Does core strength work prevent lower back pain recurrence?

Triathlon Forum
1

Hi all,

Looking for opinions – especially from professionals (chiro’s, MD’s). I’m coming off of 9 weeks of basically no training as a result of a flare-up of lower back pain. This is an injury that I’ve struggled with for nearly 20 years, and it seems to resurface randomly. It’s in the L4/L5 area, and at its worst, it radiates pain down the leg(s) (one or both). After several weeks of treatment from my Chiro/ART/Graston practicioner (and triathlete), I’ve now been pain-free for a week, and have been able to ride the spin bike in the gym several times this past week without pain (tried to a couple of weeks ago, and it flared up instantly). I’ll try to run for the first time today and see how it feels. He speculates (my word, as I’m reluctant to use the word “diagnose” without an MRI) that it’s a degenerative disk of some sort (either herniation, or bulge) based on symptoms (radiation of pain down the leg, range of motion, etc). After having trashed 5 months’ worth of offseason training, and turned my race plans upside-down, I’m looking for ways to prevent this from happening again, if possible.

Anyway – on to the question. Does “core” work prevent this sort of injury from recurring? I’ve read the numerous debates about core work and its effects, or lack thereof, on performance. I’m not interested at all in performance-improving aspects of core work, but solely on prevention of injury recurrence. My normal approach to core work in the past has been to do 10-12 week (2-3x week) of core work (pikes, supermans, crunches, obliques, etc) at the start of the offseason, and then I trust that the swim/bike/run load applies enough stress on the core to maintain an adequate level of core strength/fitness. However, this approach hasn’t seemed to work for me for injury prevention.

So, will a more rigorous, or more focused (on exercises specific to lower back stabilization + stretches) program prevent recurrence? If so, is there a routine/book/website you recommend for exercises specific to lower back injury rehab and prevention? I’d really like to be able to go an entire season without losing several weeks to this. :frowning:

Thanks,
John

2

Hi all,

Looking for opinions – especially from professionals (chiro’s, MD’s). I’m coming off of 9 weeks of basically no training as a result of a flare-up of lower back pain. This is an injury that I’ve struggled with for nearly 20 years, and it seems to resurface randomly. It’s in the L4/L5 area, and at its worst, it radiates pain down the leg(s) (one or both). After several weeks of treatment from my Chiro/ART/Graston practicioner (and triathlete), I’ve now been pain-free for a week, and have been able to ride the spin bike in the gym several times this past week without pain (tried to a couple of weeks ago, and it flared up instantly). I’ll try to run for the first time today and see how it feels. He speculates (my word, as I’m reluctant to use the word “diagnose” without an MRI) that it’s a degenerative disk of some sort (either herniation, or bulge) based on symptoms (radiation of pain down the leg, range of motion, etc). After having trashed 5 months’ worth of offseason training, and turned my race plans upside-down, I’m looking for ways to prevent this from happening again, if possible.

Anyway – on to the question. Does “core” work prevent this sort of injury from recurring? I’ve read the numerous debates about core work and its effects, or lack thereof, on performance. I’m not interested at all in performance-improving aspects of core work, but solely on prevention of injury recurrence. My normal approach to core work in the past has been to do 10-12 week (2-3x week) of core work (pikes, supermans, crunches, obliques, etc) at the start of the offseason, and then I trust that the swim/bike/run load applies enough stress on the core to maintain an adequate level of core strength/fitness. However, this approach hasn’t seemed to work for me for injury prevention.

So, will a more rigorous, or more focused (on exercises specific to lower back stabilization + stretches) program prevent recurrence? If so, is there a routine/book/website you recommend for exercises specific to lower back injury rehab and prevention? I’d really like to be able to go an entire season without losing several weeks to this. :frowning:

Thanks,
John

I’m not a professional, just a N=1 experience.

I had “lazy glutes” which caused my lower back pains and knee problems (I’m in my late 20s). Doctors and PT diagnosis it (with a more suitable medical terminology) and most of my pain is pretty much gone - through the use of strength and core training. So yes, for me (n=1) with muscle imbalances, my lower back pains and knee problems went away. I just had to deal with the burning sensation from running hard that my weaken areas are being strengthen and being biomechanically correct.

3

More n=1 experience, anecdotally backed up by a lifetime of back problems and a bunch of work w/ PTs and other cyclists w/ similar issues: NO QUESTION. Core stability helps comfort on the bike, full stop, especially so if you have back problems, and most especially if you ride in aero position. IMHO and experience, anyway.

4

“Does “core” work prevent this sort of injury from recurring?”

The short answer is no and it depends.

“My normal approach to core work in the past has been to do 10-12 week (2-3x week) of core work (pikes, supermans, crunches, obliques, etc) at the start of the offseason, and then I trust that the swim/bike/run load applies enough stress on the core to maintain an adequate level of core strength/fitness.”

This kind of core work will not balance you sufficiently to prevent a relapse. It is not what is needed.

