Talking Core Stability with a Spine Specialist

I treat people who have low back pain all day long in the clinic.  I see people with osteoarthritis, disc herniations, spinal stenosis, and radiculopathy.  It is what I do… and I absolutely love it.  And given the fact that it is the number one reason that people go to visit their MD’s, I am very busy doing what I do!

However, when people outside the clinic hear that I specialize in the management of complex spinal disorders, the random questions start coming. “I have this pain in the right side of my back… do you know what I should do to fix it?”  “Why do I get pain when I am sitting at my desk for 3 hours at a time?  Should I get a new chair?”  Everyone is looking for a quick fix, but no one is thinking about a long-term plan.

Unfortunately, there are no simple answers for how to manage low back pain.  However, there are specific actions which have been validated in the literature which reduce the risk of low back pain.  None of these actions are quick fixes.  They all involve a long-term plan… focused around completing a consistent Core Stability program at the gym. 

Core Stability has become a very popular buzzword in fitness.  Everyone has heard it, but many people do not really know the true meaning of the term.  Core stability is the trunk’s ability to stabilize itself against outside forces.  It is the ability of the muscles in the abdominal and back region to withstand the forces from the outside world and maintain a static/erect position.   A good everyday example of someone demonstrating good core stability would be a person who can lift a heavy piece of luggage into an overhead compartment on a plane without “having to throw their back into it”.

Core Stability programs at the gym focus on exercises which challenge the muscles of the abdominal region in a relatively static position… hence the word stability.  There is not a lot of back motion in a core stability program.  Programs should be completed consistently (around 3 times per week) for at least 25 min in order to be effective.  Exercises should focus on all of the muscle groups around the spine.  One must make sure to challenge the back muscles, abdominals, and muscles on the side of the abdomen during each session.  The more recent literature has emphasized using functional groups of muscles together while completing Core Stability programs and have de-emphasized the importance of targeting one muscle group at a time.

Full body movements are now very much in favor and are being emphasized.  Exercises such as squats and side lunges with overhead lifts are encouraged… as long as you keep your low back in a neutral position throughout the entirety of the exercise.  The idea of a Neutral Spine has also been in the literature and fitness magazines a lot lately too.  The research now states that most exercises should be performed with a neutral spine.  Now what does that mean exactly?  You should have a little bit of a curve in your low back (not completely flat) throughout the entirety of the exercise.  If you do not….your spine is not in neutral and you are putting your structures at risk.

Check back over the next few weeks as we discuss more specifics about how to create a long-term plan to protect your spine!

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Diana grew up in a small suburb north of Boston. She received her clinical doctorate degree in Physical Therapy at Boston University in 2006. Diana started practicing as a physical therapist at Massachusetts General Hospital. While at MGH, she developed a specialty in the evaluation and treatment of complex lumbopelvic dysfunction. Diana is currently practicing at Spaulding Rehabilitation Hospital in Boston where she is the Orthopedic Clinical Supervisor of the Spine program. She is presently a Boston resident and her interests outside physical therapy include cooking, walking on the Esplanade, and international travel.

One Response to “Talking Core Stability with a Spine Specialist”

  1. […] the last few blogs, we have had the chance go over what Core Stability means.  We have also been able to discuss the importance of the “Neutral Spine” position and […]