The Transversus Abdominus – the secret weapon against Lower Back Pain
Most people know that strong abdominal muscles help with lower back pain, but just doing regular sit ups is not necessarily the answer – we must be more specific than this and make sure we are activating specific muscles in the correct way for abdominal exercises to have any effect on back pain at all. However, when done correctly specific abdominal exercises can have a huge impact on helping lower back pain.
The most important abdominal muscle in preventing and rehabilitating lower back pain is the Transversus Abdominus (TA). The TA is the deepest core muscle, and is a large muscle that wraps horizontally around the body like a corset, starting from the ribs and continuing down to the pelvis.
When the TA tightens, it functions to form a deep internal corset that acts to draw the abdomen in and stabilize the spine during movement. The pelvic floor and buttock muscles also help the TA correct lower back pain by helping to stabilise the pelvis.
Many studies have shown that this pattern of protection is disrupted in patients with low back pain, and isolated strengthening of these muscles has been proven to reduce back pain.
In people who don’t have back pain, the TA is activated at a low level all of the time. When you go to perform any movement, such as bending forwards or lifting something, the TA tightens before you perform the movement to protect the spine. In people who have back pain, the TA does not tighten, leaving the spine vulnerable.
Food for thought – does back pain cause the TA to become weak and lazy, or does a weak TA cause the back pain in the first place?
It is like the chicken and the egg – and it works both ways. If you have a weak TA, then you are much more likely to injure your back or have pain in the first place. However, once you have back pain, the pain itself causes the muscles to become inhibited and not work properly. So it is a viscous cycle, and unless you break this cycle by strengthening and retraining the muscles, you are set up for a life of chronic back pain.
So what is the best way to strengthen these muscles? Specific retraining of these muscles is very important, as you can actually perform abdominal exercises without even using your TA. A lot of people think they are doing sit ups, or plank style exercises and using their abdominals correctly, when in actual fact they are only strengthening their more superficial abdominal muscles and not using their TA at all.
Pilates is the best way to retrain your core muscles, as with every movement you perform you first have to activate your TA, and keep it tight throughout the movement. Pilates starts of basic, learning how to activate the TA correctly, and progresses from there. In Pilates you strengthen the TA by not only directly working the abdominals specifically, but also when working other areas of the body as well such as the arms and legs, as we need to retrain the TA to tighten before we do any movement in life, not just whilst performing abdominal exercises.
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