You roll around on your Swiss ball like a grizzly with a back itch. You do crunches and work your obliques like a champ. So you must have good core stability, right? And core stability will reduce back pain and prevent injury, right?
Yes, no, maybe. Research on back pain, experts say, is frustratingly spotty and the subject of debate.
Research suggests that, yes, exercises that target core muscles may reduce back pain and prevent future injury, but whether these exercises are substantially better than other structured exercise programs for chronic back pain has not been proved. And not all researchers agree on which components of the body's core muscles are most crucial to preventing a back injury and reducing pain after suffering an injury.
A seminar on the role of core stability in reducing and preventing back pain attracted a full house last week at the American College of Sports Medicine's 12th annual Health and Fitness Summit and Exposition in Long Beach. Presenter Marjorie King, director of the graduate athletic training program at Plymouth State University, in Plymouth, N.H., outlined the current state of the field: a need for more research and moderate support for the use of core stabilization exercises to decrease low-back pain and increase low-back function.
King thinks that some who practice core stability are missing at least part of the boat. "One of the biggest misconceptions people have about core stability is that by doing crunches, they're getting at core stability," she says. Crunches address the trunk, or "global" muscles, which exercisers more commonly work. But to really target core stability, she says, exercisers need to attend to the often-ignored spinal, or "local" muscles.
Local muscles include the little intersegmental muscles, the multifidi, that run along the vertebrae. These muscles don't move a lot but are thought to play a role in keeping the spine stable during movement.
Other musculature involved in local stabilization include pelvic floor muscles and the transversus abdominis muscle, the deepest of the abdominal muscles. This muscle is horizontal in design, King says, and functions like a corset, stabilizing the spine.
Core stability training "is the standard of care, it's what people do, in my field anyway," says Dr. Christopher Standaert, a physiatrist (a physician specializing in physical medicine and rehabilitation) and clinical associate professor of rehabilitation medicine at the University of Washington in Seattle. But, he adds, "There's never even been a uniform agreement on the definition."
