My core is weak and I have back pain: Should I do sit-ups?

My core is weak and I have back pain: Should I do sit-ups?

My core is weak and I have back pain: Should I do sit-ups?

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One of the most commonly prescribed treatments for generalized back pain is physical therapy.  More specifically, a program to lessen pain while improving flexibility, posture, and provide strengthening are the overall goals of the program. Long-term, we discuss core strengthening to help promote a healthy and functioning spine.  The core represents the stabilizing muscles and supporting structures of the trunk that protects the spine and allows us to do most daily and recreational activities.  It is always great to hear from patients who present to the office and share with us that they have been doing core strengthening exercises.  However, when we probe a little deeper, many are actually doing good old fashioned sit-ups, believing that this is the key component to building strong abdominal muscles (and making their back better!).  Why not have a strong set of abdominal muscles and visible 6-pack to show for it?

So are sit-ups effective at building the core and are they safe for most?  The answer may surprise many.

The evidence is mounting that lying down and repeatedly flexing the spine will only cause further problems. This can result in promoting more rapid wear of the disc associated with repetitive sheer forces. Studies in the medical literature have found that repeated spinal flexion can have adverse effects on the intervertebral discs.  Think about this, we often focus on posture as another aspect of a healthy spine. If someone sits with their back rounded (spinal flexion) and abdomen contracted, is that a normal posture?  The obvious answer is a resounding NO! This is exactly the position that we are in while doing a sit-up.  Furthermore, sit-ups (and crunches) work specific abdominal muscles and the hip flexors but do not work the entire set of core muscles.  We know that when abdominal muscles are strong and back muscles are weaker, the back is more susceptible to injury. So if sit-ups are not good for someone with a “healthy” spine, imagine the potential consequences for someone who already deals with issues related to low back pain. Going back to my introduction, the patient’s we are seeing in the office are not coming to see us because their back is feeling good!

There are many good alternatives to sit-ups that can be done without any special equipment. The bottom line is sit-ups get a big thumbs down in regards to building the core and helping the low back.

Citations

  • Hansen L, Anders C. Influence of different control strategies on muscle activation patterns in trunk muscles. Physiol Rep. 2014 Dec 1;2(12) PubMed PMID: 25501425

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Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

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The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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