Janet Fabbri (Musculoskeltal Physiotherapist)
Chronic back pain causes weakness in the deep stabilizing (or postural) muscles of the lower back. Recent research has shown that by increasing the strength and stability of these muscles, pain can be reduced. These muscles work at a low intensity (30% of Maximal Voluntary Contraction) and are normally switched on by the brain prior to any physical movement. When pain is present, the brain does not pre-set these muscles prior to movement, so movement occurs without any base stability, causing a shearing of the lumbar spine joints, which causes more pain. By understanding how to contract these muscles, movement will be less painful.
The muscles to concentrate on are the deep lower abdominal muscles (Transversus Abdominus – acts like a corset), the deep lower back muscles (Multifidus) and the front pelvic floor (Pubococcygeus – the muscle that stops the flow of urine).
Lie on your back with your knees bent up and your feet on the floor, maintaining a normal curve of your lower back (Don’t flatten or over arch it). Place one hand over your lower abdomen, below your navel. Place your other hand higher over your lower ribs. Gently pull in your lower abdominal muscles, as if you are pulling your navel to your spine. Then try to pull the front of your pelvic floor up (as if you are trying to stop yourself from urinating). Hold these muscles firmly, but not so tightly that you cannot breathe. Then, think about breathing in and out at your lower ribs, taking relaxed gentle breaths. Feel your lower ribs expand and contract with the breath. Take six (6) breaths in and out slowly, concentrating on your pelvic floor, lower abdomen (firm, but not too tight) and your lower ribs (freely moving with the breath).
Other Handy Hints:
– Imagine a piece of string is tied to 2cm below your belly button and it is being gently pulled towards your spine.
– Imagine the muscles of your lower abdominals (or tummy) are thing to draw your two hip bones towards your belly button.
– Try this exercise in four (4) different positions:
o Lying on your tummy
o Four-point kneeling (on all fours)
o Sitting (or driving)
o Standing and walking
When to use Abdominal Stabilization
Abdominal stabilization should be used during any movement and also during static postures. With practice, abdominal stabilizing will become automatic
– Lifting and carrying the washing basket, shopping bags
– Pushing the shopping trolley
– Lifting your children
– Washing the car
– Sitting in a chair, or driving
– Rising from a chair
– Turning in bed, or getting out of bed
REPETITION IS THE KEY TO SUCCESS