Are you doing sit-ups and crunches to help support your aching back? Stop. In the name of all that you have already put your spine through, please, stop. I teach therapeutic exercise in a physical therapy clinic and I hear myself repeating the same thing over and over again. Stop doing sit-ups, stop doing crunches, stop, stop, stop, stop, stop….. (In my own head, what I am hearing is the voice of Charlie Brown’s teacher: WAHN, WAHN, WHAN, WHAN, WAHN, WAHN… )

It’s a mistake to think that what we need is increased strength in our abdomen. Did you know that people with a history of disabling back pain, whether they are currently in pain or not, have a better ability to hold a sit-up type position than their pain-free counterparts? (It’s true. I’m not making this up.) The tests were done by Stuart McGill. He’s a doctor of kinesiology at the University of Waterloo in Canada. He has done too many tests to count on how our muscles are firing, or not firing as the case may be, and has produced a wonderful body of work in ‘Low Back Disorders’ that explains why some exercises work and others don’t. The book is a little dense: it’s not meant for the lay person but if you are determined you can get through it.

In any case, one of the more remarkable studies he did was to test muscular endurance on those with and without a history of back pain. When holding a sit-up type position, those with a history of back pain were stronger. The exact position is this: Seated with the knees up and the soles of the feet down, the person being tested is asked to lean back against a wedge.

The angle is about 35 degrees off of perpendicular. Next the wedge is removed and the timer starts. On average, the person with a history of disabling back pain was able to hold this flexed position for almost 20 seconds longer than someone with no history of back pain.

Now the position does rely on the stabilization of not only the abdominal musles but also relies heavily on the hip flexors. But so does a crunch and a sit-up. The best exercise for the abdomen (whether you have back pain or not) is to not engage the hip flexors. An example of that type of exercise is below in Part 6 of 8 on back pain.

After several more tests were completed this position is the only one where those with a history of disabling back pain tested stronger. They were weaker in spine extension and right and left side-bending (the obliques). So THAT is where the time should be spent if you are trying to prevent back pain: your spine extension muscles and your obliques. You can strengthen the obliques with the exercise that will be in the next installment of the back pain series and the spine muscles with the final installment.

In the meantime, you can get yourself going with the exercises below. All of these exercises and more are compiled in my DVD: Pilates for Healthy Bodies. You can purchase the DVD on this website. Good luck! –Karena