Is better core strength the answer to all back pain?
As a devoted Pilates instructor I would love to answer this question with a simple “YES!”. Unfortunately though – the answer is a little more complicated than that.
Over the years as I’ve met more people with lumbar-pelvic pain, I’ve come to realise there appears to be some sort of consensus that having a strong core will be the ‘cure all’ for such pain. If only it were this easy!
Firstly lumbar-pelvic pain is quite a general term used to describe pain of varying origins within the lumbar spine and/or pelvic girdle. The underlying cause for pain in this region can vary considerably from person to person. So the idea that one solution (more core strength) will be the answer for each individual situation is unlikely.
An analogy I like to use to describe this point is likening your body to a car. In the same way that a car requires many different components working together to run well, the same can be said for our bodies. Like a car we require the correct fuel (nutrition). We need an electrical system to relay messages (similar to our nervous system). We need the correct shock absorption to limit loading through inappropriate areas (as we do via our feet and thorax). We need a centred wheel alignment to prevent wear and tear in the wrong places (just like we need appropriate posture and body symmetry). We need the engine to provide force (the same way our muscles assist in movement). And lastly we need nuts and bolts to hold the whole car together (just like our core).
Now if you took your car to the mechanic you would expect them to check all of these functioning systems to accurately diagnose which may be contributing to the problem. Similarly for each person who presents to their healthcare provider with lumbar-pelvic pain, a thorough assessment needs to be conducted to determine the cause of the problem. Unfortunately there is not simply one answer for each and every individual.
So is a weak core the culprit for your lumbar-pelvic pain? Possibly. However there may be other factors contributing to the problem, such as an alignment (postural) issues or poor shock absorption through the thorax. Each person is different.
So should everyone with lumbar-pelvic pain run out and dress themselves head to toe in lycra and become a dedicated Pilates fanatic? Or become a professional “planker”? Not necessarily. In much the same way that not everyone with knee pain should immediately begin quadricep strengthening exercises. Am I refuting that good core strength is required to function optimally? Not at all. I am simply trying to encourage people to consider all functioning parts when diagnosing the cause of lumbar-pelvic pain. If you are experiencing lower back or pelvic pain I would suggest you visit your local healthcare professional who will provide a thorough assessment and diagnose the components that may be contributing to your pain and point you in the right direction as to what exercises may help or hinder your progress.
Now it would be silly of me not to point out that Pilates is not simply all about ‘core strength’. Pilates is a very well rounded form of exercise that can help to improve mobility, core strength, pelvic floor dysfunction, peripheral strength and overall movement patterns and posture. So certainly Pilates is a discipline to consider wether or not you have pain for great general health and prevention of injury. For locals I can highly recommend a fantastic boutique Pilates studio in Avalon that is run by the lovely Jessica Dalziel. Pure Form Pilates offers private 1:1 classes or semi-private classes of 1:3. All instructors are highly qualified and passionate about their discipline. Visit www.pureformpilates.com.au for more information.