An Update on Core Strengthening


An Update on Core Strengthening

I personally avoid using the term “core” as it is more of an umbrella term that means something different to everyone. Ask a Physiotherapist and some might describe the “core” as the deepest layer of trunk muscles, ask Joe Blow and they’ll tell you it’s your six pack.

You could argue that none of the above are incorrect, however by simply saying “core”, you risk being misunderstood.

Because there is no universal definition for the “core”, it can be used to describe all (or some) of the superficial and deep muscles of the trunk and pelvis that both move the spine and pelvis, but also generate and transfer force from the body to the extremities and vice-versa.

The phrase “core” became popular after an article was published in 1996 which discussed the correlation between chronic low back pain and certain muscles within the “core” being slow to turn on. These muscles were your Transversus Abdominus and Lumbar Multifidus.

From these results, the assumption was then made that if we strengthen these “core” muscles we will improve back pain. As such, every low back pain patient was given “core strengthening”.  Some got better, some had no improvement and some got worse.

Unfortunately, identifying that the “core” muscles were delayed in patients with chronic low back, doesn’t automatically imply that it was the cause of back pain.

As is the case for rehabilitation after any injury, there is no recipe. Not all back pain should be treated the same.

The evidence does not support core strengthening for all back pain .   There is only low level evidence to support core strengthening for a small population of chronic low back pain sufferers.

If you suffer from low back pain or any other injury, continue with pain-free exercises and make an appointment.  After thorough assessment, I can teach you the likely cause of your symptoms and equip you with the skills and knowledge to make the necessary changes.


If you would like to read further information on this topic, search the sited articles:

Hodges, P. W., & Richardson, C. A. (1996). Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine, 21(22), 2640-50.

Searle, A., Spink, M., Ho, A., Chuter, V. (2015). Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation, 29(12), 1155-67.

Wong, A. Y., Parent, E. C., Funabashi, M., Kawchuk, G. N. (2014). Do changes in transversus abdominis and lumbar multifidus during conservative treatment explain changes in clinical outcomes related to nonspecific low back pain? A systematic review. J pain, 15(4), 377.