Go Beyond Crunches For a Strong Core

Enter just about any gym around and you will see areas with cardio equipment, with weights, and with mats. That last place, which is dedicated to stretching and abdominal work, usually has two or three people who are finishing their workout. They diligently do their crunches, on the quest for the elusive “six-pack.”

Most people have heard about “The Core.” The topic is discussed all over the gym, among trainers, in most fitness classes, and among members comparing their core routine with someone else’s. Sadly, although it is a hot topic, there are still many people who think those crunches they do at the end of their workout are the best way to strengthen their core.

While the abdominals are definitely a part of the core, they are only a small part. The core actually consists of many different muscles, from the hips to the shoulders, on the front and back of the body. These muscles stabilize the spine, pelvis and shoulder girdle to create a solid base of support. The muscles make it possible to stand upright, to move efficiently, and to distribute the stress of weight-bearing activities. A strong core will improve posture, enhance performance in athletics and all daily activities, and reduce back pain.

If you think about what many people do throughout the course of their day (sitting at a computer, slumped on the couch watching TV, slouching in their car as they drive), you will realize that they spend a great deal of time with their spines flexed forward and shoulders rolled inward. While the abdominal crunch exercise is designed to strengthen the abdominal muscles, it flexes the spine forward, thus potentially aggravating an already terrible posture.

What we require our bodies to do when we are not slouched over is fairly demanding on our spines. Think of picking up a child and swinging him onto your hip. Think of working in your yard, bending, twisting, and lifting heavy items. Our whole core has to work together to protect the spine from injury during these aggressive movements.

I want to give you some specific exercises you can do to begin to strengthen the muscles surrounding your spine, and I encourage you to do these exercises at the beginning of your workout routine. This is when you will be able to give the maximum effort, with the minimum chance of injury. At the end of your workout, fatigue has set in and you run the risk of doing the exercises with poor form. It is also way too easy to skip these when you are tired and just want to finish your workout.

Plank: Begin face down, with your weight resting on your forearms and toes. Your elbows should be directly under your shoulders and your body should form a straight line from your neck to your ankles. Hold this position for 60 seconds. If you feel pain in your lower back, modify this by dropping to your knees and forearms.

Side Plank: Lie on your right side with your legs straight and your left leg on top of your right. Your weight should be resting on your right forearm and the outside of edge of your right foot. Position your right elbow directly below your right shoulder. Make sure your body is a straight line from your head to your ankles. Hold this position for 30 seconds, then switch sides.

Hip Bridge: Lie on your back with your knees bent at a 90-degree angle and feet flat on the floor, arms resting at your sides. Engage your hamstrings and glutes and lift your hips, creating a bridge. Keep the glutes squeezed tight as you maintain this bridge for 60 seconds.

Push-Up Walkout: Start in a push-up position. Walk your hands out as far as you can without letting your lower back sag, then walk back in to the starting position. Continue doing this for 60 seconds.

Mountain Climbers: Start in a push-up position. Keep your abdominals tight and your body in a straight line. Raise your left foot and bring your left knee toward your chest. Return to start and repeat with your right leg. Focus on keeping the torso and shoulders in the same position and your spine stable, without rushing through the exercise.

Hopefully these exercises will get you well on your way to building a strong core that will keep your spine and the rest of your body safe. Now, sit up a little straighter, relax those shoulders down and back, pull your abdominals in, and breathe deep!

Often my patients ask me “What is the best method of maintaining my low back on my own to avoid pain and re-injury?”

Combining stretching and strengthening, along with cardiovascular routines for stamina, function to minimize low back pain and injuries.

Personalizing your conditioning workouts to your back condition and your goals is also essential to maintenance of a healthy spine. Runners should do more lower-extremity stretching and “cardio” workouts, where a swimmer would do more upper-extremity and possibly strengthening activities. A proper warm-up and cool-down prior to and following exercise is mandatory to reduce injury possibilities. I suggest all joints be stretched in a controlled environment, no matter what your sport preference is. A brief “cardio” warm up is always a good idea to get circulation to the body and engage the heart rat to increase in preparation for increased activity.

Always keep a good conscious focus on your body and spinal posture when exercising. Keep the curves of the spine in balance and maintain a straight spine whenever possible. Use your larger, stronger muscles such as the gluteals in the buttocks and quadriceps in the front of the legs whenever possible.

Any continuous irritation or pain should be communicated to your chiropractor to check for asymmetries or imbalances in your structure. Taking responsibility for your own health by maintaining your spine with stretching and strengthening will definitely keep your doctor bills down and enhance your quality of life.

Taking the workout to the back of the body

Crunches, curls and sit-ups may be standard workout fare in gyms, basements and living rooms across the land. 

But the authors of a new book suggest people get plenty of that movement in their daily lives. They say to get a really strong midsection the back of the body needs to be worked.

