Core Stabilisation for Back Pain 101

First of all what is core stabilisation?

In yoga, the term ‘core’ is used to broadly describe all of the musculature that supports and stabilises the lumbar spine, sacrum and pelvis. Stabilising muscles do not change length during movement; rather they stabilise and support the trunk during movement, which can be particularly helpful for students in the rehabilitation and prevention of lower back pain.

 

What muscles are involved?

Studies have shown that core stabilisation exercises which train and strengthen the deep abdominal muscle called the Transverse Abdominals (TA) and the deep spinal stabilisers called the Multifidi can be effective in helping to reduce pain and the risk of re-injury. One study, in particular, showed that people who’d been trained to strengthen their spinal stabilisers had only 30% recurrence of lower back pain after one year, versus a control group who were not given any spinal strengthening exercises and suffered an 84% recurrence rate.

The TA is the deepest layer of the abdominal muscles. Its muscle fibres wrap around the spine like a wide belt or corset, attaching at the bottom of the ribcage and at the top of the pelvis all the way around. When the TA engages it has the dual action of:

  • narrowing the waist, as if you were tightening drawstring pants and;
  • gently zippering the lower belly in and up as if you were doing up a tight zipper on your jeans

The Multifidi, on the other hand, are a group of tiny individidual muscles that provide stability to the spine, keeping the vertebrae in a safe position. These muscles come into play when:

  • the lower back is either neutral, such as when you’re standing with good posture in Mountain Pose
  • in slight back-bending or extension movements, particularly performed against gravity, such as Bird-Dog pose.

Bird-dog pose

It’s important to understand that the co-contraction of TA at the front of the trunk and the Multifidi at the back of the trunk will serve to maintain a neutral curve in the lower back and pelvis. Hence core stablisation techniques which work both the TA and Multifidi are all exercises in which the trunk is kept still and in neutral whilst the arms and legs move to provide challenge.

 

How do I engage the Transverse Abdominals and Multifidi?

To get a sense of how to engage these muscles start by lying on your back in Constructive Rest Pose. Have your knees bent, feet on the floor about hipwidth apart and parallel. You should notice that your lower back is in its neutral curve and we want this to remain the case throughout the whole exercise.

Constructive Rest Pose

 

To engage the TA:

Bring your fingertips to the skin just to the inside of your frontal hip points. In a relaxed state the skin beneath your fingers should feel relaxed and soft.

Breathe in allowing the belly to relax. As you breathe out imagine narrowing the hip points towards one another as if you were tightening a drawstring, and at the same time, zipper the lower belly in and up as if you were doing up a tight pair of trousers. The muscle beneath your fingertips should feel like it firms. The belly will also flatten slightly, as if you are sucking the contents of your abdomen up and back towards your spine. However do not flatten your lower back or tilt your hips back during this contraction as this will stop the multifidi from serving their proper function, which is to maintain the neutral curve of the lumbar spine.

Breathe in to release the contraction, as you breathe out repeat. This is a subtle engagement working at about 10-20% of your maximum effort. Repeat for 5-10 breaths.

 

To engage the Multifidi:

Continue with the above exercise but this time, as you breathe out imagine the muscles of the lower back contracting slightly upwards the naval at the same time as the TA engages drawing the naval in and back towards the spine. It’s as if the front and back of your body were coming closer together or co-contracting to meet in the middle of your body each time you exhale.  Again, the engagement is subtle and the pelvis or lower back should not move. Repeat for 5-10 breaths.

 

One final, important word

Whenever we work to strengthen an area of our body it is important to maintain an awareness of the bigger picture or overall intention of a yoga practice. Core stabilisation exercises therefore should become part of a bigger overall practice that serves to create greater function, strength and mobility throughout the whole body in normal everyday movements. As Aline Newton says so eloquently in her book “Stabilisation: The Core and Beyond”:

“ From the perspective of the body in motion, the work of the transversus system is not to make the trunk stable like a fortress, but to help make possible the transfer ot movement been hands and feet. Holding tension in the center of the body severely interferes with smooth transmission of the forces across the joints that is the basis for graceful movement.”

