Lumbar and Cervical Stabilization Exercises

Core Strength for Back and Neck Rehab

Many rehab clinics and physical therapy offices now routinely give back and neck patients “core strengthening programs.”

These programs, which focus on the muscles of the abdomen, back, hips, and shoulders, may improve postural alignment which in turn may help reduce pain.

Core strength also contributes to the kind of body mechanics necessary for avoiding the back strain that may occur while engaging in daily chores, sports or dance.

Benefits of core strength translate into pain relief, says Susan Eaton, yoga teacher and head of outpatient services at Saint Francis Memorial Hospital in San Francisco. “Good posture habits encourage a healthy alignment of the bones and curves of the spine, and allow muscles to maintain their normal length.”

What Is "The Core"?

Andre Panagos, MD, clinical assistant professor of rehabilitation medicine at NYU Langone Medical Center, describes the body’s core as a pressurized cavity capable of supporting huge amounts of exertion—much more than the back muscles.

Panagos points out that if everything but the bones of the spine were removed, and just 20 pounds were placed on top, the vertebral column would buckle and collapse. Muscles around this pressurized cavity provide more support for physical work than does the spinal column, he says.

The abdominals are key core muscles, but those in the pelvis and back play important roles as well.

Types of Core Strengthening Programs

Core strengthening gives you strong, flexible trunk muscles that support well-aligned bones. Exercise programs for the core target the muscles located very close to the spine itself, as well as those in the pelvis.

These days core strengthening programs can be found in many forms and may be called by a variety of names including Pilates, lumbar stabilization, cervical stabilization, core support, and trunk exercises. Types of programs range from healthcare provider-prescribed (stabilization programs) to personal training sessions and gym workouts (Pilates, yoga and abdominal routines) and more.

Classes and Workouts for Core Strengthening

Outside the back clinic, a core strengthening program might take a general approach to abdominal development, or it may use highly refined mind-body techniques that employ breathing, body awareness, and ideal alignment along with the abdominal work.

Finding a program and a teacher appropriate to your level of ability and for your injury or condition is imperative. Here are some tips:

1. Interview the instructor regarding certification, experience, and expertise working with back and neck pain, and communication skills (including good listening skills).
2. To avoid worsening an injury or condition, try to find a teacher who can recognize when it is appropriate for you to see a healthcare provider or therapist, and is willing to refer you out.

Before You Begin a Core Strengthening Program

There are many core strengthening programs from which to choose but performed correctly, each type should aim to create and develop reliable body posture.

To work core muscles, you first have to reach them, and that usually comes in the form of an introduction and/or preparation. A good instructor or therapist will provide this to beginners (along with reminders as you progress).

Instruction and preparation work may include breathing techniques and information on where to place body parts such as your feet, pelvis, and shoulders—all geared to help you locate and activate your deep abdominal muscles, and to work in good alignment. You should not have to work through the pain to get good results with core strengthening programs.

Beware of Crunches

Panagos warns about doing ab crunches: “When you do crunches you are only working only in one plane. But the spine and its muscles are three-dimensional—they go all the way around. That is where core strengthening, which are not ab crunches, can really help.”

Core Strengthening Exercise - The First Series

Once you have an awareness on how to activate your deep abs, try a few simple exercises that work all the posture muscles. These exercises begin the process of developing trunk stability. Examples include the pelvic tilt, and a few easy yoga-like poses such as supported bridge and a spinal twist, if appropriate for your condition.

Core Strengthening Exercise - Stabilization and Dynamic Stabilization

As you advance, your skilled therapist or instructor will give you arm and/or leg movements that challenge the trunk to move. It will be your job to keep your trunk still while performing them. This is is what trains the ab, back and other postural muscles to stabilize the spine.

After you have mastered the skill of a still torso, you can challenge yourself even further by performing the exercises lying on rounded pieces of equipment such as fit balls or foam rollers. This type of exercise is known as dynamic stabilization.

Through stabilization and dynamic stabilization exercises, you will likely not only find yourself with a stronger core but also improved balance and coordination.

The Ideal Core Strengthening Program for You

The ideal core strengthening program is one that is individualized to fit into your lifestyle and works well with your personality. Rather than trying to knock out 10 or more ab-killers once or twice in hopes of getting a strong core, it is better to work with your healthcare provider, therapist, trainer or teacher to create a program you can and will do daily.

According to Eaton, creating a core strengthening program isn’t as simple as following a few exercises from a book or website. “Not every exercise is right for every person,” she says. “People with back or neck problems who have never exercised will need a very different program from athletes with an injury looking to get back in the game.”