Core exercises for low back pain? A chiropractor explains:

By Sydney CBD Chiropractor Dr Remy Leonard

Ever wondered why your Chiropractor keeps prescribing you core strengthening exercises to fix your lower back pain?

In today’s blog we will discuss what muscles make up the core, how to engage your core muscles and what the relationship between core strength and back pain is. We will also demonstrate examples of exercises which engage your core muscles.

Chiropractor Dr Remy Leonard educating a patient about the lumbar spine and low back pain

Which muscles make up the core?

When most think about “their core” they think of their abs or six-pack region just below the ribs. While the abdominals are an important part of the core, we must also consider other muscles too. The rectus abdominis, internal and external obliques, the transverse abdominis, multifidus, diaphragm and pelvic floor are also considered important core muscles. Without the stabilization provided by the core muscle system that surrounds the spine, it would not be able to withstand the forces exerted by the lower limbs.

Think of the core like a can of coke. The cylindrical component comprising of the transverse abdominis at the front and sides, the multifidi at the back. The can of coke is sealed top and bottom by the diaphragm and the pelvic floor respectively.

All these muscle groups work together as a cohesive whole to stabilize the pelvis and lumbar spine when they are placed under stress by activities such a bending, twisting, lifting, stretching, walking, running and jumping.

It is important to realise that activation of the core muscles is not the same as abdominal strengthening. That is – it is possible to have strong abdominals but a weak core. Activation of the core is not something that most people do consciously, therefore it is important to learn how to effectively co-contract these muscles while performing your exercises.

How to engage core muscles?


Despite appearances and the assured nature of the facts presented by some teachers/anatomical texts, it is not possible to totally isolate one or the other muscle in any particular movement. However, to feel the activation of the transverse abdominis place two fingers on the bony prominences on the front your hip bones, move your hands an inch towards your belly button and down an inch towards your toes.

You should now be directly over the transverse abdominus muscle. When you contract your core correctly, you should feel a gentle tightening under your fingers – it should feel as if you took in your belt one extra notch. If the muscles under your fingers start to “dome”, then you are contracting too much and recruiting larger muscle groups. It is important to learn how to engage your core in various positions as well as during activity in order to provide maximal spinal stability.

“If the muscles around the lower back are weak, your body is forced to rely on more passive structures like ligaments, intervertebral discs and bones for stability. It is when these structures are overloaded pain can ensue.”

What is the relationship between core strength and back pain?

The concept here is that if the muscles around the lower back are weak, your body is forced to rely on more passive structures like ligaments, intervertebral discs and bones for stability. It is when these structures are overloaded pain can ensue. However, core strengthening is more than just getting a six pack, developing a strong core will decrease the likelihood of injuries and can also teach you proper spinal alignment.

Core exercises to avoid low back pain:

Weighted russian twist to develop strength of the core muscles - aiming to reduce low back pain

1. Weighted Russian twists
In a seated V position on a table or mat with a weight or medicine ball in your hands, twist your body to one side and then the other while maintain V position. Repeat 10-20 x.

2. Prone Bridging on Elbows
Lie on your stomach on a table or mat with your forearms/elbows on the table/mat; rise up so that you are resting on your forearms and toes; maintain abdominal draw in; your back should be completely straight; hold this position for 15 sec – 1 min. Progress in increments of 15 seconds. Repeat 5-10 times.

Hanging crunch is a gym based exercise used to work core muscles to help avoid low back pain

3. Hanging leg lift using elbow support
When using the elbow support leg lift machine, your legs should be straight down with your pelvis rolled slightly backwards. This will be your starting position. As you contract your abs Raise your legs, ensuring you keep them straight, until the torso makes a 90-degree angle with the legs. Repeat this 5-10 times.

Core activation and spinal stability are things we all take from granted. They play a huge factor in your everyday life and functions. With a few lifestyle adjustments, regular exercise and visits to your chiropractor, you can greatly improve in balance, strength and core stability. Not only will your posture improve, and you will feel better, but those tasks that seemed to be “too much” will suddenly become much easier. Start at the core and ignite change by taking care of your own body, it is the very least you owe yourself!

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