Best Core Engagement methods for Back Pain Relief

Summary

This 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

00:00

🧘 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.

05:02

🤔 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.

10:02

🏋️‍♂️ 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.

15:02

🌟 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.

Keywords

💡Core Engagement

Core engagement refers to the conscious activation of the muscles surrounding the trunk to provide support to the spine. In the context of the video, it is a central concept for managing and preventing back pain. The script emphasizes that core engagement is not about isolating specific muscles but rather about using all abdominal muscles synergistically to support the spine, as opposed to the common misconception that exercises alone can solve back pain issues.

💡Chronic Back Pain

Chronic back pain is a persistent condition that lasts for an extended period, often resulting from overuse or wear and tear on the spine. The video discusses how traditional exercise solutions may not always be effective for this type of pain. The script mentions that the goal is to reduce or reverse the excessive wear and tear that leads to chronic lower back pain.

💡Compensations

Compensations in the context of the video refer to the body's tendency to use stronger or more dominant muscle groups during exercises, which can lead to muscle imbalances. The script points out that exercises are prone to these compensatory movements, potentially exacerbating back pain by strengthening existing imbalances instead of providing relief.

💡Intra-abdominal Pressure

Intra-abdominal pressure is the pressure within the abdominal cavity, which can be increased through core engagement to provide stability and decompression to the spine. The video uses the 'Coke can analogy' to illustrate the importance of maintaining this pressure for spinal support, likening the can's stability to the stability provided by an engaged core.

💡Abdominal Bracing

Abdominal bracing is a method of core engagement where the abdominal muscles are slightly expanded to create a 'bracing' effect, which is likened to preparing for a punch in the stomach. The script explains that while bracing can provide stability, it may not always engage the deep abdominal muscles, such as the transverse abdominis, which is a key component of a healthy core.

💡Muscle Imbalances

Muscle imbalances occur when certain muscle groups are stronger or more dominant than others, leading to an uneven distribution of effort and potentially contributing to pain or injury. The video discusses how exercises can sometimes reinforce these imbalances, which is counterproductive for individuals with chronic back pain.

💡Endurance

In the context of core engagement, endurance refers to the ability to maintain a low-intensity core connection throughout the day during normal activities. The script contrasts this with strength training, which is more intense and specific to the gym environment. Endurance is critical for supporting the spine during daily activities and preventing back pain.

💡Synergistic Muscle Group

A synergistic muscle group refers to multiple muscles working together in a coordinated manner to perform a movement or maintain a posture. The video emphasizes that all abdominal muscles should work together, rather than isolating one muscle group, to effectively support the spine and prevent back pain.

💡Activities of Daily Living (ADLs)

ADLs are the everyday activities that a person performs, such as washing dishes, gardening, or stepping into the shower. The video script discusses the importance of core engagement during ADLs to provide continuous support to the spine and prevent back pain, rather than focusing solely on exercises that may not translate to these daily tasks.

💡Breathing Techniques

Breathing techniques are methods of controlling the breath to enhance core engagement and stability. The script introduces an exercise where exhaling all air engages the core like a corset, followed by inhaling into this engaged state to increase intra-abdominal pressure. This technique is highlighted as a powerful tool for developing a core connection.

💡Floor Work

Floor work involves using the floor as a base for exercises that help develop core connection and stability. The video script suggests that being on the floor provides valuable biofeedback for aligning the spine and is a fundamental method for engaging the core, as it mimics the natural development of core strength in infants.

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