniques which work both the TA and Multifidi are all exercises in which the trunk is kept still and in neutral whilst the arms and legs move to provide challenge.
How do I engage the Transverse Abdominals and Multifidi?
To get a sense of how to engage these muscles start by lying on your back in Constructive Rest Pose. Have your knees bent, feet on the floor about hipwidth apart and parallel. You should notice that your lower back is in its neutral curve and we want this to remain the case throughout the whole exercise.
Constructive Rest Pose
To engage the TA:
Bring your fingertips to the skin just to the inside of your frontal hip points. In a relaxed state the skin beneath your fingers should feel relaxed and soft.
Breathe in allowing the belly to relax. As you breathe out imagine narrowing the hip points towards one another as if you were tightening a drawstring, and at the same time, zipper the lower belly in and up as if you were doing up a tight pair of trousers. The muscle beneath your fingertips should feel like it firms. The belly will also flatten slightly, as if you are sucking the contents of your abdomen up and back towards your spine. However do not flatten your lower back or tilt your hips back during this contraction as this will stop the multifidi from serving their proper function, which is to maintain the neutral curve of the lumbar spine.
Breathe in to release the contraction, as you breathe out repeat. This is a subtle engagement working at about 10-20% of your maximum effort. Repeat for 5-10 breaths.
To engage the Multifidi:
Continue with the above exercise but this time, as you breathe out imagine the muscles of the lower back contracting slightly upwards the naval at the same time as the TA engages drawing the naval in and back towards the spine. It’s as if the front and back of your body were coming closer together or co-contracting to meet in the middle of your body each time you exhale. Again, the engagement is subtle and the pelvis or lower back should not move. Repeat for 5-10 breaths.
One final, important word
Whenever we work to strengthen an area of our body it is important to maintain an awareness of the bigger picture or overall intention of a yoga practice. Core stabilisation exercises therefore should become part of a bigger overall practice that serves to create greater function, strength and mobility throughout the whole body in normal everyday movements. As Aline Newton says so eloquently in her book “Stabilisation: The Core and Beyond”:
“ From the perspective of the body in motion, the work of the transversus system is not to make the trunk stable like a fortress, but to help make possible the transfer ot movement been hands and feet. Holding tension in the center of the body severely interferes with smooth transmission of the forces across the joints that is the basis for graceful movement.”
With this idea in mind, in my next blog post we’ll explore some of my favourite exercises for teaching core stabilisation to my clients that train to stabilise the core and lower back whilst mimicing real life movements. Stay tuned!
Credits to Tummee for their awesome images!