The relationship between back pain and core stability are often directly related, but not often discussed together. In discussing the relationship between back pain and core stability the big question is, what is the core?
To picture the region of the core, visualize a cylinder. The front of the cylinder is like your abdominals, with four layers of abdominal muscles, and if you go to the back, there you’ll find the back extensors, there are different layers of back extensors. On the bottom of the cylinder is your pelvic floor, and on the top is your diaphragm, which not many people pay attention to.
The diaphragm works in a way where, when you breathe, it goes down. So, as it goes down, it draws air into the lungs. The diaphragm is important because, as it lowers, it creates pressure. Thinking of the cylinder analogy, as you bring the top of the cylinder down, it creates this pressure that helps stabilize your low back.
Sometimes, during the day, when you're stressed, you tend to take in shallow-breathes. When taking shallow-breath or chest breaths, the diaphragm doesn't work very well, it doesn't lower as much as it should. The goal here then is to make sure that you're relaxed and you're using that diaphragm, trying to get you out of what is called the sympathetic state, the fight or flight state. We want to get you into the parasympathetic state so that you can breathe better, use your diaphragm more, and have less back pain.
If you have ever been in some type of acute pain and you're scared to move, what do you do? You hold your breath! Or, if you've ever had any acute low back episodes, in order to pick something up, you hold your breath, you're essentially holding on for dear life. This is more of a protection mechanism, but it's really hard to get out of it unless you restore proper breathing techniques.
In this section I’m going to walk you through proper diaphragmatic breathing, which will guide you out of an acute state.
Starting by laying on your back, and just breathe normally.
Take a deep breath in and breathe out (try and notice where you're breathing from).
If you’re breathing from your chest, you’re getting too much accessory movement and not enough from the diaphragm. A simple exercise you can do to fix this is place one hand on your belly, and the other hand on your chest. Think of keeping the chest on your hand still and only your belly rises as you inhale through your nose and exhale slowly. Inhale through your nose, make your belly rise, and breathe out slowly.
Doing this will bring you out of the sympathetic state and into a parasympathetic state, and allowing that intra-abdominal pressure to improve, creating better core stability.