Updated: Jul 16, 2020
Does core strength help low back pain? Some of you may be shocked to hear that your core may not be the problem, and your core exercises might actually be preventing your recovery!
The Issue with "Weak Core"
❌ Many people believe that their low back pain or sciatica pain is due to a weak core but this is usually not the case! The core is thrown under the bus all the time as individuals of all shapes and sizes are told their core needs strengthened to resolve their low back pain. If this was true then these people would feel better after focusing on their core, but often they don't. If core strength was the issue then it would be impossible for powerlifters or strong-men to get low back pain seeing as though they have insanely strong cores, but yet they suffer just like everybody else! This is something that many have been told for years, but they have not had proper guidance. This can lead to confusion and poor outcomes with different types of low back pain and sciatica as the journey of acquiring core strength persists.
Can Core Exercises be Harmful?
Yes, core exercises can actually be harmful in one's low back recovery. What you don’t want to do is to start doing 1 million sit ups every day trying to strengthen your core for your lower back pain. This actually can aggravate a lot of disc pain and sciatica issues! This is evident as the US Army is aiming to phase out sit ups due to spine injuries.
Yes - you read that right, the classic sit ups are not entirely advised. Now why is that? This is because the repetitive loaded rounding of the low back can enhance sensitivity in the low back. Many individuals, that either have low back or sciatica issues or are susceptible to these issues, may find movements similar to sit ups aggravating.
Here is a graphic showing intervertebral disc pressure with different postures. Notice how the greatest pressure is with sitting and bending forward. Now if you take that posture, snapshot it, and rotate it then it will look exactly like a sit-up!
LOOK, IT'S A SIT-UP!!!
So as you can see, this is why individuals with disc herniations or disc bulges might not like this core movement and actually find it flares things up and may prolong recovery.
What about Leg Raises?
Leg raises can be particularly bothersome for those with sciatic nerve pain or sciatica leg pain. This individuals often experience increased nerve pain down the leg with forward bending tasks such as tying their shoes, picking something off the floor, or stretching their hamstrings. The same concept of increased disc pressure is occurring as discussed above, but the action of the legs straightening here adds a different component on the sciatic nerve. Here's how...
As you can see, with the legs straight and the hamstrings in a stretched position, you are actually stretching your sciatic nerve. Now this isn't an issue if you don't have sciatic nerve problems, but if you do then this can be very sensitive. Now let's take this position of bending forward creating this sciatic nerve pain and rotate it a couple times.... what does it look like?
IT'S THE SAME THING!!!
As you can see these "leg raise" positions are the exact same as the picture demonstrating sciatic nerve tension. These core movements can bother both disc bulges and sciatic leg pain due to the pressure on the low back and the lengthening of the hamstrings (stretching of the nerve).
Once again don't hear what I'm not saying. I'm not saying that sit ups or leg raises are "bad". I'm saying that if you are reading this then you probably have some kind of low back issue, and it's important to recognize movements that may be disadvantageous for these individuals at this point in time to help them get closer to recovery. Once you properly rehab your low back with a thorough program and you are bulletproof, then you will be able to perform any movement you want without worry!
What Core Exercises Would I Advise Then?
As opposed to core exercises like sit-ups, crunches, or leg raises that can be bothersome for low back issues, I advise to begin with a set of exercises known as "McGill's Big 3". These core exercises were established by Prof. Stu McGill as spine friendly exercises that put very little pressure on the spine, but still generate a large amount of core activation. These are a great starting point for those wishing to work on their core but struggle with those other movements.
1. Curl Up
2. Side Plank
3. Bird Dog
I cover these movements in detail in the full video listed at the beginning of this article so be sure to watch that so you know how to perform these exercises properly!
For anyone struggling with disc herniation pain or sciatica pain, these can be much less aggressive and more spine friendly than other core exercises.
How Important are Core Exercises for Disc Herniation and Sciatica Relief?
Typically when I am going through a proper online assessment with a client that has disc herniation and/or sciatica pain we find significant relief with specific movements that don’t involve the core. It is crucial to identify the specific movements that are going to address the root of the issue before focusing on the strength of other areas. Is core strength and overall strength important for lower back issues? Absolutely! Is it the solution to a majority of disc herniations or sciatica though? Absolutely not! This is obvious by the hundreds of individuals around the world that contact me for help with their lower back pain that have been trying core exercises for years. I can guarantee their core is not the issue!!! You need a proper assessment!
If Core Strength Isn't the Solution, What Is?
This can vary from person to person but in my experience with online clients around the world there is a similar pattern among many individuals with disc herniations or sciatica that is commonly missed. The majority of my clients have had low back issues for years and have tried Chiro, PT, medication, injections, orthopedists - you name it! It seems like they all were missing some key components..... First I would recommend my free low back guide that discusses multiple factors that contribute to lower back pain!
Then if you still feel like you are
missing out on your life at 100%
wasting thousands $$$ on interventions that aren't producing results
working with someone you feel does NOT care about YOUR GOALS
worried about this leading to drugs or surgery
Then it's time to take action! No time to waste!
✅ Ready to ATTACK Low Back Pain?
✅ Are you sick of guessing your way through this low back pain?
✅ Want to prevent drugs or surgery?
Thanks for reading! -Dr. Grant Elliott