Lumbar Neutral and Core Stabilization: The Essentials

If you have back pain, you’re often told you need to do exercises. You may have heard of core stabilization. What exactly is core stabilization, and why would exercises help your back pain when it already hurts to move?

Core stabilization is a series of exercises aimed at finding the best position in which to hold your back, and then strengthening in that position to create your own “brace” out of your muscles. You may be avoiding things like walking your dog because the yanking on the leash hurts, or you may not be able to sit up in bed because it feels like you’re not strong enough to support the weight of your own torso. So why do exercises?

One of the big points in physical therapy is the tactic of strengthening the muscles around a painful joint. Having more muscle strength decreases the amount of motion a joint is subjected to. If you have pain, decreasing the small sliding and twisting motions can reduce pain, because inflamed, injured, or low cartilage joint surfaces are often a source of discomfort. To repeat the idea, if you can decrease the grinding of joint surfaces, that means less pain. To decrease this motion, you must increase your strength in a very specific way.

So let’s get specific. The first thing you need to do is find your lumbar neutral. Some people are told to push the small of their back into the floor, but that is a less precise way of doing it. Let’s step it up by having you find your actual lumbar neutral. Start by lying on your back with your knees bent. Flatten your back by pushing the small of your back into the bed or floor, then arch the small of your back, creating a hollow between you and the surface. At some point between fully arched and fully flat, there is a position that feels just right. This is your lumbar neutral. Take a moment to arch and flatten until you find that spot, then freeze in the position that feels normal or natural. Practice this until you can find your lumbar neutral quickly and easily.

The next step is an isometric exercise, which means you’re going to tense your muscles without moving anything. While lying down, carefully hold your lumbar neutral position while tightening your abs, back and pelvic floor. Hold this for 10 seconds. Do this 10 times, twice a day. Once you’re good at that, try moving your arms, your legs, or both while maintaining your lumbar neutral position perfectly still. It might seem silly to do these exercises lying down. We start lying down because it is the easiest position.
The next step is to find and hold your lumbar neutral in sitting, standing, walking, and eventually while doing anything. Keep practicing and keep trying more challenging positions, such as while cooking, driving or walking your dog. Soon it will become a habit. You’ll know you’re a pro when you can hold your lumbar neutral while lifting weight.

If you’re struggling with back pain or having trouble finding and maintaining your lumbar neutral, a physical therapist can help guide you through these steps and tailor them to your specific needs. At BioMechanic Physical Therapy, we work one-on-one to identify the root of your pain and build strength safely and effectively. If you’re dealing with issues like these, call BioMechanic Physical Therapy at 757-917-7857 to schedule an appointment and get started on feeling better.