 “Sitting at desks, working on computers, waiting in traffic, we are continually contracting our abs, throwing our shoulders forward and, ultimately, shutting down the back of the body, said Dr. Eric Goodman, co-author with Peter Park of “Foundation: Redefine Your Core, Conquer Back Pain, and Move with Confidence.”

 “If we’re going to keep our posture and our spines strong, it has to be done by exercising the back of the body as the core of the body,” explained Goodman, a chiropractor based in Santa Barbara, California.

 The exercises illustrated in the book require no machines or equipment and take the spine as the body’s center of stability. In the signature, or founder exercise, knees are bent over ankles, the body hinges from the hip joint, and movement originates in the pelvis, hips and hip joints.

 “You’re sticking your butt out on everything,” explained Park, a trainer and owner of Platinum Fitness gyms, said. “We’re aiming for the posterior chain.”  Park is cycling great Lance Armstrong’s strength and conditioning coach. The seven-time Tour de France winner wrote the forward for the book.

 “Lance needed it more than anybody,” Park said of the workout. “It opened him up. (With his) rounded back, rounded shoulders he almost looked funny off the bike.”

 The exercises are designed to augment, rather than replace, a regular fitness regime, Goodman said.  “We don’t want people to stop doing yoga or Pilates. If you’re currently doing cardio or other training just add foundation to it,” Goodman said. “If you’re doing it properly, 20 minutes is plenty. It’s hard.”

 Neal Pire, spokesperson for the American College of Sports Medicine, said the concept of “hinging” or loading the posterior chain while maintaining neutral spine is mainstream, but he’s never seen a book entirely devoted to it.  “Extension is key, because we do indeed live in a flexed state,” he said, adding that if the public perception is that abs are the core, the public is mistaken.

 “The core involves two sets of muscles: deep muscles whose roles are primarily stabilizing the spine, or more generally the trunk, and shallower muscles whose primary role is movement,” Pire explained.

 Goodman advocates a four-to-one ratio of back-to-front training.  “For every four exercises you do for the back of the body, you get to do one for the front. I think that’s the opposite of what most people are doing.”

 Park said too many workouts reinforce sedentary postures.  “You see a guy who is sedentary all day go to the gym, do bench presses and ride on a bike. He’s reinforcing what he did all day,” said Park.

 “We’re trying to bring everyone back to the center, where they should be. I think this is the missing link.”

Back Pain Myths:

Myth: Only overweight people get back pain.
While being overweight can put you at high-risk, it is not the ONLY risk factor. As mentioned, eight out of 10 people are affected by back pain — not everyone is overweight. Anyone can suffer from back pain. According to WebMD, eating disorder patients may suffer from bone loss and have back pain. Other risk factors for back pain are smoking, old age, stress and depression.

Myth: Back surgery is the best medical option.
According to a recent study, complex and sometimes risky spine procedures are often overprescribed for simple back pain, which can lead to higher costs and greater complications. It’s increased 15-fold in just six years. Patients with back pain can improve their condition and overcome pain relief without complex surgery with physical therapy and anti-inflammatory medication. According to another study from The Journal of the American Academy of Orthopaedic Surgeons, 90 percent of patients with low back pain will see their symptoms fade on their own within three months. The first course of treatment for patients with low back pain should be non-invasive.

Myth: Stay in bed until pain goes away.
You can rest for one to two days for an acute injury or strain, but anymore can cause the muscles to weaken and slow your recovery. If you are going to rest in bed, make sure you get up and walk a few minutes every hr to keep your muscles strong.

If you rest and don’t feel better and experience pain with any of these symptoms: trouble urinating, weakness, numbness in your legs, fever, weight loss, you should go see your doctor immediately.

Myth: Exercise is bad for your back.
If you work your abs, your core, this could help condition the back muscles and stabilize the spine. Exercises like yoga can really be good for the back; it can help reverse the muscle weakness by strengthening the mid-section, which can help decrease the stress on the spine.

Ashton also shared how to avoid back pain with these tips from the National Institutes of Health:
• Always stretch before exercise or other strenuous physical activity.
• Wear comfortable, low-heeled shoes.
• Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.
• Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting.
• Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.
• At home or work, make sure your work surface is at a comfortable height for you.
• Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books.
• Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles. A diet with sufficient daily intake of calcium, phosphorus, and vitamin D helps to promote new bone growth.
• If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Also, for women who are pregnant and experience back pain, Ashton said in most cases is limited and will resolve.

In most cases, according to the North American Spine Society, medication is not a good option.

Ashton said pregnant women should not use any medication during pregnancy without permission of her physician. She said some treatment options include learning exercises to support muscles of the back and pelvis, using supportive garments that may be helpful with certain causes of back pain in pregnancy and using spot treatments such as heat and cold. If your pain persists despite these measures, or you develop any radiating pain, numbness, tingling or weakness in your legs, Ashton said you should consult with a spine physician with expertise in women’s health issues and/or pregnancy related disorders. They will be able to assist you in diagnosing and treating your specific problems.