I can guarantee you that you there is a remedy. How do I know? I have also had back pain on and off for 25 years. I did my first tri in the mid 80’s and first of many Ironman’s in 97. I lived in one the meccas of all things sport and sports medicine in the States. The best back surgeons told me that I would have to live with the pain until it became intolerable then they would operate. Disk herniation and degenerative disk disease. Lower lumber spin totally locked up. Pain down the legs. I went to the best physical therapist. Nothing really worked until I took ownership of my back. That means it was up to me to fix it. This is NOT a 2/3x’s a week thing. It is a DAILY practice. Today and forever. Don’t hand this off to the doctors or physical therapists. If you are prepared to devote 30 mins a day to managing your back every single day then pm me and I will send you some info.

5

I’m not a professional, so, FWIW…

I had a serious back injury in 1987 that took a year to recover from. I did recover though, and was able to walk, run and ride again normally.

If I use a rowing machine and do exercises for my core (abs, obliques and lower back) then I am more comfortable and can train more than if I don’t. Without doing core work I get sore on the bike quickly. With core work my runs are more comfortable, I can run more and ride more.

6

For me, yes. Not 30 minutes a day, more like 15 every other, but yes. Best tool has been that stupid wheel with 2 handles.

7

More N=1. Crippling back pain for 2 years. Same symtoms as you…pain radiating into leg and very limited range of motion. Tried chiro, core strengthing, accupucture. The only thing that helped me was deep tissue massage. 8 - one hour sessions and completely pain free. That was about 15 yrs ago. Now I concentrate on hamstring and glute stretching and 1 or 2 trips to the massage therapist each year and all is well.

8

The right “core” work very well might. But you need to actually work with someone who can help you figure out what the “right” exercises actually are.

In other words, back pain is your symptom. But what’s causing it? That’s what you need to figure out first. Then you need to figure out how to solve that problem. Then you need to undertake those actions.

This is why when people ask about “strength training” and the like, the results are, at best, quite inconclusive. If you want to improve at swimmimg, biking, & running, then doing those three things will make you better at doing those three activities. It’s a very simple, direct, and well established cause-and-effect.

But let’s say you have lower back pain. Is that from weak lower back muscles? Or is it from lower back muscles that are overworking to compensate for weak abdominal muscles? Or is it an alignment issue, where one side is weaker than the other? Etc., etc., etc.

To draw an example, people often think - when I bike, I push on the pedals, so if I can push more weight, I will be able to push on the pedals harder, and I will be a better cyclist. But that’s rarely the case. The limiter is very rarely how hard you can push on the pedals. It’s how long you can push hard on the pedals. And that’s not been conclusively shown to be helped by increasing how much weight you can push. But that isn’t to say that your cycling might not be helped by doing something other than cycling. But the question as to “what else besides cycling?” does NOT have a general answer.

EVERYONE will get better at riding by riding. But NOT everyone will get better at riding by doing certain exercises off the bike. Some people may. But some others may see no benefit. And some others may actually see a decrease in performance.

This because the things that are common to all of us when we cycle are best worked by cycling. But those things that limit us when cycling - besides just the obvious “needing to be better at cycling motions” - are quite a bit more varied. And since the limiter for most people is often so overwhelmingly just the simple lack of cycling-specific fitness, the best - and most clear - remedy is simply to bike more. But if you have low back pain and that limits you in your ability to ride your bike in the first place, then yes, you need to address it. But unlike the very simple answer as to “Why can I hold 400w for one minute, but not for one hour?” there is no equally simple or good OR (virtually) UNIVERSAL answer as to why you have lower back pain…

9

From experience (6 months of rehab to correct my off center spine) chiros and physios are your best friends. Even if it stops hurting, keep seeing them occasionally. Stretching your lower back is also a very good idea, even if its just 5-10 minutes a day before your workout, just give your back a little lovin’. Once it starts to feel a bit better, you can get onto lower back strengthening exercises and the like. From what i’ve been told, core work can be an issue if you dont know whats going wrong. If its just an issue of one muscle being stronger than another and pulling things in weird ways, core work can make the problem worse. So find out whats going on, then find a PT who can help you out.

10

I just sent you a private message, John.
Feel free to get in touch if you have questions.
In health
–Andrew

11

I had lower back pain and it was because my hip flexors were too thight
.

12

mine was caused by really tight hamstrings. since i started stretching them 3x per day, i’ve been pain free.

13

For me, if I’m off my core training for some reason my lower back gets very sore when biking. I guess that’s why my PT told me to do them for the rest of my life.

14

Do you do any indoor rowing in the offseason? Do you find that rowing helps work the glute?

15

I used to have horrific back pain once in a while for unknown reason. I found my reason involved two factors. Weak core and poor hamstring flexibility. My change took several weeks but unless you have a disc issue it should get better. You’ll have to work through some pain until it gets better. Strong core = strong back. Need to be consistent working these areas.

16

I used to have horrific back pain once in a while for unknown reason. I found my reason involved two factors. Weak core and poor hamstring flexibility. My change took several weeks but unless you have a disc issue it should get better. You’ll have to work through some pain until it gets better. Strong core = strong back. Need to be consistent working these areas.

What did you do for the tight hams…?