Quite often, we get asked by our patients for the best chiropractic lower back exercises. We also get asked whether a patient should see a chiropractor or physiotherapist for lower back pain. The reality is, there really isn’t such thing as “chiropractic exercises for lower back pain” that are different from “physiotherapy exercises for low back pain”. More accurately, there are good exercises for lower back problems and bad ones, given to us by good quality scientific research.
Best Exercises for Back Pain
There have been a number of studies published in recent years on muscular recruitment patterns in the abdomen and lower back. This has improved our understanding of how the different muscles in this region help to stabilize the lumbar spine (lower back) during different tasks. The transversus abdominis muscle is a horizontal muscle located in the abdominal and lower back region. A 1999 study published in the Journal of Manual Therapy found that subjects with a history of lower back pain showed a delay in activity of the transversus abdominis muscle during rapid upper limb movement, so re-training and strengthening this muscle should be helpful.
Transverses Strengthening for All?
The aforementioned research helped to substantiate the idea that muscular control in the abdomen and lower back can play a role in certain types of lower back pain. Unfortunately, many health and fitness professionals extrapolated the results to mean that the transversus abdominis muscle is the most important stabilizer of the spine for all people during all activities. This idea is not really supported by research. Nevertheless, an exercise called the abdominal hollow has become very popular as a method of strengthening this deep abdominal muscle and assisting people with low back pain. It has also been used by some as a strategy to protect the spine during different activities.
Application of the Abdominal Hollow
Given the literature that exists on the topic, the abdominal hollow is probably best used as a way of practicing how to activate the transversus abdominis (and another muscle called the internal oblique) so these muscles can be “ready to help” when our spines need it.
How to Perform the Abdominal Hollow
To perform the abdominal hollow, draw your navel inward toward the spine and slightly upward. The goal is to hold this contraction and feel tightening in the muscles below the navel while maintaining a normal breathing rhythm.
The Best Exercises for Back Pain
Many people want there to be one muscle (and therefore one exercise) that will either prevent or eliminate lower back pain. At the present time I am not aware of any research that gives us this. Fortunately, there has been some literature published in recent years that does offer some useful strategies to help stabilize our lower backs during activity. I recommend using an abdominal “brace” during activities that may put your lower back at risk of injury. An abdominal brace is not a back brace as you may know it, but rather a strategy of activating various muscles. To perform the brace you would simultaneously activate as many muscles in the abdomen and lower back as possible at a very low percentage of their maximal contraction strength. This low level contraction has been shown to assist in stabilizing the spine while minimizing compression of the vertebrae.
Back Pain and The Role of The Back Muscles
If we’re keeping consistent with the current literature, it’s best to think that all of the muscles in the abdomen and lower back each play a part in protecting your spine during different tasks. The abdominal hollow is not really the best strategy to protect your spine during activity, but it may be a helpful exercise to use on occasion as a way to practice activating some of our deeper muscles. There is literature to support the use of the abdominal brace as a way to help protect your back during various activities.
Proper Exercises for Back Pain
The proper exercises for your back pain depends on your diagnosis. Although the aforementioned exercises are generally understood as safe, evidence based exercises for low back pain, it is always recommended that you consult with a knowledgeable practitioner who can tailor a plan specific to your condition. The exercises that a chiropractor would recommend for lower back pain are usually the same as physiotherapy lower back exercises. For lower back pain treatment, chiropractic and physiotherapy are both great options. For more information or to schedule an appointment please call us at 905.220.7858 or email us at firstname.lastname@example.org
Hodges PW. Is there a role for transversus abdominis in lumbopelvis stability? Man Ther 1999; 4: 74-86.
Grenier SG, McGill SM. Quantification of lumbar stability by using 2 different abdominal activation strategies. Arch Phys Med Rehabil 2007; 88: 54-62
Vera-Garcia FJ, Elvira JL, Brown S, McGill SM. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. Journal of Electromyography and Kinesiology 2007; 17: 556-567.