Core Strength Isn’t the Problem (necessarily)

The world (namely influencers on instagram and well-meaning people) will tell you your back hurts because your core is weak. It’s bologna. Sure, it sounds logical and it feels like a simple explanation, but the research really doesn’t support that the way most people think it does.

Plenty of people with strong cores still have back pain and plenty of people with weak cores have no pain. The reality is, pain is rarely caused by one thing and it rarely has a simple explanation (or a simple quick fix). So, this begs the question: Why do so many people feel weak, unstable, or guarded through their torso when pain does show up?

Well, this is where we have to get a bit nuanced and make sure we’re looking at the big picture and the system as a whole.

How Pain Changes Core Function and Stability

One of the biggest things I wish people knew is that our bodies are incredibly adaptable. They are also quite effective at protecting us against any threats. So, while we can adapt and improve, we can also see a negative side of things when pain or some other stimulus is impacting the body’s homeostasis (balance). Pain, for instance, changes how the body recruits and organizes movement. It may dull the neural firing or make a muscle really not love moving. This may lead to fear of movement, some funky movement mechanics, a shift from usual activities. It’s trying to keep you safe, but this often includes things like gripping, bearing down, breath holding, or a stopping of movement altogether.

You may notice you feel really weak or that you lack stability after an injury. The thing is, this may not be a true strength issue per se, but it may be inhibition from the nervous system. If the body perceives a threat (whether it’s a real threat or not), then it’s going to assign a feeling that makes you not want to injure whatever part feels that threat. Simply put: if we have pain in our back, our body wants to focus on recovery, so it’s going to make some movements painful if it feels those movements are going to impact recovery.

This sensation alone doesn’t necessarily mean our core is dysfunctional, it doesn’t necessarily mean a movement is risky, it just means that our body is trying to do its job. This is actually a good thing. I’d be worried if your body didn’t do this.

What the Core Actually Is (And Why It’s More Than Abs)

Let’s chat about the core though, because even though it’s not necessarily the cause, it does still play a role. The core is basically a pressure canister: the pelvic floor is the base of the core, the abdominals and back muscles are the sides, and the diaphragm and vocal folds are the top. One of the key functions of the core is to create stiffness and stability when we lift heavy things. It also is important that this section (and every section) can move. When we breathe, for instance, the core responds. We inhale and the diaphragm and pelvic floor lower while the ribs and torso expand. When we exhale the diaphragm and pelvic floor rise back up and the torso gently draws in and up. This typically goes smoothly, but things can impact how this system functions. Think stress, pregnancy, etc.

One common example of this is upper ab gripping. Side note: I’ve written more about how poor pressure management affects leaking and prolapse symptoms here. I see this a ton in my postpartum ladies, but also in folks who’ve been dealing with some chronic back pain, high stress, or tension holding patterns with every lift. Ever notice that crease in the upper abs and then how it rounds out slightly below? You may be an upper ab gripper. Our bodies LOVE to be efficient, so when these systems aren’t firing off like we need them to, the body can and will compensate. This strategy is trying to create stability. But, what’s really happening is the body sending excessive pressure out and down on the belly and pelvic floor. We’re getting limited rib mobility, breathing changes, excessive downward pressure, and this can result in things like diastasis, prolapse, incontinence, or just a generally grumpy and tense pelvic floor.

Why Core Strengthening Alone Does Not Fix Back Pain

Well that’s a trick question, because this can actually play a really helpful role in back rehab. The reality is that we can build all the strength we want, but if we don’t deal with the whole system from lifestyle factors to beliefs of movement to movement itself, then we aren’t going to get long-lasting changes.

So, we will often use core training in rehab for back pain, but we have to look deeper. We need to make sure we’re managing pressure and load well, that we’re sleeping to support recovery, that we’re managing stress and tension patterns, and that we’re building confidence in movement.

What Pelvic PT Actually Looks At

There’s a common misconception that pelvic PT is just for the pelvic floor, but really it’s about looking at the whole system interacts including the pelvic floor. When someone comes in with back or hip pain that keeps returning, we look at:

• How their body manages load

• How their ribs move

• How the pelvic floor responds under pressure

• How breath and movement are coordinating

• How stress, sleep quality, nutrition, and hydration influence the system

• How their body has adapted around past injuries or life events (and what underlying beliefs they have)

• How their body moves functionally

Back Pain is Not a Life Sentence

If you take nothing else from this blog, please hear this: Your body is adaptable and resilient. It does not matter how old you are. You are capable of making change. Your body wants to move and support you, it just sometimes needs a little help. Give yourself the space to be a beginner and know that if you have an injury or are experiencing pain, your body is simply giving you information. We just need to learn what that information is telling us and what we can do about it.

Your body is doing the best it can with the tools it has been using for a long time. And if those tools aren’t working anymore, there are better ones available.

We offer one on one in person treatment sessions as well as remote performance coaching to help individuals with back or hip pain get back to the gym, playing with kids, or just the day to day.

Book a consultation and let’s make sense of what your system is trying to tell you.