Abs and Back Pain

What are the best ways to work my abdominals if I have back pain? A question often asked of me once people know I am a Pilates Instructor and lower back pain specialist.

Firstly it is not as simple as just developing the abs if you have back pain. There is no doubt that the abdominals can play a key role in overcoming back pain, but it is important to view the whole body and not one small part of it.

The way you work the abdominals will depend entirely on the cause of the back pain and the muscle imbalances present in your body.

If you have non-specific back pain with no diagnosis, there are lots of options in Pilates. You will need to be guided by what movements make your body feel good and what movements have an adverse effect. It will be a matter of trial and error putting together exercises that work for you as you move and condition your body.

If there is a diagnosis then your GP or physio should offer you guidelines for exercise, particularly what to avoid (e.g., flexion, extension or rotation of the spine).

In most cases spinal stability and controlled mobility will be the goal to easing back pain. This involves developing the muscles of the core, (including but not restricted to the abdominals), which support the spine and control its movement.

An exercise programme should be tailored to overcoming the imbalances in the muscles of your body, with an emphasis on the core muscles.

Addressing areas such as strength, and flexibility, limitations in either can place undue stress on the body’s structure particularly the pelvis and spine. For instance, if the muscles of the back are very tight (which is often the case with back pain) not only will it limit spinal flexion, but will also inhibit the recruitment of the abdominals.

Often people are given exercises to strengthen the abdominals, which they do at home, performing them in a fashion that will be doing them little good and could be making the problem worse. I believe that it does not come down to one muscle group but rather a group of muscles working together to create stability and correct movement patterns.

Work the abdominals in different ways, with the legs on the ground initially and later with legs lifted off the ground. Give specific attention to recruiting the Transverse abdominus and working the abdominals in different ranges of motion – flexion, lateral flexion and rotation.

Remember muscles need to be stretched, including the abdominal muscles.

Be consistent, as this is key in developing not only strength and flexibility, but also in reinforcing positive movement patterns and overcoming bad habits

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