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Core exercises and back pain

People suffering from back pain often think resting is the most effective way to get rid of the pain. Although it may feel good to rest, getting up and moving is best for your back. One important exercise for back pain is abdominal work, but there’s a catch. Core exercises may be causing your back pain, too. Not all, but many of your favorite ab workouts are back busters. In fact, exercise is just one form of treatment necessary for most cases of back pain.

The problem with those doing core exercises is some rely on the “core work” they did in high school or see on a fitness video. Too often, core training is done with good intentions but poor execution. Read on to learn more about the core and the worst 20 core exercises giving you back pain.

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Core Training and Back Pain

Your core is essential for spine stability and health. There’s more to it than just having nice looking abs. Your core allows your hips, knees, back, abdomen, and pelvis to work together as one healthy unit.

Anatomy 101: Get to Know Your Core

To better understand why you need to rethink your core training, it’s important to get to know the anatomy of the core first. No, the core isn’t just abdominals. The muscles that make up your core are:

Erector Spinae

The erector spinae is a group of back extensors. It’s responsible for trunk extension, allowing you to bend backward. The erector spinae work with the obliques for lateral flexion so you could bend your body to the side.


Multifidus is responsible for stabilizing the spine. When you move, it holds your spine still.


The obliques are responsible for trunk rotation. They also work with the rectus abdominus and erector spinae to perform lateral flexion (bending to the side).

Rectus abdominus

The rectus abdominus is also called trunk flexors. It lets you bend forward. Rectus abdominus also works with erector spinae and obliques to perform lateral flexion.

Transverse abdominus

This muscle is the deepest core muscle of the three abdominal muscles.

Why You Need Core Work

core exercises back pain

You must include core training in your health and wellness plan. Most of your daily activities and athletics require core muscles and core strength for stamina and support. Core work is essential for balance and stability, especially when you’re sitting at a desk at work, squatting at the gym, or playing ball. As you can see from the quick anatomy snapshot, the core allows you to complete all the movements you do every day.

When you do core work, your body benefit from:

  • Strength and power of the torso
  • Muscle balance and muscles working together properly during movement
  • Balanced distribution of body weight
  • Healthy posture
  • Reduction in back, knee, and hip pain
  • Improved fine motor skills
  • Injury prevention
  • Improved agility and response

Why Does My Back Hurt?

Right now, you’re probably thinking, “Wait! You just said core training and exercises are good for back pain, so why does my back hurt when I do abs exercises?”

To answer that, we need to go back to anatomy. When people say “core,” they think abs. Many of the “abs exercises” target only one muscle group and put unnecessary pressure on the spine. One feature of many abs exercises is unnecessary loading on your spine, especially on the disks and vertebrae in the lower back.

Unfortunately, many of the core exercises with which people are comfortable are guilty of this.

Brief History of the Sit-Ups Epidemic

core exercises sit ups

It isn’t your fault. The focus on the transverse abdominus is a trend straight from the 1990s, according to the NY Times.

An Australian physiotherapy lab conducted a study in the 1990s that attempted to figure out the source of back pain. The researchers placed electrodes on participants’ midsections before instructing them to quickly flap their arms. The source of the back pain, according to team was the transversus abdominus. In those with healthy backs, the rectus abdominus tightened to stabilize the spine. In participants with low back pain, the transversus abdominus didn’t fire as early to stabilize the spine.

And so, a theory was born that says if people tucked their tummy when they exercise, back pain would go away. Of course, when the fitness world caught on, videos and classes exploded with exercises for the transversus abdominus.

Sports medicine professionals cite this as just one of the core training myths that dominate past and current exercise cultures. When exercises focus on only one area or muscle, it pulls the body out of alignment, causing imbalances and often resulting in painful back injuries.

Rethink Your Core Exercises

Now, if you study the anatomy of the core, you’ll find out that core training is more than abdominal exercises. Your core is more of a corset than a washboard. Core training includes exercises for the hips, the obliques, and the back. What good are washboard abs if you have to limp around with a back injury because of them?

