The basic message I want to get across to my patient’s with low back pain is about your personal responsibility to support the muscle system of the spine. Have you heard of Core Stability? If you are into Pilates, yoga or strength training you have experienced core strength training and stability training.
If you are my patient you have heard me talk about the fascia and the joints. In particular for the low back, I talk about the fascia, muscles, and joints around the sacro-iliac joints. These are part of your low back stability system. Contrary to what old rheumatologists will tell you, the sacro-iliac joints – which connect the fused section of the lower spine (the sacrum) to the pelvic/hip bones on either side – do need to move during normal daily activities such as walking and running. These bones were meant to move. On the other hand the lower lumbar vertebra were not meant to move very much. These lower lumbars usually need stability training to get them to “hold” in place better.
You will feel me touching and testing the motion of these joints and the surrounding fascia. It is both necessary and desirable that the sacro-iliac joints move, because they need to act as shock absorbers between the lower limbs and spine, and also as a way of providing proprioceptive (body positioning awareness) feedback for co-ordinated movement and control between the trunk and lower limbs.
As the SIJ is capable of movement, that movement needs to be properly controlled, as with any of the body’s joints. Some control comes through the natural architecture of the low back and pelvis, but more is possible by using the surrounding muscle, ligament and connective tissue system (fascia) to provide compression on the joints. This is important because we can influence the effectiveness of the compression through exercise and re-training after injury.
I will give you exercises to support the muscles and fascia that help to stabilise the pelvic girdle:
- For the back side I like arch ups;
- For the front side I like abdominal curls or planks:
- For the sides I like the side bridge.
If you practice just these three core exercises and train every day for three weeks it will help you improve the fascia system of support. These are just the beginner poses. I will progress you to the intermediate and advanced exercises.