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Tired of Transversus Abdominus squeezes for Low Back Pain?

Updated: Oct 21, 2023

You're in Luck! A research article entitled "The Myth of Core Stability" brings to light several important points that encourage us to reconsider how important some of the most common exercises (i.e. transverse abdomens engagement) for low back pain may be unnecessary. 

Typical Transversus Abdominus Engagement

The myth of core stability originates from a study in 1996 by Hodges and Richardson that found a change in timing activation of local core muscles (Transverse Abdominus, Multifidus) in those with chronic low back pain. This study and other related studies promoted extensive use of local stabilizer exercises (non-weight bearing and not specific to functional tasks) in typical rehabilitation now. For example, local stabilization exercises (i.e. Transverse Abdominus or multifidus training) are more important than global or dynamic stabilizers with notion by improving delayed onset of those muscle firing in patients with low back pain compared with control group without low back pain.

These assumptions have been refuted by other studies. For example, a study in 2006 by Bastiaenen, C.H., et al. entitled Effectiveness of a tailor-made intervention for pregnancy-related pelvic girdle and/or low back pain after delivery: short term results of a randomized clinical trial, had 635 out of 869 pregnant woman drop out of a low back pain study due to the spontaneous unaided recovery of pain within a week of delivery. This demonstrates that local stabilization training is not sufficient enough to resolve low back pain and return to functional tasks in activities of daily living.

Squats are one of many greats option to improving low back pain

Research has shown that local stabilizer exercises are no more effective than other forms of exercise. There is weak evidence supporting this longstanding theoretical model only focusing small muscle group training. Furthermore, low back pain has been proven to be best improved by loading the low back utilizing dynamic stabilizers (i.e. carrying, lifting, plank, Turkish get up, crawling, and rolling pattern) and strengthening the supportive gluteal muscle group through functional compound exercises(i.e. squatting, deadlifting, step up, lunge, and kettlebell swings).

Once we can have efficient control over low back pain with movement, it is advised to move on integrating functional movement patterns (discussed above paragraph) to establish an individualized exercise program with right dosage (vigor and volume) of functional training based on your current level of capability. Clinical Experts in Columbia Physical Therapy In Motion can certainly help you how to cope with low back pain and develop specific functional training for your needs and return to active lifestyle.

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