Lower back pain rehabilitation - it’s about more than just the core!

Health & Fitness

  • Author Holly Mcintosh
  • Published October 1, 2023
  • Word count 550

Lower back pain is a common condition that we see and treat here at Four! While many associate it with core muscles and abdominal strength, the road to effective rehabilitation is actually more diverse and comprehensive. This article aims to explore the broader picture of lower back pain rehabilitation and highlight the various muscle groups and aspects that contribute to a healthy and pain-free lower back.

The Core's Role

Before we delve into a broader approach to lower back pain rehab, let's briefly acknowledge the importance of core muscles. Core muscles, including the transversus abdominis, multifidus, and obliques, provide essential stability to the lumbar spine. Strengthening the core helps maintain proper posture, support the spine during movement, and prevent unnecessary strain. However, it's crucial to recognize that the core is just one piece of the puzzle.

The Multifaceted Approach

  1. Hip muscles: strengthen those glutes!

The gluteal muscles, made up of gluteus maximus, medius, and minimus, play a significant role in lower back health. Weak glutes can contribute to poor pelvic alignment and gait patterns, which may ultimately lead to lower back pain. Incorporating exercises that target these muscles, such as squats, lunges, and hip bridges, can help improve hip stability and reduce the risk of pain.

  1. Spinal extensors and paraspinal muscles

The erector spinae and paraspinal muscles run alongside the spine, helping with back extension and maintaining posture. These muscles can become weak or dysfunctional due to poor movement patterns, pain or injury. Strengthening these muscles can aid in improving load capacity of the lumbar spine and reducing pain.

  1. Hamstrings and the posterior chain

The posterior chain is used to describe the muscles through the back of our bodies, in particular the lower back muscles, glutes and hamstrings. Balanced strength and flexibility throughout this chain is important in supporting the lower back during movement. Exercises to improve both hamstring mobility and strength such as romanian deadlifts are a great way to improve biomechanics and prevent injury.

  1. Pelvic floor muscles

The pelvic floor muscles provide stability to the pelvis and can be important for individuals with certain types of lower back pain, especially if there's a pelvic floor dysfunction component. Our pelvic and women’s health physios are experts in this area!

  1. Faulty movement patterns

If you are lifting heavy weights or objects at home, work or in the gym, doing so with poor technique may increase your risk of back pain. There are certain ways that we can teach you to move in order to utilise the right muscle groups to prevent injury or simply to get the most out of your workout!

  1. Holistic view: mind-body connection

Acknowledging the mind-body connection - or in technical terms psycho-social factors that contribute to pain and injury - is pivotal in lower back pain rehabilitation. Stress, anxiety, and even negative emotions can contribute to muscle tension and exacerbate pain. This is something that your physio can help to identify and work on with you.

How we can help you

Rehabilitating lower back pain isn't a one-size-fits-all endeavour. Each individual's pain triggers, muscle imbalances, and movement patterns are unique. Therefore, at Four we aim to provide an individualised approach to assessment and treatment in order to get you back to doing the things you love without that pain in the back! Book online here.

Holly is both a full-time physiotherapist and co-director of Four. She has been working as a physiotherapist since graduating from the University of Otago in 2013. Following on from this she has completed a number of further training courses including a post-graduate diploma in sport and exercise medicine. https://fourphysio.co.nz/physiotherapy

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