So here’s the situation: you are a 40 year old who decides to play touch football over Thanksgiving. Let’s say you haven’t been as active over the past couple years but decide to trot out and throw around the pig skin anyways. Things seem to be fine until you reach out to grab your fourteen year old nephew and you feel your back tense up. You gingerly walk back towards the house as your back tightens up. As you get back to your house the first thing a family member suggests is to “work on your core.”

Would core strengthening have prevented this injury? What is the “core” anyways?

Let’s start with the idea of core muscles. When you look at our abdominal muscles there are layers.

Core Muscles

At the deepest layer there is the Transvere Abdominus, which acts like a corset. The next layers are the internal obliques, external obliques, and finally the Rectus Abominis (aka the 6 pack muscles). These abdominal muscles, coupled with the muscle that run along your sides and back make up your “core.”

Now that we understand these muscles, does strengthening this group help with low back pain? Like most things in life, it depends.

There are many structures in the low back that can elicit pain and as Physical Therapists it is our job to figure out the structure and form a plan to fix it. There is one specific type of low back pain that does respond best to core strengthening.
Common complaints from patients that would fall into this treatment group include1,2:

  • Urge to self-adjust, or pop back with temporary relief
  • Increasing frequency of low back pain (3 or more prior episodes)
  • Younger age (<40 years old)
  • Shaking or unnecessary movement when returning from bending over
  • Locking/catching in spine
  • Increased hamstring flexibility
  • Pregnancy or post-pregnancy

The common issue here is that the muscles are not able to properly control spine movement, which results in pain because tissues are stretched beyond what is normal and the body reacts through muscular spasm or repetitive injury to one of the back structures.

If this sounds like you, core strengthening would be a good way to start to reduce pain and promote overall function. If this doesn’t sound like your back pain core strengthening may help, but there may be more focused treatments that would fully resolve your pain.

Curious about other forms of low back pain?

Stay tuned as we dive into further forms of pain and treatment options. As always, don’t hesitate to reach out if you have questions, concerns, or would like a free screening for your pain or mobility issue.


Fritz JM, Cleland JA, Childs JD. Subgrouping patients with low back pain: evolution of a classification approach to physical therapy. J Orthop Sports Phys Ther. 2007; 37:290 –302.

Alrwaily M, Timko M, Schneider M et al. Treatment-Based Classification System for Low Back Pain: Revision and Update. Physical Therapy. 2016; 96:10-57-1056.