Best Core Engagement methods for Back Pain Relief
Summary
TLDRThis presentation challenges the common belief that exercises are the solution to chronic back pain. Instead, it advocates for mastering core engagement to support the spine throughout daily activities. The speaker discusses different core engagement techniques, emphasizing the importance of balance and endurance over strength. The focus is on maintaining a healthy core connection for all-day support, using simple exercises and proper breathing to prevent excessive wear and tear on the spine.
Takeaways
- 🧘♂️ Core engagement is the focus for addressing chronic lower back pain, rather than just strengthening specific muscles.
- 🏋️♂️ Exercises are not inherently the solution to back pain and can sometimes contribute to wear and tear on the spine.
- 🤔 The approach to core engagement should not isolate specific muscles like the transverse abdominis but should work with all muscles synergistically.
- 🔄 Chronic lower back pain often results from excessive wear and tear on the spine, and the goal is to reduce or reverse this.
- 💪 The issue with exercises is that they can lead to muscle compensations and may not translate well to activities of daily living.
- 🤝 Core engagement should be a master skill that applies to all activities, providing support to the spine throughout the day.
- 🤔 Abdominal drawing in or hollowing may favor the transverse abdominis but can leave other core muscles disengaged.
- 🛡️ Bracing is a method of core engagement that involves slight expansion of the core muscles, providing more stability and support.
- 🍃 The 'Coke can' analogy illustrates the importance of maintaining intra-abdominal pressure for spinal support and decompression.
- 🌀 Balance in the musculature around the core is crucial to prevent power leakage and ensure effective core engagement.
- 🌄 Strength is not as important as endurance when it comes to core engagement for daily activities and preventing back pain.
Q & A
What is the main focus of the presentation on core engagement?
-The presentation focuses on chronic lower back pain and the concept that exercises are not the solution to back pain, emphasizing the importance of core engagement for support and stability of the spine throughout daily activities.
Why does the presentation claim that exercises are not the solution to back pain?
-Exercises can lead to compensations due to muscle imbalances, contribute to wear and tear on the spine, and may not translate to activities of daily living, potentially causing more pain after workouts.
What is the approach to core engagement that the presentation suggests?
-The approach is to engage all muscles synergistically rather than isolating specific muscles like the transverse abdominis, aiming for a healthy core engagement that applies to all activities.
What is the 'Coke can analogy' mentioned in the presentation?
-The Coke can analogy is used to explain the importance of maintaining intra-abdominal pressure for spinal support, comparing the stability of a pressurized can to the stability of the spine when core muscles are engaged.
How does the presentation differentiate between concentric contraction, abdominal draw-in, and bracing in core engagement?
-Concentric contraction increases compression on the spine and is not preferred. Abdominal draw-in focuses on the transverse abdominis but may not engage all core muscles. Bracing expands the core muscles, providing more stability and support but may skip activation of the transverse abdominis.
What is the significance of maintaining a core connection throughout the day for back pain sufferers?
-Maintaining a core connection provides continuous support for the spine during all daily activities, preventing excessive wear and tear, and is crucial for managing and overcoming chronic back pain.
Why is endurance more important than strength in the context of core engagement for back pain?
-Endurance is more important because the goal is to maintain a low-intensity core connection throughout the day during various activities of daily living, rather than high-intensity strength training specific to the gym.
What role does breathing play in developing core engagement?
-Breathing is a powerful tool for developing core engagement as it helps to create familiarity with the core muscles and can be practiced throughout the day, focusing on maintaining engagement while inhaling into the engaged core.
How does the floor serve as a tool for developing core connection?
-The floor provides valuable biofeedback for aligning the spine and practicing core connection by pushing away from the floor, mimicking the natural development of core strength in infants.
What is the final recommendation given in the presentation for individuals dealing with back pain?
-The final recommendation is to 'get down on the floor and connect to your core,' emphasizing the importance of practicing core engagement in a way that can be sustained throughout the day for spinal support.
