Low Back Pain is a common perceived complaint in the majority of the human population today. Most, if not all people will encounter low back Pain at least once in there lives.

The onset and treament of low back pain is to far to complex sum up within this article, however I will be adressing the cause through a mechanical perspective. Furthermore, what I am adressing in this article is one of many mechanical causes of low back pain, and it should be understood that this treament approach to low back pain will prove to be of significance to you, if your current state of pain is a symptom of what this article states.

Additionally, low back pain can be the result of many health aspects such as emotional - physical, mental and spiritual. Once again, this article explains one of the physical - mechanical causes, however not the emotional - spiritual.

In summary this article will explain the:

• Anatomy and interrelative functions of the lower spine and Abdominal muscles


• Causes and people vulnerable to low back pain


• Treament approach via exercise management (check video demonstrations)

Anatomy and interrelative functions of the lower spine and abdomnial muscles

The human spine is made up of the cervical, thoracic, Lumbar, sacrum and coccyx. The lower spine has 5 vertebrae and it is within this region of the spine (also cervical) where the vertebra is very hypermobile (alot of movement). Bending forwards and backwards causes movement shifts of one vertebrae over the other, which is more pronounced in those that have low back pain.

Muscles that contract isometrically (no movement)  help resist this excess shifting of vertebra movement via an indirect stiffening effect on the verterba. The key muscle in stiffening the lower spine is the Transverse abdominis (TA). Anatomically, this muscle is the deepest  of the abdominal muscles, which originates from the fascia of the back, posterior illiac crest, and 12th rib and inserts on the lateral anterior two thirds of the iliac crest. It forms a belt like fasion around around the lower abdomen and its role functionally, is to contract to decrease the volume of the intra-abdominal space and in doing so increase its pressure. It is this pressure that causes this stiffening effect on the vertebrae and in doing so aids in stability of the lower spine. 

This muscle is categorised as a inner unit muscle as it's role primarily is to stabalize the spine rather than cause gross movement of the spine such as sit-ups and back extensions.

Conversely, the outer unit muscles such as the external and rectus abdominis, play a role in performing gross motor movements of the spine (flexion, side bending, rotation). The external oblique originates from the lateral side oif anterior ailliac crest and inserts to the 5th, 6th, 7th , and 8th ribs. Functionally, its role is to perofrm trunk rotations and foward flexion. The rectus abdominis performs the role of forward flexion (rising up from a lying down position).

 Causes and people vulnerable to lower back pain

Assuming that you have a general understanding of the functional difference between the inner and outer unit muscles, I can explain how these two untis work co-dependant on each other for optimal performance and stability. In clients with low back pain the traditional sit-up or crunch works the outer unit muscles (rectus abdominis). If the inner unit muscle (Transverse abdominis) are not functioning due to either reflex inhibition (injury that "switches" of muscle function) or weakness from deloading or immobilization, this creates an immediate strength imbalance between the 2 units, making the outer unit muscles much stronger relative to the inner unit muscles.

You might be reading this and thinking so what if there is an imbalance between the 2 units. Remember, if the outer unit muscles are the ones that assist in gross movements such as flexion rotation and extension of the spine, and the inner unit muscles are not firing, then this creates no stiffness of the spine, thus allowing the outer unit to cause large movement shifts of the vertebrae leading to further instability, re-injury, and possibly pain.

So does this mean that I can never perform sit-ups and develop 6 pack abs? No, What this means is that once you can properly activate the inner unit muscles such as the TA, then you can progress to outer unit muscle strengthening.

However, the good news is that even if you have a strong TA to stabalize your spine, with weak obliques and rectus abdominis you can also set yourself up for injury. If your obliques are weak, and you approach to flex to one side at high speed while standing, most work will be taken up by the TA and other stabilizers to compensate for weak obliques thus leading to injury.

In conclusion the progression is to strengthen  the stabilizers (inner unit) then the bigger more powerful muscles (outer unit).

Treatment approach through exercise management

My vidoes that are titled core conditioning demonstrate both verbally and visually, on how to activate the inner and outer unit muscles correctly with good form and technique.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Added: 17-07-2011