Functional Rehabilitation of Low Back Pain With Core Stabilization Exercises: Suggestions for Exercises and Progressions in Athletes

Joshua Johnson, Utah State University

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Introduction: Low back pain is very common in the adult population and accounts for more time lost form work than other diagnoses. It also affects athlete's at all different levels of competition and results in missed practice and game time. Diagnosing and treating a specific pathology is often difficult and because clinical evaluation and raidologic studies are often unable to find a root cause. A popular treatment approach with a high volume of anecdotal evidence is the use of core stabilization exercise in the treatment of low back pain.

Purpose: To evaluate exercise as a treatment for low back pain with a specific emphasis on core stabilization and provide an outline of exercises and progression to help clinicians in treating the athlete with low back pain.

Methods: A search of electronic databases was performed including; PubMed, SPORTDiscus, Google Scholar, and Cochran Databased. Key Words used: Lumbar stabilization, core stabilization, low back pain, athletes, exercise, and core strengthening and any combination of these words.

Exercises and Progressions: Based on the search of electronic databases their does appear to be some efficacy established in the general population of core stabilization exercises. However, at this time does not appear to be superior to other exercise interventions. There are no specific studies involving athletes so evidence based treatment of athletes using core stabilization is limited. The literature seems to establish a need for total core muscle recruitment to stabilized the spine and does not identify one specific a need for total core muscle recruitment to stabilize the spine and does not identify one specific muscle as being critical for spinal stability. The program designed is based on firing of the entire core muscular to stabilize the spine with an emphasis to functional movements that imitate sport-like situations. The exercises chosen were based on how effectively they challenge the muscle groups without causing loads that may be detrimental to recovery and pain free movement.

Conclusion: Due to the demands placed on the athlete's lumbar vertebrae, spinal instability may be a significant source of pain in athlete not diagnosed with other pathologies. While at this time there is insufficient evidence to support or refute the use of stabilization exercise in the treatment of low back pain in athlete's, this paper hopefully gives insight into some exercises that may be used to reestablish core muscle strength and endurance.