“That’s the thing that scares me the most, is that I don’t know if it’s ever going to stop.”
“That’s the thing that scares me the most, is that I don’t
know if it’s ever going to stop.” Is a great line from one of my favorite
YouTube short film clips: It’s Not About
the Nail. But the phrase also applies to my own worries about our constant
attempt to so easily blame a weak core as the source of back pain. Some
researchers and clinicians have been working to debunk this commonly held
misbelief for some time, see Eyal Lederman’s The Myth of
Core Stability or Peter O’Sullivan’s Core
Stability: separating facts from fiction as a couple examples. One would
think that we could move past this illusive search for the weak core impairment
that needs fixed to eliminate back pain.
That’s the thing that scares me the most, is that I don’t know if it’s ever going to stop.
I get an email feed
from Pain Week as one of many sources to stay current with pain research and
current topics around pain. The most recent headline was: AVOIDING
RUNNER'S CHRONIC BACK PAIN: IT'S ALL IN THE CORE. Needless to say, it perked my interest so I
read the story. I’m guessing the opening few lines sounded very convincing to
many, especially when they referred to the high-level technology (force place,
motion detection, and computer simulation) used in the research. The results
have to be good if they used high-level technology, right?
Then you get to the
results: “When your deep core is weak, your body is able to compensate in
a way that allows you to essentially run the same way. But that increases the
load on your spine in a way that may lead to low back pain.” I have to do is a
few planks and my pain will go away, right?
That’s the thing that scares me the most, is that I don’t know if it’s ever going to stop.
I dug a bit deeper
into results by following the links to another news story. It came from Newswise, so the information should be wise, right? The
title of this press release: “Study Uncovers Potential Key to Preventing Back
Pain in Runners” and it provide the findings summary in the second paragraph. “The
study, published in the Journal of Biomechanics, suggests that runners with weak deep core
muscles are at higher risk of developing low back pain. And, unfortunately,
most people’s deep core muscles aren’t nearly as strong as they should be.”
That’s the thing that scares me the most, is that I don’t know if it’s ever going to stop.
Trying to figure out how the authors came to this
conclusion, I decided not to take the news media’s slant on the research and
went straight to the paper, found here.
So how was the study done? They used data from 3 people that had consented to a
previously published study. They took that data and made computer simulations
of running and then ran various computer simulations of what would happen if
you weakened some of the core muscles. Their findings showed that taking away
some of the muscles lead to increased axial load onto the spine. Their findings
suggest that all deep core muscles contribute to maintaining stability of the
spine. I can agree with all of these. I struggle with how these findings
suggest that just getting your core strong enough is all that needs to be done
to prevent back pain.
That’s the thing that scares me the most, is that I don’t know if it’s ever going to stop.
One limitation listed in the study that never made it to the
news media reports listed by the authors was that because it was a computer
simulation running kinematics were forced to stay the same after the muscle
weakness was simulated into the model and thus it is unknown if people may
alter kinematics to compensate for muscle weakness. Oh, and one more limitation
provided by the authors: “It is unknown if this phenomenon is entirely
realistic clinically.”
Once again, we see the public being feed a story that isn’t
accurate about back pain and the dreaded core weakness as the cause by twisting
up research to make inaccurate claims.
That’s the thing that scares me the most, is that I don’t know if it’s ever going to stop.via Dr. Kory Zimney, DPT
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