Core Stability & Back Pain


Therapeutic exercise is most effective when it addresses the cause, not just the symptoms, of a problem. Poor postural alignment, muscular imbalance and improper movement dynamics may cause pain-producing back problems, but these problems may stem from inactive core muscles. These deeper abdominal muscles support the spine and the internal organs, while enhancing balance and stability.


The core muscles that play a key role in spinal stability include the multifidus, located in the spine, the transverse abdominal muscle, which is a deeper abdominal muscle and the pelvic floor, which supports the internal organs.


The multifidus, which runs from vertebrae to vertebrae, is a postural muscle which supports spinal stability. The transverse abdominal muscle compresses the diaphragm to expel the air during respiration, and is responsible for voluntary abdominal muscle contraction. While the pelvic floor muscles control urinary continence and sexual functioning, they also support and stabilize the pelvis.

Types of Core Stability Exercises

Exercises that do not use spinal movement, such as the plank, engage the multifidus. Assume a prone position, and balance on your elbows and forearms. Create a straight line from the top of your head to the base of your spine. Draw your belly in and hold the position for as long as possible. Work your transverse abdominal muscle by taking a breath in. As you exhale, draw your belly in and imagine that you are emptying the air from a balloon. Hold an abdominal contraction for 10 counts. Do this exercise throughout the day to train your transverse abdominal muscle to become more active.
Activate your pelvic floor muscles by imagining that you are going to the bathroom, trying to stop the urine flow. Do this 10 times daily.

Expert Insight

Australian physical therapist Paul Hodges of the University of Queensland studied the relationship between the transverse abdominal muscle and lower back pain. Hodges found that people without low back pain automatically activated their transverse abdominal muscle a fraction of a second prior to limb movement, whereas back pain sufferers activated their transverse after limb movement. Since the transverse abdominal muscle is a stabilizer, the delayed reaction caused spinal movement, which may compress the disks and cause back pain.


A 2006 study published in the “Journal for Strength and Conditioning Research” detailed the benefits of stability ball training for core muscle development and back pain prevention. Lead author Jacqueline M. Carter reported that ball exercise increased spinal stability in sedentary individuals. Exercises may include crunches and oblique curls on the ball, or sitting upright and lifting one foot from the floor.

About this Author

In 1999, Lisa Mercer’s fitness, travel and skiing expertise inspired a writing career. Her books include “Open Your Heart with Winter Fitness” and “101 Women’s Fitness Tips.” Her articles have appeared in “Aspen Magazine,” “HerSports,” “32 Degrees,” “Pregnancy Magazine” and “Wired.” Mercer has a Bachelor of Arts in psychology from the City College of New York.