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The NEW Myths Of Low Back Pain

low back pain

There used to be a host of myths around low back pain that more current research helped us understand was outdated. Ideas like stretching solves low back pain, or our posture was the cause of low back pain, were often thought to be the pillars of key solutions. However, they proved not to be as impactful as we originally thought. This has led us to new discoveries that have proven to actually be pretty darn effective in helping low back pain.

Sadly, new myths have arisen (thanks social media) from people misunderstanding the current science, trying to get views and likes by being controversial, and sometimes just making mistakes. Let’s look at some of the more current myths of low back pain and what we actually know about these subjects.

Core Stability Is No Better Than General Exercise

There has been a lot of push back on core stability being helpful for low back pain. As we have explained (in posts like this one HERE) core stability often gets blamed for not being so effective because we don’t have standard exercises for what makes for core stability training and often how the exercises are performed is pretty lacking. However, overall, when we look at meta-analysis studies (those studies that look at many studies at once), we see the idea that core stability training is no different than just exercising for low back pain is not true!

“Compared to general exercise, core stability exercise is more effective in decreasing pain and may improve physical function in patients with chronic LBP in the short term.” (1)

“These findings indicate that in patients presented with NSCLBP due to lumbar segmental instability, core stability exercises plus general exercises are more efficient than general exercises alone in the improvement of excessive lumbar vertebrae translation and rotation.” (2)

Now, before someone sends me studies that say the opposite, there are several points to be made. For one, if we don’t assess that core stability is even an issue, then it doesn’t make sense to blindly prescribe random core stability exercises. The type of core stability exercises and how they are taught (most use bodyweight which is problematic as most people with core stability issues can’t control their bodyweight) are all impactful to what type of results we can see.

Maybe most importantly, is when we discuss issues of pain in people with non-specific chronic low back pain (meaning there is no disease, structural issues to the spine, or soft-tissue damage which is one of the most common forms of low back pain is non-specific) pain is a multi-factorial issue (many things impact perceptions of pain that have nothing to do with physical issues) so we should look at functionality when we are looking at the impact of core stability training on low back pain.

What Steve Holiner shows below may not seem fancy, but done with enough intent can be very powerful.

Cory Cripe shows how to take a familiar core exercise and make it better…

Envision Fitness shows one of the best ways to use core training for low back pain in using a half kneeling position with our Arc Press…

Don’t Stretch Hip Flexors, Build Strength! 

To be honest, this is a REALLY odd one for me. Mostly because while I can tell you where people go wrong in understanding concepts about core stability, stretching, and so forth, I can NOT tell you where this one started from and how people came to the conclusion that you shouldn’t stretch your hip flexors, but stretch them.

Maybe it is because for a long time people would stretch people’s hip flexors it would feel good for a short time, but then they would have low back pain next time they came in too. So, they were trying to think of using the George Costanza method of doing the opposite (my best guess, seriously!).

However, research does show that stretching hip flexors can reduce low back pain symptoms…”The results demonstrated a significant difference in passive range of motion, pain, and disability after 8 weeks of stretching exercises in participants with NSLBP (non-specific low back pain) and limited hip extension. Therefore, it would be reasonable to infer that NSLBP might be partly related to hip flexors tightness.” (3)

This isn’t the only study to suggest similar effects from stretching the hip flexors (4), (5), (6). What is probably ideal is a combination of stretching and strengthening of the whole body, core, and integrated hip training (not isolated). Using myofascial stretching with breath work and stability as Cory Cripe shows from our Myofascial Integrated Movement (MIM) program can help tremendously…

As with the strength training that Caroline Juster shows below. Using very intentional forms of strength training that integrate the qualities of stability, mobility, and strength with the whole kinetic chains of the body, allows us to get superior results. We don’t have to do in everything but the right thing! That is what we teach in DVRT and what we will be discussing in our upcoming 6-week Online Low Back Pain & Pelvic Control Masterclass HERE and you can save 30% on our online courses and certifications for a few days more with code “mem30” HERE

 

References:

  1. A Meta-Analysis of Core Stability Exercise versus General Exercise for Chronic Low Back Pain
  2. Influence of core stability exercise on lumbar vertebral instability in patients presented with chronic low back pain: A randomized clinical trial
  3. The effect of static stretching exercises on hip range of motion, pain, and disability in patients with non-specific low back pain
  4. Stretching in the Rehabilitation of Low-Back Pain Patients
  5. Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial
  6. The Effects of Stretching and Strengthening Exercise on the Pain, Pelvic Tilt, Functional Disability Index, and Balance Ability of Patients with Chronic Lower Back Pain