With this idea in mind, in my next blog post we’ll explore some of my favourite exercises for teaching core stabilisation to my clients that train to stabilise the core and lower back whilst mimicing real life movements. Stay tuned!

Credits to Tummee for their awesome images!

5 Yoga Exercises To Realign The Spine

From a physical perspective, one of the main benefits of a yoga practice is to cultivate and maintain spinal flexibility and strength. There’s a saying ‘You’re only as young as your spine is flexible’. Having a stiff, tense and weak back not only makes us feel old, but it has a negative knock-on effect on the mobility throughout the entire rest of your body. This is why I often focus in my private sessions on helping clients to improve their spinal health and to realign the spine if their posture is poor.

The spine has five ranges of motion – flexion (forward-bends), extension (back-bends), lateral flexion (side-bends), rotation (twists) and axial extension (lengthening/traction). A nice way to sequence a yoga session is to see if you can incorporate all five of these movement patterns into the practice. If you’re short on time, or it’s first thing in the morning and you just need to gently bring some energy into your body, try the following five yoga exercises. Hold each pose for 5-8 breaths (each side if there are two sides) and you’ll be good to go!

Remember if you have any back injuries or current back pain these poses may or may not be appropriate and you might want to check with your healthcare provider beforehand.

 

Supine twist (rotation)

Come to lying on your back. Pick your hips up and shift them slightly to the left so they are slightly skewed. Bring your knees into your chest and take them over to rest to the right side.

Put a rolled up towel between the thighs if the thighs and knees don’t touch each other.. Rest your right hand on your left outer thigh and allow the left arm and shoulder to stretch out to the left, releasing the left shoulder blade down towards the floor. Take 5 deep breaths before switching sides.

 

Bridge roll ups (extension)

Come to lie on your back. Bend the knees, heels under knees and placing feet hip-width apart with the toes pointing forwards. Bring the arms alongside the hips, palms facing down.

On an inhale start to peel the hips, lower, middle and upper back away from the floor. On an exhale lower the arms, upper, mid, lower spine and hips towards the floor. Try to articulate the spine one vertebrae at at time, synchronising the movements with the breath.

Repeat 5-8 times before releasing stretching the legs out and taking a few moments to pause and feel the effects.

 

 

Cat-cow (flexion and extension)

Coming onto hands and knees, place your knees hip-width apart under your hips and your hands shoulder-width apart.

On an inhale drop the belly slightly towards the floor and arch the chest forwards (creating a little backbend in your upper back). This is cow pose.
On an exhale press down through the hands and round the back towards the ceiling, lifting the belly and front ribs up into the back body, tucking the chin to the chest and looking towards the belly button. This is cat pose (imagine an angry cat!). Repeat this back and forth motion for 5-10 rounds, synchronising the movement to the breath.

 

Downdog against a chair (flexion and axial extension)

Hold onto to a ledge, table or back of chair. Hands shoulder-width apart, palms facing downwards or even inwards if possible so that you can draw the shoulders away from the ears.

Walk your feet back, bend your knees and align your heels under your hips as you stick your bottom backwards. Work on maximising the length in your spine. Gently lower the chest down so that eventually the spine is parallel to the floor (or just above) and the ears and upper arms line up with each other. Feel for a long line of energy from the tailbone all the way through to the crown of the head. Relax and soften the upper trapezius muscles right around the ears. Hold for 5 breaths. Make sure your breath remains fluid and easy without strain or tension. Repeat twice.

This would be a good pose to repeat throughout the day!

 

Mountain Stretch and Standing side bend (axial extension and lateral flexion)

Standing in mountain pose, feet hip-width apart and parallel. Hands resting by your sides. On an inhale reach your arms up overhead, interlace the fingers and flip the palms. Hold for a couple of deep breaths. On the inhale think about stretching up through the spine, pressing outwards and up through the palms. As you exhale think about drawing the lower belly back towards the spine and softening the inner shoulders slightly down away from the ears.

Then place one hand on your hip, inhale to reach your other arm up towards the ceiling, lengthening the side of your waist. Exhale as you begin to lean over to the side stretching into the sides of your body. Inhale to come back up and switch arms, exhale to lean over to the other side. Repeat 3-5 times each side, returning to mountain pose with your arms by your sides to finish.

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