A Postural Alignment Specialist Is Begging You To Do *This* Before Core Exercises if You Have Back Pain

Photo: Getty Images/Javier Zayas Photography
For as long as I can remember, I've been told I need to do more core work to fix my lower back. My lumbar spine has always been a bit swayed. As a teenage ballet dancer, one of the most common corrections I'd get from teachers was, "Tuck in your popo!" (Which would be your butt, BTW.)

Now that my favorite hobby is running, I'll often see in race photos (especially during the later miles) that it looks like I'm leaving my butt half a foot behind the rest of my body—not the most efficient form, nor the most comfortable. My husband knows that if there's anywhere I'm going to ask for a massage, it's my low back. All that arching leaves it constantly aching.

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Physical therapists, trainers, and coaches have all prescribed the same fix over and over: lower ab work to strengthen that section of my body so I can hold my spine in a better position. But no matter how many core strengthening exercises for lower back pain I add to my routine, I've never really been able to solve the problem.

When I told all this to movement coach and postural alignment specialist Emily DePauw, she wasn't the least bit surprised.

"People think, okay, well if I strengthen my abs, then I can provide a structure of support that will reduce the instability in my spine. It makes a lot of sense because opposite your spine is your abs," she says. "It's not an entirely uninformed thought; it's just an incomplete thought."

That's because, she says, core work itself won't fix imbalances or asymmetries in your torso. For instance, when assessing my posture, she noticed that one of my hips is tilted further than the other, and that leg naturally rotates out further, twisting my spine off-balance, and causing me to arch my lower back to compensate. "When you resolve the rotation in the body, then you can recruit your obliques and your transverse abs [deep core stabilizers] much more symmetrically from right to left. And then you really are strengthening [to support] your spine better, but you wanna resolve these imbalances first," she says.

She adds that even if lower ab weakness is the reason for your lower back pain, it's worth doing some Sherlock Holmes work to figure out why they're weak. "It's not like these muscles just decided one day to be non-participatory and just be weak for an arbitrary reason," says DePauw. "This is because they're not in a position of leverage that they should be in to be used. Weakness in the core is because of a misalignment, and you wanna address the misalignment first."

"Weakness in the core is because of a misalignment, and you wanna address the misalignment first." —Emily DePauw

If you think a misalignment may be behind your own back pain, you're likely right. "Pretty much everyone is dealing with some sort of imbalance just as a result of our lifestyles and our habits," DePauw says. That could be anything from consistently sitting cross-legged, to a habit of leaning more into one hip than the other when you're just standing around, or even a hobby like surfing or snowboarding that forces you to favor one side.

You can quickly tell if you may have an imbalance if, for instance, you find you always get injured on the same side of your body, if the bottoms of your shoes wear down unevenly between your left and right feet, or if you notice more strength or flexibility on one side of your body. Or you can do a simple test: Stand up, close your eyes, and see if it feels like you have more weight in one foot than the other. A postural alignment specialist like DePauw or even a physical therapist could also help point out asymmetries, and give you some ways to fix them.

It's not that we need to be perfectly symmetrical. Just ask any pro tennis or golf player—they'll probably never have equal strength on both sides, and that's fine. "You just need to be functional," DePauw says. That means balancing out any misalignments before working on things like core strength.

For my tilted pelvis and uneven leg rotation, DePauw gave me three short exercises I could do lying on the floor to retrain the alignment in my hips. After just a few days of regular practice, I noticed my lower back lying flatter against the ground.

"You're gonna get so much more out of your core work because you actually have access to your abs in a better way," she told me. "I definitely am not villainizing abdominal work because it’s super helpful, super important. You just wanna position yourself for success first. Do this first, and then you're gonna get so much more juice from the squeeze."

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