Outlines
🧘 Core Engagement for Chronic Back Pain
This paragraph introduces the concept of core engagement as a solution for chronic lower back pain. It challenges the common belief that exercises are the cure for back pain, suggesting instead that a proper core engagement technique can be more beneficial. The speaker emphasizes the importance of engaging all abdominal muscles synergistically rather than isolating specific muscles. The goal is to reduce excessive wear and tear on the spine, which is often the root cause of chronic back pain. The paragraph also discusses the limitations of traditional exercises, such as the potential for muscle compensations and the lack of translation of gym exercises to daily life activities.
🤔 Exploring Core Engagement Techniques
This section delves into the different types of core engagement: concentric contraction, abdominal draw-in or hollowing, and bracing. It explains that concentric contraction, which increases compression on the spine, is not sustainable for daily activities. Abdominal draw-in is common in Pilates and yoga but may not engage all core muscles effectively, potentially leading to muscle imbalances. Bracing, akin to preparing for a punch in the stomach, is shown to provide more stability and support, although it might not activate the transverse abdominis muscle. The speaker shares personal experiences with back pain and how understanding and practicing proper core engagement helped overcome it.
🏋️♂️ Strength vs. Endurance in Core Training
The paragraph discusses the importance of endurance over strength in the context of core training for back pain management. It emphasizes that daily activities require low-intensity, sustainable core engagement rather than high-intensity strength training. The speaker advocates for maintaining a core connection throughout the day for spinal support during activities of daily living (ADLs). Breathing and the use of the floor are introduced as valuable tools for developing core connection, with exercises serving as a means to challenge and strengthen this connection in various planes of motion.
🌟 The Path to Core Mastery and Pain Relief
The final paragraph wraps up the presentation by highlighting the importance of mastering core engagement for overall spinal support and back pain prevention. It reiterates the benefits of applying core engagement in all activities and the simplicity of the approach, which minimizes the potential for error. The speaker encourages the audience to practice on the floor to connect with their core and to use exercises as a means to challenge this connection. The goal is to develop a sustainable core engagement that can be maintained throughout the day, providing continuous support to the spine and helping to break the cycle of chronic back pain.
Mindmap
Keywords
💡Core Engagement
💡Chronic Back Pain
💡Compensations
💡Intra-abdominal Pressure
💡Abdominal Bracing
💡Muscle Imbalances
💡Endurance
💡Synergistic Muscle Group
💡Activities of Daily Living (ADLs)
💡Breathing Techniques
💡Floor Work
Highlights
Exercises are not the solution to back pain, contrary to common belief.
Core engagement is the focus for managing chronic lower back pain.
Muscles work synergistically, not in isolation, for a healthy core.
Lower back pain often results from excessive wear and tear on the spine.
Compensations in exercises can lead to more pain and imbalances.
Exercises can contribute to spinal wear and tear if not performed correctly.
Exercises are often too specific and do not translate well to daily life activities.
Core engagement should be maintained throughout the day for spinal support.
Benefits of mastering core engagement include universal application and minimal input for maximum output.
Core engagement types include concentric contraction, abdominal draw-in, and bracing.
Abdominal draw-in may favor the transverse abdominis but can neglect other core muscles.
Bracing provides stability but may not activate the transverse abdominis in some cases.
The Coke can analogy illustrates the importance of intra-abdominal pressure for spinal support.
Muscular balance is crucial for maintaining intra-abdominal pressure and preventing leaks of power.
Strength versus endurance in core training; endurance is key for daily activities.
Breathing exercises are a powerful tool for developing core connection and familiarity with core muscles.
The floor is a valuable tool for biofeedback and aligning the spine in core connection exercises.
Exercises should be used to challenge the core connection, not as the primary solution.
The goal of core engagement is to provide better support for the spine to prevent excessive wear and tear.
Maintaining a core connection throughout the day is essential for success in managing back pain.
The end goal is spinal support, beginning with the end in mind for core engagement practices.
