Low Back Pain with Movement Coordination Impairments/Core Stability Deficits

The most important thing to remember when it comes to your low back is that it is a strong and stable structure. When we mention core stability, that does not mean your back is unstable but that it may benefit from getting stronger to complete daily tasks and sports activities.

Core stability training should target all aspects of the "corset" including the front, sides, and back as well as scapular stabilizers and hip musculature. It is important to start the program at the appropriate level - too low and you're wasting your time, too high and you may injure yourself or just compensate. The lowest level will start with basic activation exercises.

The speed and resistance should increase and include coordinated movements in all planes of motion. Planned movements should progress to reactionary in response to external perturbations.

There is a benefit to static holds, though a complete program should include both static and dynamic movements and progress toward activity or sport-specific demands. The athlete should continue a strengthening program for the upper and lower body in a pain-free range which may require reducing weight and/or complexity of their program. Cardio/ conditioning should continue so that they are ready to return as quickly as possible in "game shape." Modifications may include use of a bike or an elliptical in place of running, sprinting, or swimming.

They should complete the activity most similar to sport that they can complete pain-free. The athlete should progress through a return to sport program starting with individual drills then group drills then move to simulated game play and finally back to live action.