Motion Stability's Blog


What Exercises for My Core Can Help Prevent Lower Back Pain? by charlestlee
Brian Yee PT, MPhty, OCS, FAAOMPT

First – generally there are different roles of muscles in your trunk. Typically the smaller ones closest to your spine are considered ‘local’ muscles. Such muscles as the transversus abdominis, diaphragm, pelvic floor, and lumbar multifidus provide segmental control of your lumbar vertebra. Real-time ultrasound imaging can be used to visualize the proper contraction of these muscles as we cannot see these muscles from the superficial skin. So first step in core stability is to ensure that the smaller muscles are engaging properly. Then you have ‘global’ muscles which are the larger muscles – such as rectus abdominis, obliques, paraspinal muscles. These muscles are designed for power and stability at higher loads. Core stability exercises should integrate the function of the ‘local’ and ‘global’ muscles in proper sequence.

Once that is established, any asymmetries of the muscles should be determined. In back pain patients, it is very common to have one side of the oblique muscles contracting properly while the other side does not. This causes an imbalance of forces on your trunk and can cause increased torque to your spine – eventually leading to back pain due to excessive torsional stresses in your daily function or sport.

Once the asymmetry is addressed, integration of muscles from above and below the core need to be assessed.  The old saying ‘the knee bone is connected to the hip bone’ goes too with the muscles in your body. Such lower leg muscles as the gluteal muscles in your hip or the latissimus dorsi in the mid back affect the way your core muscles in daily function and sport. People with back pain, typically have an improper tone and sequence of these muscles working together. Over time this places increased stress on the back – regardless of how strong your core is.

As you can tell, there is a lot to consider when training your core. To recommend a standard protocol of exercises to help your back is not specific enough. A proper assessment of your muscle control and movement patterns should be assessed by a qualified movement specialist – such as a Physical Therapist – to determine what the appropriate level and progression of exercises for proper stability and prevent back injury.

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What Is The Right and Wrong Way to Bend Over? by charlestlee

image source: media-cache-lt0.pinterest.com

Brian Yee PT, MPhty, OCS, FAAOMPT

Proper bending requires a fluid ‘lumbopelvic rhythm’. This means the hips and spine should coordinate to be able to touch the ground. Ideally there should be a 2:1 ratio hip movement to spine movement. 

What we see typically in the clinic is that patients have significant restriction of what we call ‘hip hinging’ as the patients hips have restricted motion, thus requiring increased movement from the spine..with repetitive and excessive movement at the spine it creates greater torque to the spine.

The other scenario we commonly see are patients who have fear to move their spine and essentially ‘lock’ their spines in slight hyper-extension and try to bend entirely from their hips. This creates greater muscle spasms in the spine and the fear of moving can lead to altered movement patterns that do not help the back in the long run.

Please consult with a qualified health practioner to observe your bending patterns, and provide education and the tools to give you the confidence and ability to bend properly.