- Have you been told that you have a weak core and that you need to do core stability exercises to help recover from back pain?
- Have you been told if you just had a stronger core, you would be fitter, skinnier, have a better pelvic floor, a better waist line and improved sex drive?
As a physiotherapist with expertise in the management of lower back and pelvic pain I am often asked by our patients about core stability exercises. There is a lot of information (and misinformation) about the usefulness of core stability in managing back pain.
Let’s start by explaining how the core can help with back pain, and also why it’s not always the solution!
Core stability muscles are very small muscles that include your deep abdominals and also your pelvic floor muscles. These muscles contract for gently with some endurance in order to provide stability for your pelvic and SI joints, as well as your lower back. They also help to support your pelvic organs.
These muscles work with more endurance than power, much like your shoelaces do when they hold on your shoe on. There is not a lot of force required, but a small amount of gentle force that works fairly consistently.
Watch this video here on the common mistakes people make when building their core muscle endurance.
Low back pain. There are a lot of myths and misconceptions around the usefulness of core exercises in the management of lower back pain. There are many causes of lower back pain, and having a weak core can be one of thousands of different reasons. Which means it’s not always the answer.
So is the plank useful?
Planking has become increasingly popular over the years as a way of increasing core strength and stability, but does it really improve the endurance of your core muscles or offer anything effective for the lower back pain?
Here are the reasons plank is LESS than useful:
- In a plank position many people are unable to breathe effectively, with almost complete lockdown of the rib cage. If you imagine your abdominals like a water balloon, if you squeeze the top of a water balloon the bottom can blow out. So, if you’re holding your breath and compressing your rib cage in a rigid matter with downward pressure, this can contribute to downward pressure on the pelvic organs (hello prolapse!!) and downward pressure on the lower back discs- which can contribute to more problems than solutions.
- The functional use of plank is also questionable. Our core is designed to help us throughout our daily life in multiple tasks- which might include climbing stairs, running after children, lifting heavy bags, getting in and out of the car and various sports pursuits such as running, tennis, cycling or swimming. It’s not very common for any of these pursuits to involve crawling on hands and toes across the floor or holding a rigid position on all fours for 2 mins. Training specificity ultimately means that if you want to improve your capacity to lift without back pain, then you need to practice lifting with good technique at a strength that challenges you (without overloading you) with your core supporting you. So, unless you are involved in army commander crawling training as a daily activity, planking is unlikely to help you build on functional stability for your goals which might include running cycling or lifting.
- Core muscles are not designed to be a rigid cylinder that involves breath holding, a gripping or static positioning without movement. Our bodies are designed to move! Planking doesn’t support the lower back any more than holding your breath underwater does.
Are planks actually bad for you?
In most circumstances no, many people can hold a plank without serious problems. It may not be a useful thing to do, but often is not a problem.
However, here is a list of circumstances where planks can actually contribute problems.
- If you’ve had signs or symptoms of pelvic organ prolapse, pelvic floor weakness or are less than three months after delivering your baby you should not be doing planks.
- If you’ve had a lumbar disc injury, then commonly planks can increase pressure in the lower back simply through the common method of breath holding with a downward pressure.
- Neck or shoulder injuries that involve rigidity in the thorax. If you’ve had stiffness in your rib cage, neck or shoulders then a rigid plank hold can certainly add load to these areas without any real benefit.
Are there other ways to exercise the core?
Yes! There are many ways to exercise the core. Ask any good Pilates instructor who can offer a wide range of dynamic core stability exercises and they will show you!