LBP and Core Strengthening

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Hi,

I am wondering if your have read the article yet? Are you finding it easier to pick out the important facts from the articles?

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RESPONSE:

1. Low back pain is a common ailment experienced by the population as a whole and specifically with the athletic population. Core strengthening is commonly recommended as a treatment and/or prevention method for low back pain. Please read the article entitled, "Hip muscle imbalance and low back pain in athletes: influence of core strengthening." After reading this article, do you think we as human movement professionals are justified in prescribing core strengthening exercises for the prevention and/or treatment of low back pain?

Let's consider Nadler, et al's (2002) findings and other research to decide if one could justify using core strengthening exercises for prevention and/or treatment of low back pain (LBP).

Even though core strengthening has become a major trend in rehabilitation, there is limited research to spport it and the research is mixed. The term has been used to mean lumbar stabilization, motor control training, and other regimens. Core strengthening is, in essence, a description of the muscular control required around the lumbar spine to maintain functional stability. Despite its widespread use, core strengthening has had meager research. Core strengthening has been promoted as a preventive regimen, as a form of rehabilitation, and as a performance enhancing program for various lumbar spine and musculoskeletal (Akuthota & Nadler, 2004).

For example, Nadler et al (2002) attempted to evaluate the occurrence of LBP both before and after incorporation of a core-strengthening program. The core-strengthening program included situps, pelvic tilts, squats, lunges, leg presses, dead lifts, hang cleans, and Roman chair exercises. Although the incidence of LBP decreased by 47% in male athletes, this reduction was not statistically significant; the overall incidence of LBP slightly increased in female athletes despite core conditioning.

According to McGill, this negative result found by Nadler et al (2002) may have resulted from the use of some unsafe exercises, such as Roman chair extensor training. For example, roman chair exercises or back extensor strengthening machines require at least torso mass as resistance, which is a load often injurious to the lumbarspine (McGill , 2002).

Also, the type of exercises might also explain the results. Nadler's (2002) study chose exercises for the study, that included only frontal and sagittal plane movements, which may have affected the results. Future studies incorporating exercises in the transverse plane may help to clarify the relation between surrounding core strengthening exercises and LBP.

However, there are mixed reviews, as some studies support core strengthening for prevention of LBP. ...