Back pain affects 80-85% of people over their lifetime. Low back pain is the leading cause of years lived with a disability and desk workers make up 54% of those complaining of low back pain along with 50% of pregnant females. Back pain is also the leading cause of work-loss days, with one study finding that 101.8 million workdays were lost in a 12 month period due to work-related back pain. Once way to address back pain is to begin core strengthening exercises.
Why do we train the core?
Aside from popular belief, your core is more than just your sixpack abs. Your core is actually comprised of 4 different muscles: rectus abdominis, internal obliques, external obliques, and transversus abdominis. The one we are going to focus on today is transversus abdominis. Now why should we focus on this particular muscle?
anatomy lesson!
The transversus abdominis muscle is often overlooked and underworked. When performing core strengthening exercises, this muscle is important because it provides structural support to abdominal structures and increases intraabdominal pressure which helps with forceful expiration, defecation, and coughing. Think of the transversus abdominis as your own inner back brace!
So how do we train this muscle? The most important thing is to learn to find the muscle and activate it first. If you can’t turn the muscle on, you won’t train it effectively.
This series of exercises will help with 1) activation and 2) strengthening:
Abdominal brace
This exercise will teach your to turn on your inner core muscle. Lie on your back with your knees bent. Place your fingertips on the front of your hip bones, as shown below. Then bring your fingers slightly inwards.
Couch once. The push you feel against your fingertips is your inner core turning on. This is the muscle we are training!
Take a deep breath in, feeling your belly rise. Maintain that abdominal pressure by activating the transversus abdominis and breath out. Your belly should not fall with exhaling if you are able to keep the abdominal pressure constant. Maintaining your abdominal pressure (the pressure you feel against your fingertips) while maintaining your breathing is the entire exercise. This is one of the hardest things to do, so don’t get frustrated! Just keep practicing!
The abdominal brace is a foundational exercise that should be practiced before moving on to any of the next exercises. If it is hard at first, start with just trying to feel the muscle turn on. As you get better start to hold the activation for 5-10 seconds, gradually increasing the time up to 30-60 seconds.
Triple Flexion Hold
This exercise builds on the principles of the abdominal brace. Make sure you can turn your inner core on before advancing to this exercise.
Start in the same position as before – on your back with your knees bent. Activate the transversus abdominis muscle and maintain your breathing. Once you are ready, lift your legs up so your hips and knees are at 90° angles.
Keep monitoring that your core is activated with your fingers while holding this position. If it is hard, start with holding your legs up for 5-10 seconds at a time with maintenance of your abdominal brace and gradually build up to 30-60 second holds.
Triple flexion with rolling
A swiss ball is required to perform this exercise. Start in the same position as the other two exercises on your back with your knees bent. Hold the swiss ball with your hands and knees. The placement is important: the ball should be touching the inner portion of your knees and your hands should be placed directly in front of you. Imagine drawing a straight line up from your knees to your hands through the swiss ball. This is where you want your hands holding onto the swiss ball. While holding the ball in that position, lift your legs up into the triple flexion (90/90) position.
While maintaining the 90/90 position and your abdominal brace, roll to one side while preventing your spine from rotating. Try keeping your hip and your shoulder in a straight line; don’t let them break from each other. This will prevent you from rotating with your back.
This is one of the best core strengthening exercises because it teaches you to control your movement. As you roll to one side, you must control your speed and slow yourself down so you don’t keep rolling onto your side. As you roll one direction, you may feel one side of your abdominals working more. This is because that side is working hard to control your movement and speed. You may feel the shift in the side that is working more as you roll to the other side.
Remember to maintain your abdominal bracing throughout the entirety of this movement! Try to roll to each side 5-10 times.
1/2 kneel pallof hold
This exercise will incorporate a different position from the previous three. You can use any resistance band for this exercise.
Start in a half kneel position. If your right knee is up, you will set your band up to the left of you. If your left knee is up, you will set your band up to the right of you. Check the picture below to confirm your set up position.
During this exercise, the resistance band will be pulling you towards one direction. Don’t let it. Maintain your abdominal bracing and your breathing. You may feel one side of your abdominals working more than the other as they work extra hard to resist the pull of the resistance band in the opposite direction. Try to hold the position for 30 seconds, then switch to the other side.
Side Plank
Start on your side with your elbow directly underneath your shoulder. Brace your core and lift up onto your knee. Hold this position without letting your hip dip down towards the ground. Think about lifting your bottom hip up towards the ceiling!
To take this exercise to the next level, you can try propping yourself up on an outstretched arm. Make sure your hand and elbow remain directly under your shoulder. As before, keep your hips elevated and keep your core on! Try holding this for 30-60 seconds then try the other side.
As you have noticed, these core strengthening exercises avoid crunches of all kinds. That is because that targets the rectus abdominis muscle.
Try these exercises which work the inner core by providing strength and endurance for stabilization. Sometimes holding a particular position is way harder than performing any number of repetitions! Let me know what you think in the comments below if these exercises were harder than your typical sit ups or ab crunches at the gym!
Other Articles on Back Pain
- Thoracic mobility exercises
- Sciatica treatment explained
- Low back pain upon waking up
- Consistent low back pain and how it’s treated
TL;DR
Core strengthening exercises are key in helping reduce back pain as these muscles act as our inner back brace. This article covers exercises to train your core that are different from your typical sit up or Russian twist. Give them all a try!
