The Myth of a Weak Core
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Today, I want to shine a light on a common piece of advice you might have come across: “You just need to strengthen your core.” 

In the age of easy access to information, a new challenge for therapists is dealing with misinformation. The ability to Google our symptoms and self-diagnose can have huge benefits and also some real downsides.One major downside is misinformation and the prevalence of certain healthcare myths. When it comes to the treatment of back issues, nothing is more prevalent than the myth of the weak core being the cause of back pain.

What is ‘the core’?

What we’re referring to when we talk about the ‘core’ is a group of muscles that stabilise the spine, pelvis, and torso, providing support and facilitating movement. Contrary to popular belief, the core isn’t just about the abdominal muscles; it involves a network of muscles, including the pelvic floor, deep spinal muscles, diaphragm, and more.

The Myth

The most common misconception is that a weak core directly leads to back pain. Daily, I see patients in the clinic who have been told that they ‘need to strengthen their core’. In theory this makes some sense. If the core musculature is weak it may not have the capacity to properly support and stabilise the spine, putting it at higher risk of injury.

This idea has become so prevalent that many people will simply assume their back pain is due to weakness in this part of the body and go on a mission to correct it – normally with less than perfect results.

This myth tends to be perpetuated by gym and fitness culture, where the aesthetic value of abs can get confused with the functionality and importance of the core.

While core strength is undeniably important for spinal stability, research indicates clearly that the relationship between a weak core and back pain is more nuanced than a simple cause-and-effect scenario.

The more complex reality

Back pain is normally multifactorial, influenced by various factors such as movement patterns, injury, lifestyle, psychological factors, stress, sleep, diet, muscular imbalances and more. While core strength plays a role, it is rarely the sole determinant of back pain. So even if a weak core may be a contributing factor, simply doing a bunch of core or abdominal focussed exercises isn’t likely to fully address the issue.

On top of this, in many cases individuals experiencing back pain might not have a weak core but rather issues related to core coordination, motor control, or improper movement patterns.  Addressing these issues requires a different focus and different exercises than those needed to strengthen an area. Simply focusing on strengthening the core muscles might not address these underlying issues effectively.

An added complication

The issue is further complicated by the fact that for some people, training to strengthen the core muscles may even be counterproductive to improving their condition.  For people who have movement or coordination issues that are contributing to their back pain, training to strengthen the area may exacerbate the issue by increasing abnormal load on certain parts of the spine already being overworked. If your only focus is strength and not movement capacity and mobility, it may lead to greater issues. 

To illustrate this you could use an analogy of the hand.  The hand needs to have the capacity for strength and rigidity (if you need to carry something heavy) but also for coordination and flexibility (if you need to pick up a pen and write). The back needs a similar capacity.  If you are picking up something heavy off the floor, yes you need to engage the core strength to support and protect the spine. If you use the same tactic of rigidity every time you pick up a pen or tie your shoes, this will likely lead to abnormal loading and pressure on the spine, which can be a problem.

Personal, tailored interventions are best

At Sussex Back Pain Clinic, our approach involves comprehensive assessments to identify the root cause(s) of your back pain. Your treatment will encompass a variety of interventions that are completely tailored to your needs. We don’t subscribe to generic advice like ‘you just need to strengthen your core’, because we believe you deserve better. If you want to learn to truly manage your back pain, we can show you how. 

We’re here to help when you need us.

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