It’s common to hear that back pain is caused by a weak core, and that strengthening deep abdominal muscles is the solution. While this belief has been popular for many years, research and clinical practice tell us a different story. 

As Exercise Physiologists, we often hear from people who have been constantly told to brace their core and avoid certain movements. This is an attempt to protect what they’ve been told or believe to be a fragile spine, only to experience ongoing back pain. Fortunately for us, the spine is not fragile; it’s strong, adaptable, and designed to move.

Core Stability Isn’t the Only Fix 

The ‘core’ can be considered as the muscles around the trunk, including the abdominals, spinal muscles, and pelvic floor. It can be broken up in to ‘inner core’ and ‘outer core’ and has an important role in managing intra-abdominal pressure throughout movement and providing support for the spine against forces throughout movement. 

It is important, like other areas of the body, that these muscle groups are challenged appropriately through movement. Unfortunately, “activating” your core constantly or doing 20 planks a day, does not prevent or “fix” back pain. In fact, it is not uncommon for people with chronic back pain to over-brace these areas, holding tension, fatiguing muscles and likely contributing to discomfort or other complications. It may reinforce fear around movement in these areas which is also unhelpful. 

Hence, understanding the role of the ‘core’ and implementing core stabilising exercises are part of the picture in individually focused movement plans designed to improve pain outcomes for people with back pain. 

Why Global Resistance Training Matters 

Put simply, if your core is ‘weak’, then it (usually) tells us the following:

• You have weakness systemically, OR 
• Your training program is not challenging your body with a variety of forces, OR
• You have maladaptation in the way that you use the muscles due to reinforced misdirected instructions, OR
• You are not loading movement appropriately, in other words, you are not strong enough to perform the activity (either repetition or actual load).

Instead of focusing narrowly on core stability in isolation, we know that whole-body resistance training is one of the most effective approaches for managing and reducing back pain.

This could look like lifting weights, using resistance bands, or your bodyweight, to strengthen all muscle groups throughout the body, not just the trunk. This has a range of benefits:

• It improves load tolerance across the whole body.
• It builds confidence in movement, especially with functional, everyday tasks like lifting, bending, and carrying.
• It helps reduce pain through the release of natural pain-relieving chemicals in the brain.
• It improves sleep, mental health, and energy levels, which are all factors that influence pain perception.

Importantly, resistance training also helps to show how your spine or your back can handle movement and load that it was designed to do. There’s no need to constantly brace or “suck in” your core before you lift for most movements and with most loads. Save that for the heavy lifting, where the body may need greater assistance.

Rethinking Spinal Positioning and Bracing

Many people with back pain become overly focused on keeping a “straight back” or bracing tightly before they move. While good technique is important, rigid rules about posture can increase fear around movement, thus limiting movement, and prolonging pain.

Our backs are made to bend, twist, lift, and adapt. Variety in your movement is important to maintain and improve your comfort in these different positions.

So, Is Core Training Useless?

No, core exercises (meaning stabilising or rotational exercises rather than just sit-ups and crunches) still have their place in a movement plan managing back pain. The idea that core training in isolation ‘fixes an unstable spine’ is wrong. 

Core training as part of a program that provides movement against loads in a variety of movement planes, will increase movement and load tolerance, reduce fear around movement, provide greater confidence through learned safety, and is a more effective way to return to function.

The Bigger Picture

For most people, the best outcomes come from a broader approach:

• Full-body resistance training that builds strength for everyday tasks
• Varied movement positions and loading training your body to manage a broad range of movement planes and types of forces
• Education that helps people feel safe to move again
• Gradual exposure to movements that you may have avoided
• Less focus on bracing or perfect posture
• Individualised support from exercise physiologists who understand the complexity of pain and can tailor your treatment with other personal considerations. 

Final Thoughts

Back pain is common, and movement is the best thing for it. If you’ve been told to “just strengthen your core” and this hasn’t helped, it’s time to get moving and build strength in other ways too. There are many reasons why people have back pain, so it’s understandable to feel unsure if this information applies to you. For the right support, get in touch with an EP as they have a comprehensive understanding our physiology, and can guide you in the right direction.