What is it with Americans? Being an American I cannot believe the things we swallow or trends we make up. Like “core” Strength, I even refuse to say it in my practice. Sounds kick butt! Every day I get forty-year-old patients in my office telling me their back hurts and oh, by the way, I have been working on my “core“. I almost want to ask them to point the “core” out on my anatomy chart.

They ask me, “why is my back hurting I have been working on my “core”. First we have to break down the anatomy and physiology of the spine as to what the problem is with your lower back. Guess what! Your back does not hurt because you have weak “core” muscles (myth). In fact your weight has much more to do with back pain than weak core muscles.

Wait,  I am getting ahead of myself. What are the “core” muscles? If you ask your trainer at the gym he/she would probably be wrong. That is unless they read peer-review journals such as Spine. I won’t bore you with the few muscles important to spine stabilization, but those muscles responsible are mostly out of cognitive control. In other words, they are hardwired to fire consistently all the time so you can sit, walk or jump at a moment’s notice. These deep muscles are endurance muscles with a set tone, you’re not going to backbend or crunch them into shape. More important than the deep stabilizing muscles of the spine are the back LIGAMENTS!! Not as cool a buzz word as CORE, but true. Basically, your posterior ligaments that wrap your spine give your back tensile strength…a kinda fulcrum, like your knee cap.

Well as we get older, sit all day for a job, have a few kids, carry 20+pounds for few years, and have numerous micro or macro traumas to the spine your ligaments start to show some wear and tear(aka degeneration). Degeneration comes to us all and our spines destabilize.

So, you see the Biggest Loser on TV and with your unknowing destabilized and asymptomatic back you start kettle balling everyday……yeah!, whooo hoooo…..ouch. Now what I did not tell you before is that pain is a neurological problem. Or more specifically a neuromuscular problem in this example. When ligaments (discs included) become inflamed from tearing (sprain) from degeneration and kettle balling we get pain. Your hardwired muscles are now “offline” due to the neurological irritations of the sprain and the deep hardwired muscles are now atrophying(weakening) at an alarming rate. They are now flaccid not “weak”. What is the difference? “Flaccid” is not getting neurological signals causing deterioration or degeneration. “Weak” muscles are neurologically plugged in but full of marbled fat causing a contractility problem.

I work on professional athletes weekly and they all have chiseled abs and backs that rival The Hulk. Guess what, they are in my office with back pain.

Out the window with “core” strength! In with damage to the ligament structures of the back. Due to macro trauma.

What can I do to help my back?

As I just explained you have back pain due something a hell of a lot more complicated than weak core muscles or a “weak” back. Look at your life, work and home.

Work on your body weight and food you are eating. Start with endurance and center of gravity exercises as in Tai Chi. Light workout with dumbells and walking. Remember to take it slow and listen to your body.

Forget what you are seeing on TV! That is just good TV ……not good for you.

Here is the study to back up the claim:

Paalanne N, Korpelainen R, Taimela S, Remes J, Mutanen P Kauppinen J”Isometric trunk muscle strength and body sway in relation to lower back pain in young adults” Spine. 2008 Jun 1;33(13):E435-41