Back Pain Explained - What is Core Stability?

Core stability refers to the ability of the muscles around the trunk and pelvis (core) to provide stability sufficient for the efficient movement of the arms and legs.

Reduced core stability means that the muscles do not support the trunk effectively and this leads to reduced control in the area. Poor stability can lead to pain in the back but also in other areas such as the shoulders or knees.

If the ‘core’ muscles are not doing what they should be, then other muscles often compensate and become overactive. They take on a role they were not designed to and this eventually leads to muscle imbalances and pain. When we talk about the core muscles, we mean the deep muscles, not the superficial ones like the rectus abdominus (the one responsible for the six-pack!). People often mistake these superficial muscles as being the core muscles and start to strengthen them by doing sit-ups. This can actually be counter-productive as they are usually overactive anyway because the true core muscles are relatively inactive!

In the back, the core muscles can be seen as a sort of cylinder. The trunk muscles form the cylinder itself, the base is formed by the pelvic floor muscles (those that you use to hold your urine in so you can get to the toilet in time!) and finally, the lid is formed by the diaphragm (one of the breathing muscles).

When it all works well, the core muscles form a good stable unit. From this stable base, the legs and arms can function efficiently. The spine is also protected to allow pain-free movement.

When things go wrong, the base becomes unstable and there is not the support required for good efficient movement. This increases the stress and strain on the joints and eventually leads to pain.

Reduced stability can arise from trauma, poor posture, poor movement habits, repetitive movements/activities and incorrect exercises.

Much of the focus in the rehabilitation of back pain is placed on stability retraining and this is backed up by some good research evidence. It also explains the rapid rise in the popularity of exercises and fitness classes that focus on improving core stability such as pilates and the use of swiss balls.