Core strengthening exercises for lower back pain

Although there are many possible causes for back pain, poor posture is a common one. In the case of low back pain, the cause is often problems with poor pelvic alignment caused by weak core muscles. To fix the problem, you need to learn to engage your deep core muscles and then be consistent with exercises to strengthen them. It’s important that the exercises are at the right level. If your core muscles are weak and you start trying to do advanced exercises, all that will happen is that you’ll but more strain on your low back. Strength has to be built gradually, always making sure you exercise with correct pelvic alignment (as explained below). This routine includes 8 core strengthening exercises for lower back pain, which ideally you should do every day. See the end of the post for the PDF download.

How do core muscles get weak?

Weak core muscles, weak glutes, tight hip flexors and a forward tilting pelvis are a common set of issues that get worse over time. Factors that can cause this include:

• Lack of exercise
• Sitting at a desk or driving all day
• Poor upper body posture (shoulder hunching)
• Pregnancy
• Wearing high heels
• Being overweight

Why pelvic alignment is important

Our pelvis can tilt backwards and forwards at the joints with the top of our thigh bones. This is essential for a good range of movement. However, at rest it should be in a neutral position – not tilting in either direction. Often people – especially women – develop a permanently forward tilting position. Because the pelvis is attached fairly rigidly to the bottom of the spine, this pulls the lower back into an exaggerated arch, putting pressure on the spinal structures. Over time this can cause pain and an increased risk of injury.

Before you do the core routine

Please read these general exercise guidelines.

You need to have some sort of cushioned surface to do the exercises. If you don’t have an exercise mat, then use a folded blanket or something similar.

Finding neutral

The first thing you need to do with core training is to find your neutral pelvis position. This is how to do it:

Most core exercises require you to keep your pelvis held in the neutral position. In the shoulder bridge below, you start in a backward tilt position. But for most of the exercises, the neutral position should be maintained throughout.

Core strengthening exercises for lower back pain

# 1 The Pilates 100

This classic Pilates exercise is often used as a warm up.

1. Lie on the floor as shown above, with your legs bent and your head and shoulders raised.
2. Breathe in and then pulse your arms up and down by your side 5 times as you breathe out. Keep the arm movement as you breathe in for 5 pulses and then out again. Keep going with this for 10 breaths – that is, a total of 100 pulses.

#2 Heel taps

1. Start with your legs in the air like for the hundred above.
2. Holding on to the neutral pelvis position, lower one leg to the floor. It’s important not to let your pelvis move – your core muscles will have to work to hold on to neutral. Bring your leg back up to the starting position and repeat with the other leg.
3. Keep going until you’ve done 8 on each leg.

#3 Shoulder bridge

In the shoulder bridge, the idea is to control the movement and curl your spine off the floor gradually. This improves mobility in your spine, as well as making your core muscles work.

1. Start by lying on the floor with your knees bent and your feet about hip distance, with your pelvis in neutral. Now press your lower back into the floor, tilting your pelvis backwards.
2. Follow this movement through so that your lower back starts to peel off the floor. You should be aiming to come into the bridge position with a smooth, controlled, curling movement. Concentrate on working through one vertebra at a time. You will probably find this difficult at first as parts of your spine will be less flexible.
3. Stop when your whole spine is lifted and your weight is resting on your shoulders. Now reverse the movement, lowering back down one vertebra at a time. Again, it should be a smooth, controlled movement, working through each joint in the spine.
4. Do 3 of these.

#4 Ab hollowing

Abdominal hollowing is just sucking the core muscles in. You can do it in any position – standing, sitting, lying, kneeling .. but doing it in the all-4s kneeling position is good because you are working directly against gravity.

1. Get into an 4s position, then pull your belly button towards your spine as far as you can without your back moving.
2. Hold for 5 seconds, release and repeat.
3. Do this 3 times.

#5 Arm and leg raise

Your core muscles work in this one by keeping your back flat and keeping your whole body stable. If they aren’t engaged, your back will dip instead of being flat and you’ll wobble. The starting position is all-4 kneeling for this one too.

1. Keeping your abdominal muscles pulled in, lift your right arm and left leg until they are parallel with the floor. Keep your back flat and your body steady.
2. Hold for 3 seconds.
3. Lower and repeat with your left arm and right leg. Do 3 on each side.

#6 Hip flexor stretch

This stretch doesn’t directly strengthen the core muscles, but tight hip flexors contribute to the pattern of problems described above. Lengthening your hip flexors will make it easier for you to hold your pelvis in the neutral position. This exercise is last, to allow your muscles to warm up before you stretch them. Hold the stretch for 30 seconds on each leg.

1. Get into the position shown, back knee on the floor, front knee bent and directly over the heel.
2. Ease the back leg out behind until you feel the stretch in your hip flexors.
3. Hold for 30 seconds.

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