Transcripts
in this photo I do not have back
problems in this photo I have severe and
chronic back pain this presentation is
called core engagement and we're focused
mostly on chronic lower back pain so we
deal with people who uh have been
struggling with back pain for 5 10 20 40
years even we're going to start off with
a controversial statement exercises are
not the solution to back pain I think
most people might disagree with that
initially but hopefully by the end of
this presentation you might agree with
me a little bit so we're going to talk
about the different types of core
engagement pressure and balance and how
that's associated with core engagement
strength versus endurance and we'll talk
about the best tools to use for
developing a healthy core engagement so
we're not going to be singling out
muscles uh that's not the approach we
take we believe all the muscles work
together synergistically so we're not
trying to isolate the transverse
abdominis or anything you can see the
layers of abdominals we want all of them
to come to the party not just one or two
of them let's get all on the same page
here so the problem
that we deal with with lower back pain
is excessive wear and tear on the spine
if you were to sum it up all the
different back pain conditions uh most
of them are just a result of excessive
wear and tear if we're talking about
chronic lower back pain aside from an
acute trauma you know hernia to dis
bulging disc stenosis degenerative disc
disease spondi all of it is excessive
and it's wear and tear on the spine and
so that's what the goal that we have is
to try and either stop that
excessiveness or even reverse it if
possible so the normal solution is the
exercise solution besides surgery
besides pills and injections which we
all don't want to do we tend to rely on
exercises do this exercise do the plank
do the bridge do dead buug or bird dog
so the goal is to strengthen your core
and some issues with that approach are
exercises are prone to compensations so
if you have a compensation if you have a
muscle imbalance in your body and you
heavily dominate with a certain muscle
group like the quads or the hip flexors
exercises that are complex in movement
tend to favor those compensations you're
going to use your strongest muscles to
do those exercises and it can actually
strengthen the imbalance exercises can
contribute to the wear and tear on your
spine so excessive movement high
intensity training lifting weights
especially if you're not doing it right
or having those compensations a lot of
people that are struggling with chronic
Lorac pain will come away from a workout
with more pain uh especially later that
night or the next day and they're paying
the price so to speak for doing that
workout or activity so that is a
possibility and then even if you get
those first two points right you are not
compensating and you're not
strengthening your imbalance and you're
not contributing them wear and tear
exercises still have a problem and they
tend to be too specific the training
that you're performing with those
exercises is specific to in the gym and
they don't really translate to life
outside the gym ADLs activities of daily
living they don't really help you to
wash the dishes without having soreness
or pain in your back the goal is to not
have pain when you're doing the dishes
so to reemphasize the statement from the
beginning exercises are not inherently
solutions to back pain doing an exercise
like the bird dog is not the solution a
lot of it has to do with how you're
doing the bird dog and that's where core
engagement comes into play so our goal
is to have better support for the spine
and that is to be all day long not just
during the 1 hour that you're in the gym
and the way that we do that is to become
a master of core engagement and there's
some really great benefits to this so
number one it applies everywhere if you
have a healthy strong core engagement it
can apply to any exercise you do in the
gym or out of the gym whether you're
doing yard work or gardening or stepping
into the shower or whatever it is this
core engagement will apply to that
sitting for example a healthy core
engagement applies to what I'm doing
right now that's a huge benefit another
thing that's really cool is it requires
minimal input so you have to just Master
one simple thing to apply everywhere and
so you're getting maximum output from a
minimal input and I'm not saying that
it's easy it's just simple so we really
just zoom in on mastering one simple
thing instead of trying to become really
good at so many different exercises or
become uh masters of a workout routine
that involves 10 or 15 different
exercises we just Master one thing and
it applies to all of it we already
talked about simple and because of that
there's little room for compensation or
error and we are breaking things down
into the most simple parts so that it's
less complex less complicated and less
room for making mistakes or errors let's
talk about the core engagement types we
have first one is concentric contraction
that is the guy on the top right here uh
of course that is not the preferred way
this is causing increased compression
and pressure on the spine and it's just
not a a sustainable thing to to do and
walk around in your normal day so we're
not concentrically Contracting the core
