Getting Down to the CORE of the Problem

Hello, and welcome to my first ever blog!  I will be using this blog to answer questions that I often get asked in clinic, to go over some rehabilitation type exercises, and to discuss health related topics. 

One of the most common things that I treat is low back pain.  Researchers estimate that 80% of the population will experience low back pain at some point in their lives, so it is not at all surprising that this is a common problem.

When looking at back pain, there are a few different structures that could contribute to the pain including:
-       The joints of the spine,
-       The muscles of the low back,
-       The nerves that come from the spinal chord, and
-       The discs that sit in between each vertebra, to name a few.

Different treatments are prescribed based on what structure is hurt.  However, in most cases of low back pain, irrespective of the main source of pain, de-conditioning of the spine stabilizing muscles is an important contributing factor. 

Our society today spends a lot of time sitting, slumping, slouching, and adopting all sorts of strange postures.  Most jobs are completed at a desk, or in front of a computer, and very commonly the sitting continues once home from work – watching television, searching the internet, answering emails, or playing video games. Although sitting is a necessary part of our daily lives, the problems that result from too much sitting can be a pain in the back, literally.

The spine is a very important structure in the body, made up of 24 bones called vertebrae, with discs sandwiched in between.  The job of the spine or vertebral column is to protect the delicate nerves and spinal chord from injury.  The spine itself isn’t very stable.  Imagine a very tall, skinny tower.  Without proper supports, it can be easily swayed with the wind, or toppled over with a swift push.  The muscles of the “core”- work together to stabilize the spine, just like guy wires surrounding a tower. The tension in the wires must be even around the tower so that the tower stands tall and straight. If one wire is slack, the tower will lean towards the tight wire.  Similarly, the core muscles act like guy wires to the spine, they include: rectus abdominus, transverse abdominus, internal and external obliques, erector spinae, also the pelvic floor muscles, and the diaphragm.  A well-conditioned core provides even tension to the spine, creating an exponentially stronger spine than when the muscles are removed.

Sitting for long periods of time, especially in slouching postures, allows the core muscles to shut off. After years of sitting for hours and hours a day, the core muscles become lazy, and become used to shutting off.  This leaves the spine in a very vulnerable position.  Any small miscalculation from these lazy muscles can result in back pain.  Even a simple task like picking up a pencil, can cause significant back pain if your muscles do not fire properly.  Imagine if one core muscle ‘forgets’ to fire when bending forward.  The tension of the ‘guy wires’ surrounding the spine becomes uneven, which can cause injury to occur in the spine, resulting in back pain.

I often see patients that are baffled when they hurt their back doing a simple task.  They cannot understand how bending forward to pick up a dropped piece of paper, or retrieving a small bag of groceries from the trunk, can cause them to “throw out” their back.  The strength required to do the task has little to do with injury, instead, it is the de-conditioning of the core muscles in the days, weeks, and years leading up to the event that caused the injury.  Your core muscles don’t become de-conditioned overnight.  It is the result of hours of sitting, adopting bad postures, and failing to keep the core muscles’ endurance up.

So I challenge you to keep your core healthy.  When sitting down at a desk, make sure your low back is supported.  Make sure your workstation is fitted to you, so you don’t find yourself in an awkward posture.  Take walk/stretch breaks every 20 minutes of sitting. Practice hinging at your hips instead of bending your low back when lifting, shoveling, or exercising, and perhaps most importantly, make sure you condition your core muscles.  You should do exercises for your core muscles to increase their endurance and to keep them from getting lazy.  It is by conditioning your core muscles through exercise, that they can support your spine, and keep you from experiencing pain and injury.

**Stay tuned for my next entry on “The Big 3” exercises to condition your core muscles safely and effectively**

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