When doing core exercises, focus on all the muscles in the back. Your core exercises must be comprehensive and functional. Working the core involves all the core functions I’ve mentioned earlier for improved stability and back health:

  • Trunk flexion and extension
  • Lateral flexion
  • Hip strengthening
  • Stability

With that in mind, here are a few of the worst core exercises giving you back pain.

Worst Core Exercises for Back Pain

Before getting started on core exercises, remember a couple safety tips.

First, don’t start working your core if you already have back pain. You need to speak with your physician or physical therapist before trying any new workout plan. The reason: you need to know the cause of your low back pain.

Second, don’t give up core exercises and physical therapy just because your back is feeling better.

Now you are ready to begin.

When you are strengthening your core, skip these exercises to avoid back pain.

1. Sit-ups

Stop doing sit-ups. You can find better exercises that give you better results without the back pain. Sit-ups get sloppy and put too much pressure on the discs.

According to Harvard Health, one of the reasons sit-ups are so bad for your back is it forces your spine to the floor. The curved part of your spine (lumbar) presses into the floor, forcing the hip flexors to do all the work. This pulls on the vertebrae in the lower back.

2. Leg Lifts

The double leg lift is another move you cannot avoid seeing in the gym. It is credited for strengthening the core, but does it really deliver?

If you suffer from back pain, lifting both legs off the floor puts all the pressure on the spine, forcing it to hold the legs up. If you don’t have enough core strength to support the legs, your spine takes a beating.

3. Roman twist

If you have back pain, you should avoid abdominal exercises that require you to twist. These exercises are especially bad for the back if you have an existing herniation.

You must wait for the herniation to heal before you start or resume any abdominal twisting motion. Additional abdominal twisting exercises include the mason twist, Russian twist, and lunges with rotations.

If you have herniated discs, you need to be cautious when doing any back or abdominal exercises. You are better off doing anti-rotations with the band.

4. Plank

Timed plank is one of the most over-prescribed exercise in yoga classes, fitness routines, and exercise videos. If you just hold it, our core will be solid and strong. Right? Not so fast.

Timed supine planks set you up for back pain. The body should be in line, the core should be tight, the shoulders shouldn’t sink, and the hips shouldn’t sag. Well, in most timed planks, all occur. Of course, the longer you’re expected to hold the plank, the worse it becomes. Again, poor form causes a bend in the lumbar back, resulting in significant pain.

5. Bosu Ball push-up

You can do some great things with the Bosu Ball, especially if you have low back pain. Physical therapists use it to improve stability and balance.

Bosu Ball is also used to enhance exercises. When you do a push-up on a Bosu Ball, it forces you to engage your core, but if you have a weak core, your lower back will sag and bear unnecessary force as it tries to stabilize you.

6. Overhead medicine ball slam

This is a good exercise, it just isn’t the best for your back.

The overhead medicine ball exercise activates the abdominals as you lift and slam the ball to the floor. Unfortunately, when done improperly, the spine could extend beyond its range of motion and the core could get sloppy.

7. Incline/decline sit-ups

One of the troubles with the incline sit-up is poor execution. With proper form and muscle control, it can be a good exercise for the core, but fast tempos and poor posture are bad on the back.

Two things work against you with the exercise: (1) shear force on the lumbar spine and (2) destabilization of the spine. When lying in the downward motion, it elongates the spine and puts pressure on it at the same time. The trouble with an elongated spine is more range of motion. More available range-of-motion prevents stability, and as a result, the spine shifts when you sit up.

8. Hanging leg lift

The hanging leg lift is not the same as the sit-ups you would do on the floor with your legs straight. The problem with the hanging leg lift is force.

You engage your hip flexor muscles when you do the hanging leg lift. It doesn’t force you to engage the core. It forces you to use your back instead. When your legs reach 90 degrees, your hips begin to shift and compensate for the movement. You don’t actually activate the abdominals until your raise your legs past 90 degrees. Most people can’t get that far.

9. Ab roller

A word of advice: if it is an “easy” solution with big results, it is probably bad for you. Exercise takes a little effort and hard work. Actually, it takes a lot of it. The ab roller is one of those devices with big promises. Unfortunately, you don’t require any training to use it, and the faster you move it to get more reps in, the worse it is on your back.