another method is abdominal draw in or
hollowing and that's what you see a lot
in Pilates and sometimes in yoga and
what they're doing is they're pulling
the belly button towards the spine and
you often see the rib cage flaring a
little bit and a little bit of a dip
here and then the third method is
bracing and bracing is actually where
there's expansion in the core muscles so
it's not pulling in but it's actually a
slight expansion and there seems to be a
lot of confusion about that we'll talk
about the difference between the two and
which is preferred so abdominal draw in
is like I said it's pulling in the
research shows upon muscle testing that
it's highly favors the transverse
abdominis muscle but it doesn't really
engage all the core muscles the the
other three layers of of abdominal
muscles may be turned off so that is the
big downside because we want to use the
core as a synergistic muscle group
rather than trying to isolate one muscle
group thinking it's better than the
others it's designed to work together
with them not in place of them that
would be specifically pulling in and
activating that transverse abdominis
there is some use cases for that but
it's not what we want to apply in our
normal daily life of lifting up a heavy
object or something like that abdominal
bracing is more comparable to what you
would do if you were going to get
punched in the stomach you're not
Contracting downward but you're
hardening your muscles and the research
shows that bracing provides more
stability and is more supportive because
it brings in more of the abdominal
muscles but it may actually skip over
the transverse abdominis muscle in other
words that muscle may not become
activated with bracing and so that is
actually a bit of a problem if you have
an issue with muscle inhibition of your
deep abdominal muscles uh bracing may
not solve that problem we want to use
bracing in the sense that we're using
all the muscles together but we also
want to get that transverse abdominis
that deepest muscle but also just to
make sure that you're engaging all the
muscles you need to get in touch with
those deeper muscles and and know what
they feel like uh this is a picture of
me I have a personal history of chronic
lower back problems of over 10 years and
this is during my issues you can see I
was abdominal hollowing this was
actually not intentional this was a
dysfunction of my core and then uh later
in my life after I got out of back
problems I learned how a healthy core
engagement and you can see that
hollowing is not there so this would be
more similar to bracing in this photo I
do not have back problems in this photo
I have severe and chronic back pain um
you can also see my form looks better my
arms are more open everything is is
healthier in this image uh with a
healthy core connection rather than a
dysfunctional pattern that I wasn't even
trying to do all right so let's talk
about pressure and balance and how that
applies to core engagement you have not
heard of the Coke can analogy it's about
time you hear of that so a Coke can is
very stable as soon as you pop that coke
can as soon as you open the top very
easy to crush so you have lost the
pressure inside the can it becomes weak
and easy to crush so we can compare our
abdomen to a Coke can and we want to
contain that pressure in our abdomen
with the diaphragm at the top the pelvis
at the bottom and the spine and the
lower back muscles are typically not the
leak most often the leak of power is in
the front you know the abdominal wall
and if you lose that power your spine is
being supported by a Coke can that has
no pressure so we want intraabdominal
pressure and not only is intraabdominal
pressure provides stability but it also
provides decompression and you can see I
don't know what this is like an egg or
something a soft ball that you can
squeeze it actually causes a force in
the upward and downward Direction like a
stretching out and this can happen to
your spine too so we can see what
happens when you put a corset brace on
you P pull it very tight it provides
relief to the patient so we have
pressure but you can't get the benefits
from inra abdominal pressure without
balance we need to have balance in the
musculature around our core and it's
very common to have muscle imbalances
within that core muscle system and so
what happens is most often the
abdominals are the ones that become
inhibited and lned and you can see this
image that's under lost image B here the
diaphragm tends to angle so this is
showing the difference in the angle of
the diaphragm on the pet floor tends to
angle forward and then your breathing
starts the pressure of your breath
starts pushing forward out of your
abdomen and so that is a way that
pressure gets lost and so in order to
contain that pressure we need to close
the cat can we need to close that leak
and it is most commonly out the front we
need to have 360° of pressure and
requires muscular balance you can see
the abdominal muscles are what close off
that leak and allow for the
decompression to take place in the spine
the intraabdominal pressure all right so
the next topic is strength versus
endurance which one is more important
and when we are talking about
specificity which is a principle of
training with back pain we're not trying
to train for the gym so when you're in
