Core

Article by John Miller

Do Core Exercises Help Lower Back Pain?

While all back exercises that strengthen the muscles that traverse your back are essential, back pain researchers have emphasised retraining your deep core muscles as a priority.

Core Stability is your body's ability to control and support your spine via specific muscles dynamically.

Your spine is an inherently unstable area of your body. Your lower back has five vertebrae that allow twisting, bending and arching with no other bones to assist. They sit on top of a triangular bone called the sacrum, which wedges itself into the pelvis. Unfortunately, without strong support, all of these bones would fall in a heap on the ground.

Your deep core muscles are the main structures that support, control and move your lower spine and pelvis. They are also the most energy-efficient and best-positioned muscles to do the job for 24 hours a day.

However, when they turn off, your spine is not fully supported by its usual muscular corset. This lack of support makes it quite vulnerable to injury and chronic pain.

Research has shown that our back pain causes your "deep core stability" muscles to STOP working in EVERY case.

The first time you experience low back pain, your brain automatically inhibits the Transversus Abdominis (TA) muscle's regular activity. This inhibition occurs in 100% of sufferers. Unfortunately, even once the back pain has eased the TA muscle does not automatically switch on again.

Inhibition of the TA muscle exposes your spine to further trauma and hence "recurrent back pain". Each incident becomes a little more severe, and consequently, further wasting of the TA occurs.

Other causes of muscle inhibition include previous abdominal surgery, pelvic pain and post-pregnancy.

What are the Benefits of Core Stability Training?

Researchers have shown that the correct use of your core stability muscles not only prevents pain but also alleviates pain if you're already suffering. Also, your body's strength, power, endurance and performance will improve. You'll be able to run faster, jump higher and even throw further when these muscles work correctly.

For more information, please contact your PhysioWorks physiotherapist.

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Article by John Miller

Lower Back Pain Treatment Guidelines

While lower back pain treatment will vary depending on your specific diagnosis, your physiotherapist will have the following aims.

PHASE I - Back Pain Relief & Protection

Managing your back pain is the main reason that you seek treatment for lower back pain. In truth, it was the final symptom that you developed and should be the first symptom to improve.

Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include ice, electrotherapy, acupuncture, de-loading taping techniques, soft tissue massage. A course of non-steroidal anti-inflammatory drugs such as ibuprofen may also help in this phase.

PHASE II - Restoring Normal ROM and Strength. Early Back Exercises.

As your lower back pain and inflammation settles, your lower back pain may feel better. Still, you are more vulnerable to re-injury during this honeymoon period when you don't have pain, but your muscles and ligaments are weak. During this phase, your physiotherapist will turn their attention to restoring your normal lumbar spine motion. Plus, they'll assess your muscle length and resting tension, muscle strength and endurance, proprioception, balance and gait (walking pattern).

Your physiotherapist may commence you on a lower abdominal core stability program to facilitate your important muscles that dynamically control and stabilise your lower back and pelvis. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best back exercises for your specific needs.

PHASE III - Restoring Full Function

Depending on your chosen work, sport or activities, your physiotherapist will aim to restore your back's function to allow you to return to your desired activities safely. Everyone has different demands for their lower back that will determine what specific treatment goals you need to achieve. For some, it is merely to walk around the block. Others may wish to run a marathon or be a fast bowler. Your physiotherapist will tailor your back pain rehabilitation to help you achieve your own functional goals.

PHASE IV - Back Exercises - Preventing a Recurrence

Recurrence of lower back pain can occur. The main reason for a recurrence is due to insufficient rehabilitation. In particular, poor compliance with deep abdominal core muscle exercises. You should continue a version of these back exercises routinely a few times per week. Your physiotherapist will assist you in identifying the best activities for you to continue indefinitely.

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Lower Back Pain

Article by John Miller

Back Pain is Multifactorial

Lower back pain is a complex condition, especially if it has been present for some time. Retraining the Transversus Abdominis and Multifidus are significant milestones in the road to recovery. It is, however, often not the whole solution.

Depending on your needs, a comprehensive rehabilitation program will be designed for you by your physiotherapist. Your rehabilitation will probably require other interventions in addition to the Transversus Abdominis and Multifidus and core strengthening exercises. These techniques may include joint mobilisation, lumbopelvic alignment techniques, massage, muscle releases and stretches, leg and arm strengthening, posture correction and various other modalities to reduce your pain.

Your physiotherapist will discuss your treatment options specific to your needs during your consultation.

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