10. Bicycle crunches

Bicycles while lying on your back combine two lower back no-nos: crunch position and both legs off the floor. This exercise demands a lot from your core, and if your core isn’t strong enough, your back pain will get worse. If you don’t have a strong core or if you experience back pain, leave one leg straight and bend the other knee instead.

11. Ab twist machine

The ab machines are common back pain culprits. It promises efficiency and ease, but they also promote poor form. When you sit in an ab twist machine, you do three bad back movements all at once: flexion, bending, and rotation, all while under a load.

12. Prone superman

The prone superman causes too much internal pressure on the spine. The force on the spine with this exercise is a level that exceeds normal back control, which can cause or exacerbate back injuries. The prone superman puts the ligaments, discs, and joints at risk.

13. Glute-ham-developer (GHD) ball toss

If you know a CrossFitter, you know the GHD ball toss. It is one of the most dangerous and careless exercises for your back.

Sure, it activates the hips, which is great for spine and core stabilization, but the form is terrible for the back. The GHD ball toss forces the spine past its safe range-of-motion, which puts too much load on the discs in the back. The spine is forced to go through unnatural range of motion with large loads it can’t handle.

14. Side bends

Your trainer tells you to grab a dumbbell, stand tall, and do a crunch to the side. This exercise is called an oblique crunch or abdominal side bend. One of the biggest mistakes people make when doing the side bend is not having weight in both hands. Usually, people put a weight in only one hand. When doing the bend, you should not move your hips or shift your spine. Unfortunately, those are the first things people do when bending.

15. Crunches

Aren’t crunches the epitome of ab training. Sure, that is what you were taught, but it is far from the truth. Crunches kill your back. When you do crunches, you are probably pulling up on your head, allowing your back to leave the mat, and crunching up too high. These actions put unnecessary pressure on the spine. Opt for reverse crunches instead.

16. Roman chair leg raise

The roman chair leg raise is a no-no because of the intense pressure and stress the raise puts on the lower back. There are a couple problems with this exercise: you lean forward (which is not good for low back pain) and hundreds of pounds of force on the spine.

17. Lying sit-up

Here we are again with the sit-ups. The lying sit-up is a common exercise in Pilates. It promises line activation and core strength. Unfortunately, if you don’t start out with core strength, you are causing a lot of back pain.

The lying sit-up requires you to extend your legs straight out while you roll the back up to a sitting position. If you are engaging only hip flexors, they pull at the lower back and cause a lot of pain.

18. Burpees

The Burpee get a lot of credit for killing calories and strengthening the entire body, but if you have a bad back, you get more pain than it’s worth. The exercise activates many muscles in the body, especially in the lower body. If your muscles are weak, you push too hard, you go too fast, or you slam yourself to the ground too hard, you will burn up calories and your back.

19. Bent-over rows

I mention bent-over rows because they work the back muscles and among others involved in core strength. A strong posterior chain is great for core stability and function, but with all the sitting you do all day, bending over to row is the worst thing you can do for back pain. The back, spine, and core MUST be strong enough already before you try to strengthen them with bent-over rows.

20. Seated ab crunch

Here is why so many people love the seated ab crunch machine: abs while sitting. Who wouldn’t? If you have back pain you shouldn’t.

I am going to bet that sitting is what caused your back pain in the first place. Now, when you perform the crunch action on the machine, you bend forward. Again, bad for your low back pain. You should be extending your back –not bowing to the injury. Also, the seated ab crunch is a machine that is poorly designed. It asks for you to get hurt.

If I have killed your ab routine, reconsider what you’re doing. It isn’t that doing these will absolutely cause back pain, but they likely will increase back stress, especially if done improperly, like most are, and possibly lead to low back pain.

The options are limitless. Remember, no one-size-fits-all approach to fitness will help you achieve your goals. You need a core exercise plan that considers your activity levels, your goals, and your body.

Stop trying to get “stronger abs” in box, and call. COR physical therapists for a consultation. Not only can we assist with back pain, but we can also help you transform your workout to prevent back pain.

If YOU are in the Bay Area, Apply for a BACK PAIN EVALUATION