Back pain affects nearly 80–85% of people at some point in their lives. It is one of the leading causes of missed workdays and long-term disability. Desk workers are particularly at risk, making up 54% of those complaining of low back pain. 50% of pregnant females will also experience low back pain and discomfort at some point during their pregnancy. 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. One of the best ways to address back pain and support long-term spinal health is through targeted core strengthening exercises. A strong core provides stability, improves posture, and helps protect against injury. This post will review what the core really is, why it matters for back health, and specific core strengthening exercises you can start practicing today to build strength and stability.
**This is not medical advice. Please consult your medical provider for more information.
Why Train the Core?
Many people think of the core as just the “six-pack” muscle. In reality, the core includes several layers of muscles, including the rectus abdominis, internal obliques, external obliques, and transversus abdominis. Of these, the transversus abdominis is especially important for stability and back health. It functions like your own internal brace, supporting abdominal structures, helping maintain intra-abdominal pressure, and protecting the spine during daily movements such as lifting, coughing, and standing.
When this muscle is weak and underused, the back takes on more strain, increasing the risk of injury and chronic pain. That’s why many physical therapists focus on teaching patients how to correctly activate and strengthen this deep layer of the core before advancing to more complex exercises. You have to master the foundation before you try more complex moves.
How to Activate the Transversus Abdominis
Before strengthening, it’s essential to learn how to activate the core properly. If you can’t turn the muscle on, you won’t train it effectively. One way to find it is with the abdominal brace exercise.
Lie on your back with your knees bent and use your fingertips to find the front of your hip bones, then bring them in towards your belly button, just slightly inward. Cough gently—you’ll feel the muscle contract under your fingers. That’s your transversus abdominis (or transverse abdominis) engaging. Practice breathing while maintaining this brace. As you exhale, your belly should stay stable instead of collapsing. Holding this gentle contraction while breathing naturally is the foundation for all core strengthening exercises.
Remember, it is more than just tying to “suck in” your abs. You are actually trying to maintain the pressure within your abdomen, This is known as intra-abdominal pressure or IAP. When done correctly, you can maintain IAP with all exercises and movements. This is what helps you maintain a neutral spine, keeps posture upright, and also helps with your pelvic floor.
Core Strengthening Exercises for Back Pain Relief
You will notice that these core strengthening exercises avoid crunches of all kinds. That is because crunches target the rectus abdominis muscle, not your transversus abdominis.
The exercises below work the deep core by providing strength and endurance for stabilization. Sometimes holding a particular position is way harder than performing any number of repetitions.
First, you have to learn to turn your deep core muscles on. This will be the first exercise covered below, followed by progressions. You must first master turning on your transversus abdominis before you can begin the other exercises. Let’s begin!
Abdominal Brace
Lie on your back with your knees bent. Place your fingertips on the front of your hip bones. Then bring your fingers slightly inwards towards your belly button.
Cough 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 intra-abdominal pressure (IAP) constant. Maintaining your IAP (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 (you should still feel the pressure under your fingertips like you did when you felt the cough in the abdominal brace exercise described earlier). If it is hard, start with holding your legs up for 5-10 seconds at a time, making sure you maintain IAP with your normal breathing. Gradually build up to 30-60 second holds over time.
Once you are able to hold 1-2 sets of 60 seconds, move on to the next exercise.
Triple Flexion 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. Also make sure not to arch your back. This will cause you to lose your IAP and your abdominal brace.
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. Repeat for 2-3 sets.
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. See picture.
During this exercise, the resistance band will be pulling you in one direction. Your goal is to NOT let it. Maintain your IAP 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.
Repeat 2-3 sets for 30 second holds on each side.
Side Plank From Elbows and Knees
Start on your side with your elbow directly underneath your shoulder. Engage your core and lift up onto your knees. Hold this position without letting your hip dip down towards the ground. Think about lifting your bottom hip up towards the ceiling.
Keep your back from arching and your ribs from flaring to maintain your IAP.
Hold this position for 30-60 seconds. Repeat 2-3 times. Then, repeat on the other side.
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, your core engaged, and remember to breathe normal!
Hold this position for 30-60 seconds. Repeat 2-3 times. Then, repeat on the other side.
Why These Core Strengthening Exercises Work
Unlike traditional crunches or sit-ups, these exercises target deeper stabilizing muscles rather than just the superficial abs (your rectus abdominis). The deep core improves posture, reduces stress on the spine, and helps prevent injuries. By training endurance and control (not just strength), you teach your body how to stabilize during daily movements and activities, like carrying groceries, lifting your child, or sitting at a desk for long hours.
How Often Should You Do Core Strengthening Exercises?
For most people, 10–15 minutes of core training 3-4x/week is enough to build strength and endurance. The goal is not to exhaust your core, but to train it to activate reliably and support you throughout the day.
A few key things:
- Consistency matters more than intensity.
- Your core is composed of many muscles. Just as you train any other muscle, it needs rest. Don’t overtrain or you will do yourself a disservice.
- It’s not enough to just train your core. You also need to apply it to daily life. Learning to engage your core is step one. Strengthening it is step two. Step three is engaging your core while lifting, standing, sitting, and beyond. This is when you will really start to see the results.
FAQs About Core Strengthening Exercises
Are core strengthening exercises good for back pain?
Yes. A stronger core reduces strain on the lower back and helps manage chronic pain. It also helps manage pain with all daily activities, such as carrying groceries, lifting your child, and standing, walking, or sitting for long periods of time.
Do I need equipment for core strengthening exercises?
Most exercises can be done with no equipment. You can use resistance bands or a Swiss ball with certain exercises to add variety and for use as a progression when certain exercises become easier.
Can I replace crunches with these exercises?
Absolutely! And you should be replacing crunches with some of the exercises listed above! (You can find more HERE too). Crunches mainly target the rectus abdominis. This is not part of your deep core. Your deep core musculature is what provides stability and protection to your spine and lower back.
How long before I notice results?
Some individuals may notice some small changes within the first week of adopting these newer exercises. Most, with consistent practice, will begin noticing improved stability and reduced back discomfort within 4–6 weeks. Emphasis on consistent. You want to aim for working on these exercises a minimum of 3x/week. On top of that, utilizing what you have learned with your daily activities will be the major key. What I mean by this is once you have learned how to turn your core on, you then have to learn to engage it while doing functional activities. Once you learn to apply what you have learned, the real magic happens!
Other Articles Related to Core Strengthening Exercises & Back Pain
- What It Actually Means to ‘Engage Your Core’
- How to Strengthen Your Deep Core
- Forget Crunches! There are Better Ways to Improve Core Strength
- Back Pain Travel Tips: A Physical Therapist’s Guide to Long Drives and Flights
- Quadratus Lumborum: Stretches and Exercises to Relieve Back Pain
- Low Back Pain Upon Waking Up? Try These 3 Things!
References
Guo HR, Tanaka S, Halperin WE, Cameron LL. Back pain prevalence in US industry and estimates of lost workdays. Am J Public Health. 1999;89(7):1029-1035. doi:10.2105/ajph.89.7.1029
TL;DR
Back pain is one of the most common health issues worldwide, and a weak core is often part of the problem. Core strengthening exercises focus on training the deep stabilizing muscles that protect the spine and improve posture. Start with the abdominal brace and progress to more challenging exercises like the triple flexion hold, paloff hold, and side plank. Aim for 10–15 minutes of training several times per week to build a stronger, healthier core. This post reviews what the core really is, why it matters for back health, and specific core strengthening exercises you can start practicing today to build strength and stability.
