Back Pain… Why is it so Common?

Why do so many of us get back pain?

For many of us, computer work is what pays the bills... am I right? But... it’s not the only factor contributing to back pain. Yes, sitting all day instead of crouching, rotating, and lifting as our ancestors did plays a huge role, through, I would bet many of them had back pain as well - and I’ll tell you why.

Like most people in the fitness world, I believe movement is medicine. Although, HOW we move plays a major role. Being dynamic in our movements gives our joints and muscles the lubrication they need to maintain full, pain free ranges of motion, but starting without getting injured can be tricky...

The building blocks of our core…

We have many different core and trunk muscles to help stabilize us, but just doing crunches and planks till you’re red in the face isn’t going to cut it. It starts with two very important muscles (well, technically 4 if you if you include the diaphragm and the pelvic floor, which you should, but that’s for another time). Today we’re talking about the Transversus Abdominis and Multifidus.

The Multifidus is primarily responsible for stabilizing the vertebrae within the spine - especially in the low back. Weakness or atrophy (wasting away) of this muscle will often lead to chronic low back pain, sciatica, and stiffness, which is commonly the cause of back strains when simply bending over - then, resigning us to the couch for the next few days. Strength, functional mobility, and proper alignment of the spine/body mechanics are key factors to waking up this muscle and getting it functioning properly - allowing us to bend with confidence. Without a healthy multifidus, it is near impossible to access smooth and controlled movements of the spine and trunk.

Transversus Abdominis (TvA): is primarily responsible for stabilizing the spine, maintaining posture & balance, and managing intra-abdominal pressure. Its horizontal muscle fibers create a corset-like compression on the organs to maintain stability and support for the trunk during long lever activities, such as leg lifts. To keep the spine in a safe position as our long levers fight against gravity, we need proper strengthening of this massive, yet sometimes lazy, muscle, as it enjoys delegating its job to the hip flexors, compressing the low spine, or using pressure as a means for stability. Because of its size you could have stronger or weaker areas, such as stronger upper abdominals and weaker lower abdominals. It is important to work this muscle evenly and be aware of tight vs. weak areas.

So, how do I strengthen these muscles??

When learning how to access your deep core, patience is key. Whether you’re recovering form a recent strain or working on your one rep max, it is crucial you start from the beginning and avoid skipping steps. I’ll warn you, the first few steps are a little dull, but they can make a great morning and evening routine with some relaxing music.

Step #1. Diaphragmatic Breathing

I cannot stress the importance of this exercise enough. As I mentioned earlier, the TvA helps manage intra-abdominal pressure during breath exchange, but it’s also how the TvA is activated! As you inhale, your TvA stretches and expands - think about the lengthening of your bicep during a bicep curl, you want to stretch your arm straight before starting your next rep. Same goes for the TvA.

You want to feel your trunk expand 360° (ribcage, back, and belly) like a soft, supple balloon (without tightening your neck muscles), then, as you exhale, feel the ribcage and belly shrink, gently drawing in the front, back, and side walls of your abdomen, like the tightening of a soft and flexible corset.

Note: this is different than sucking in. You should feel the strength and stability increase the more you exhale.

Moving on to Stability...

Once you’ve gotten the breath down, lets take it a step further by challenging the stability of your pelvis. This is where the multifidus and TvA start working together.

Step #2. Knee Fall-outs

Again, this is a slow progression. We’re adding in movement, coordinated with breath. To effectively engage your deep core muscles, it is important to begin the exhale right before the movement to preemptively turn on the TvA. If you move before you exhale, you will probably be using intra-abdominal pressure as a trunk stabilizer - rather than deep core muscles. Using pressure as a stabilizer has it’s place, but used incorrectly can result in hernias, urinary stress incontinence, core weakening, etc. Begin by inhaling to stretch your TvA, then start the exhale right before one knee falls towards the floor (with control). Make sure you are exhaling the entire time the leg is moving and try not to grip in your buttocks to compensate for the core. Pause to inhale, then exhale (same concept as above) to lift the leg back to its original place. The key is to keep the hips stable and still as your leg moves against gravity.

Note: spine should be in a neutral position for all exercises, meaning, there should be a small gap between your low back and the floor.

Continuing to Build...

Here, you will focus on keeping the spine stable and neutral, as well as the pelvis. Make sure not to lift your leg too high as you want to avoid squishing the air pocket between the mat and your low back.

Step #3. Marching

Hang in there as the breath is a little different.

Inhale the same as above, then as you exhale, lift and lower one leg (in the same exhale) a few inches off the ground. If your belly pushes up into your hands as you lift your leg, you’re probably using intra-abdominal pressure rather than core muscles. If this is you, try lightening your foot rather than lifting it fully off the ground to ensure the belly lowers away from your hand. To get the multifidus involved, imagine you could sandwich your organs using the front back and sides of your ribcage and belly using the exhale - this takes time and practice to master.

Disclaimer... This might not feel like a workout, at first

Accessing the TvA and Multifidus begins with nervous system retraining. If these muscles haven’t been working like they should, we have to reteach our brain to use them correctly. This is why it’s a slow process and often gets skipped.

These are seemingly very easy exercises, and if done incorrectly, they are. But... you’ll be missing the good stuff! Once you get the hang of how these muscles work and activate, it will unlock movement in everything you do. You will begin to use these strategies when vacuuming, gardening, walking, lifting, sprinting, biking, and so on. You will start moving with more confidence and ease, and realize how much strain you’ve been putting on the wrong muscles!

Alright friend, I hope this has turned on some lightbulbs!

The bottom line is, you shouldn’t have to “just have to deal with it,” or be told, “that’s just a part of aging.” Regardless or how many pregnancies you’ve powered through or anti climactic surgeries that didn’t give you the outcome you’d hoped for, working on strengthening these muscles will ALWAYS be beneficial and WILL help reduce pain. That’s a promise.

Next Steps...

If you’re ready to take back control of your life and not be ruled by pain, I’d love to help! With 10+ years as a pilates instructor and extensive training/experience working in a pelvic floor clinic as a Certified Occupational Therapy Assistant, I am excited to use all my tools to help you retrain your body into a more confident version of yourself. You shouldn’t have to worry every time you bend down to pick something up, or feel confined to the couch, yet again, as you’re in “too much pain.” You deserve to gain back your freedom of movement and to tell your pain, “ain’t nobody got time for you!”

I’m ready!

I know this is a lot to take in, but not to worry! I’m available in Sacramento for in-person sessions or online for virtual appointments. We will take things at your pace, with consistent check-ins to evaluate the best plan of action for YOU.

To get started, please schedule a FREE consultation so we can discuss your needs and challenges, and so we can find a plan that works best for you.

That’s all for now. I hope to meet you soon!