the gym doing exercises you're actually
training for or being in the gym but
with back pain we're dealing with it all
day long and just doing normal daily
activities and so ADLs are the
specificity we spend the majority of our
time doing them we want to have support
for our spine during ADLs so that means
we're not operating within a strength uh
scale we're operating at low intensity
and we're ramping up and down our core
engagement depending on the activity
we're doing so if we're sitting we
should have some spinal support but it's
not 50% or even 30% it might be 2%
engagement but if we get up and we go to
reaching the cupboard for a glass of
water we might ramp up to 12% and so
this is what we're going to be doing
throughout our day with a healthy core
engagement and strength is more in the
80 90 100% intensity level and that is
not what we're training when we are
awake we have 16 hours to do this and
that requires massive endurance for that
reason success with getting out of back
pain depends your ability to maintain a
core connection and that's what I like
to call it it's a maintaining a
connection to your core throughout your
day it has to be sustainable so so most
often it's going to be low intensity
connection so let's talk about the best
tools for developing this core
connection first one is breathing
breathing is one of the most powerful
tools that I've used and uh we use in
helping our patients to First just
develop a core connection and or develop
familiarity with those muscles and it
also requires a lot of Focus breathing
is something you do all day long and so
if you are thinking about your breathing
you are focused they go together the
second tool is the floor that is the
most valuable for developing core
connection we're going to talk about
that and exercises number three and I'm
going to come back around to that first
statement where I said exercises are not
the solution let's talk about breathing
we're going to do an exercise together
it's a two-part exercise that going to
be done really quickly the first thing
you're going to do is you're going to
Exhale all your air and you're going to
feel your core muscles engage like a
corset so we can do that right now get
it all out and feel that engagement and
then the second part of this exercise is
we're going to actually inhale into that
engagement and we're going to feel the
increase in pressure intra abdominal
pressure that occurs when you inhale
into that engaged core so after you
exhale maintain that engagement and
breathe into it don't send your breath
out your belly try to send it down and
back and that will help you to maintain
that engagement and you might feel
yourself even get a little taller when
that happens since I've been practicing
that for over 10 years I definitely feel
myself gain a millimeter or two of
height for sure all right so let's the
floor so the floor is I think the second
most valuable tool for developing core
connection uh this is what we used uh
originally to develop our core babies
and infants developed their core before
the arms and legs and they did this by
pushing away from the floor and so this
is exactly the technique that we model
after with our patients and with our
students uh and the floor is fantastic
for getting biof feedback and aligning
the spine and just so many wonderful
things so getting down on the floor is
our motto get down on the the floor and
you connect to your core I we teach a
specific way to connect and push away
from the floor exercises exercises are
not the solution but they are tools that
we use we first develop that core
connection and then we use exercises to
challenge that core connection and so it
really doesn't matter what exercise
you're doing whatever you choose to do
it's a form of a challenge to that core
connection for you to be able to
maintain that connection with the
resistance of that exercise and each
exercise is going to be specific to a
certain plane of motion or a certain
rotation or whatever it is and the goal
is to be able to maintain the connection
against everything and so we use the gym
as a training ground to develop a
connection that can withstand whatever
we want to do in life whether that's
play basketball or go you know water
skiing or whatever uh we have trained
that in the gym to review the goal is
better support for your spine to help
prevent that excessive wear and tear and
we want that support all day long and
the way we do that is we become a master
of core engagement and the benefits are
that it applies everywhere it's minimal
input it's not easy but it's simple and
that leaves little room for error with
the healthy core connection it doesn't
matter which exercise you do because
your spine is supported when you do that
exercise and the exercise becomes the
challenge strengthening it for that
specific movement and so I started with
a kind of a quote and I want to end with
a quote as well begin with the end in
mind and the end goal is support for
your spine so that's what we want to
begin with we appreciate you here at
Core Balance training for leaning into
your health and it makes us want to lean
back and give you more education and
more of what's going to help you to
climb out of the Spiral of back pain so
until next time get down on the floor
and connect to your core
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