Often people with back pain are told that their “core” isn’t strong, that they should “strengthen their core” to relieve their back pain.

What is your core?

Roughly speaking, when people refer to the core they mean the muscles between the base of your ribs and your hips:

• The pelvic floor muscles
• transversus abdominis
• multifidus
• internal and external obliques
• rectus abdominis
• erector spinae (sacrospinalis) especially the longissimus thoracis
• the diaphragm
• the latissimus dorsi
• gluteus maximus
• trapezius

Is your core important?

Incontinence – your pelvic floor is a key part of preventing incontinence – urinary and faecal. It can also be a factor in constipation and other bowel complaints. It is the hammock that all your internal organs rest on – so keeping it strong keeps everything where it should, functioning as it should! Lower back pain – if you aren’t using the big muscles in your stomach, those large erector spinae muscles are picking up the slack. They get tight and locked, your spine isn’t being supported properly, and this can cause excess pressure, resulting in lower back pain or sciatica. Upper back pain – the core muscles are basically the big, strong muscles. They do the hard, stabilising work so that the little muscles in the upper back can help you move and reach. When the core isn’t active the smaller muscles try to do a big muscles’ job – and they don’t like it so you get pain. This results in neck pain, shoulder pain and even headaches. Breathing – your diaphragm is also part of your core – so if you aren’t using it properly you aren’t breathing properly either!

Skip the sit ups

Sit ups put excess pressure on the discs in the lower back and, often strain the upper back and neck unless your technique is perfect. In a recent review after the annual fitness test in the US Army, 56% of the injuries came from the sit up portion.

What to do instead

Use the Plank position and all its variations to work the deep core muscles without the pain! Find a good Pilates instructor – not all are made equal! Make sure the classes are small and that they watch you constantly. We are very lucky here in Marbella to have one of the best Pilates instructors I’ve ever met, but if you aren’t sure, ask them about their qualifications. You aren’t aiming for a six pack – what you want is to make sure that the big muscles are pulling their weight and the little muscles aren’t working too hard! Flexibility and mobility is what you’re going for!Try a Free 15 minute telephone consultation to find out how we can help.

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7 things your doctor didn’t tell you about back pain

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