Physical Therapy Core Exercises for Back Pain

Research shows that core exercises can reduce back pain. In this post I share the 3 different types of physical therapy core exercises I use when treating patients for back pain. While a weak core is not the only cause of back pain, it can be a factor. But simple crunches and sit ups aren’t enough to reduce back pain and avoid it in the future. In order to truly build core strength, you need 3 types of core exercises. Read to the end for a video.

Core Exercises for Back Pain #1: strengthen the Deep Core Muscles

This is where I start with patients. You must learn to “turn on” and then strengthen the deep core muscles in order to provide adequate support to your spine. My favorite way to start teaching patients how to recruit the deep core muscles is through diaphragm breathing. This exercise increases activation of the transverse abdominis creating stability around your spine. To learn more about breathing patterns and core muscle firing, read Dr. Keller’s post here.

Pilates is a great way to learn how to turn on your deep core muscles. It’s effectiveness in reducing back pain is also found in this research article.

Once you’ve learned proper diaphragm breathing, you can further strengthen the deep core muscles with exercises like toe taps and bridges.

Toe Taps – lay on your back with your legs bent in a 90/90 position. While exhaling and keeping your inner abdominal muscles tight, tap one toe to the ground and then bring it up. Your low back should not arch and your abs should stay tight as you tap your toe.

Bridges – lay on your back with your knees bent and your feet on the ground. While exhaling, pull your core in and lift your hips.

Core Exercise for Back Pain #2: Strengthen the core In Functional Positions

Once you learn to recruit your deep core muscles, you need to learn to use them during functional tasks. They need to both turn on and be strong enough to support your spine as you bend, lift, twist, walk, and run. Strengthening the core muscles in functional tasks also means that you need to strengthen your core muscles in different planes. Think forward/back, side to side, and twisting. Squat variations and carries are two of my favorite ways to strengthen the core in functional positions. Below is an example of each exercise.

Squat Press – hold a light weight at your chest and push it forward as you go down into a squat. You’ll find that you have to really use your core muscles to hold the weight out in front of you as you squat. For more of a challenge, hold the weight out in front the whole time, going down and up.

Marching Carry – hold a heavy weight down by your side. Keeping your core in and standing as straight as possible, march your legs. For more of a challenge, hold the weight at shoulder level with your elbow bent in a “waiter” position.

Core Exercises for Back Pain #3: exercise to Fatigue for Increased strength

Once you’ve learned to engage your deep core muscles and trained your muscles in functional positions, you need to truly build strength in the core. This strength allows your back to handle more and more stress during the day. Think lifting a heavy box versus a light box. The only way to truly build core strength is to work the muscles to fatigue. Again, crunches and sit ups are not the only or best way to do this. You still want to choose exercises that promote engaging your deep core muscles and working them in functional positions. Below are two exercises I have been loving lately to increase my own core strength. Yes, they are both variations of the plank.

Plank Pull Through – start in a tall plank with a medium weight behind one hand. Reach with the opposite hand and pull the weight to the other side of your body. Try keeping your body as still as possible, not rocking side to side as you lift your hand to pull the weight through. This exercise is great for rotational strength.

Plank Leg Lift – start in a tall plank with a weight on the outside of one of your feet. Lift your leg up and over, then back. Perform on the other side. Next place the weight in front of both feet. Lift your leg forward and over the weight, then back. Perform on the other side. This works your core and your glutes and teaches you to maintain a good spine position while your legs move. Don’t let your back arch.

I Made a Video of These 3 Core Strength Types!

If a picture is worth 1,000 words, a video is worth even more! For each exercise in the video, can you name which type of core exercise it is?! Be sure to follow me on Instagram, Facebook, and YouTube so you can see all my videos!

Please subscribe so you don’t miss my next post in this series. Next up, how to bend correctly! As well as an introduction to workspace ergonomics.

Disclaimer: These strategies are not a substitute for full medical evaluation. You should consult your doctor if you are experiencing any new pain. If any of these strategies sound especially helpful for you, be sure to discuss with your doctor the best way to implement them into your health plan. There is also significant benefit to having a full movement assessment performed. I recommend asking your doctor about seeing a physical therapist!