Can a Strong Core Prevent Disc Herniations?
There are many different definitions of the ‘core’ depending on the source and context. The core can be thought of as the four layers of abdominal muscles: transversus abdominis, external and internal obliques, and rectus abdominis. We can also think about the core in more detail as the musculature that surrounds the entire lumbopelvic region. In addition to the abdominal muscles, this would include the deep muscles of the spine, the gluteal muscles posteriorly, the pelvic floor musculature inferiorly, the hip abductors and rotators laterally, and the diaphragm superiorly. These muscles inherently support the spine along with many other important structures including a huge array of incredibly intricate and strong ligaments.
When it comes to the intervertebral discs it is not fully understand why they behave in the way that they do in terms of pathology. While it is believed that trauma can result in disc herniations there is strong evidence to suggest that the majority of herniations are a part of the natural aging process (Brinjikji et al. 2015).
Very little research has been done looking at preventing disc herniations and therefore specific research looking at core strength is essentially non-existent. There is some research that looks at the efficiency of core strength exercises as conservative treatment for disc herniations, but *correlation does not imply causation*. Jeong et al. (2017) found that a lumbar stabilisation exercise not only improved proprioception sense but also had positive effects on lumbar disc function recovery in a group of 30 patients with disc herniations. A systematic review by Hahne et al. (2010) concluded that there was moderate evidence to favour stabilisation exercises over no treatment for patients with disc herniations.
I personally think core work is great. It makes me feel fully connected to my body, strong and centered. But let’s release the idea that it has some magical healing or protective powers when it comes to our already robust intervertebral discs. At the end of the day you can have a weak core and no issue with your discs, a weak core and disc issues, a strong core and disc issues or a strong core and no disc issues!
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References:
Brinjikji, W., et al. 2015. “Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations.” American Journal of Neuroradiology 36(4): 811-816.
Hahne, A., Ford, J., and McMeeken, J. 2010. “Conservative management of lumbar disc herniation with associated radiculopathy: a systematic review.” Spine 35(11): E488–E504.
Jeong, D., Choi, H., Kang, J., and Choi, H. 2017. “Effect of lumbar stabilization exercise on disc herniation index, sacral angle, and functional improvement in patients with lumbar disc herniation.” Journal of physical therapy science 29(12): 2121–2125.