Healthy Abs vs. Unhealthy Back
I often run into people that ask me about proper exercises to help them strengthen their “core” when they have back pain. When I tell people to try to stay away from the typical sit-ups, GHD, and pretty much anything that has to do with bringing the thigh closer to the stomach I can often see confusion storming in their brain which is why I people need to be informed about what is really happening when they do those exercises.
For years people have been ingrained with the thought that strengthening your core was simply strengthening your abs. Eventually we seemed to move on to accept that it also meant strengthening your sides and back but that we still needed to focus on those ever-important abdominal muscles. And how is it even possible to strengthen those muscles without sit-ups, crunches, raising our legs, or anything that has to deal with flexing our lumbar region? If it’s a normal person without much exercise education then they’ll go ahead and do sit-ups and crunches because…well, that’s just what you do to get abs. If it’s an athlete or person with experience in the gym, then I’ll often get that confused look as if they don’t know what else to do.
What Do The Abs Do?
The fact is, our abdominal muscles are not designed for large length change, they’re not designed to help us flex our torso hundreds if not thousands of times, and they’re not the muscles that are getting strengthened when we do all those leg raising exercises. If they’re not designed for those actions then why do we keep doing all of these exercises? We say we’re doing it to get healthy and because we feel the burn but plenty of research has now shown these exercises often cause more harm than good.
When we flex forward with our torso with sit-ups, crunches, rope pull-down crunches, toes to bar, GHD, or knee to elbows, the biomechanics of the lumbar disc naturally pushes the inside of disc posteriorly and the outer annular fibers of the disc are stretched. No matter how strong you are, or how stable your core is, if this is done enough times then the posterior annular fibers tear which can result in chronic low back pain, or even disc bulges and disc herniations. If you’re young you might not notice any pain yet in your low back and just ignore what I’m saying because you think if it doesn’t hurt yet then it must be alright. But do you really think your annular fibers are somehow stronger than everyone else’s? Every person has a finite number of times they can flex forward before there is a rupture in those outer disc fibers. Why would waste the number of times you can do this on exercises that are supposed to be making you healthy? Save it for bending over to tie your shoes or picking up your kids.
Stop Doing Abs with Hip Flexion
Some of you might think that exercises that raise your legs instead of purely flexing your torso might be a good option instead. The abdominal muscles in no way can raise the legs. The abdominal muscles purely stabilize the torso while the iliopsoas and rectus femoris raise the legs. Have you ever noticed how when you’re doing abdominal exercises that include hip flexion such as with sit-ups or hanging knee raises your low back starts to extend when you get tired? That’s because the abdominal muscles are tired from stabilizing and have a much smaller cross section than the hip flexor muscles. The abdominals have basically given up but people continue to crank on their hip flexors over and over.
Doing leg-raising actions or sit-ups while keeping the torso stable results in tightening the hip flexors. These are commonly already tight in athletes from these exercises, and also in the normal desk jockey from sitting all day. Furthermore, flexing the hip with a bunch of leg-raising ab exercises also results in the same posterior push of the lumbar disc and stress on the posterior annular fibers. This may be more pronounced in common Cross-Fit exercises like toes to bar and knee to elbow where fast ballistic movements are used.
What Exercises Should You Do?
Typically any exercise that focuses on stressing the core while keeping it stable is a good core exercise that will not injure the back if done correctly. Planks, side-planks, quadruped, and push-ups are examples that are always good exercises to add to someone’s exercise routine. It’s also important to stress the core with more complex movements requiring full body movement. Kettlebell swings are a good example as long as they are done with correct form.
If you have any further questions about exercises for low back problems feel free to contact Dr. Tyler Tonso at Avenues Health Center to schedule an appointment. Remember consulting with a medical professional should always be done before a new exercise routine.