Lower back pain is the culmination of many different problems that result in an irritating form of chronic pain. Since there are many possible causes, back pain can be tremendously difficult to treat and prevent.
However, there is a common issue that prevails in the majority of lower back pain cases. The problem is a weakness in what happens to be one of the primary muscles responsible for support of the lower back – Transverse abdominis (or TA).
A (fun) anatomy lesson
The Transverse Abdominis is the innermost layer of the group of muscles that we commonly refer to as our “abs.” Unfortunately, it gets lost in the shadow of its much more attractive big brother the rectus abdominis (the “6/8-pack”). However, Transverse Abdominis is a much more practical and useful muscle especially for those inflicted with lower back pain. It is often referred to as the body’s natural “weight belt” or “corset.” Its role as it contracts is to pull the abdominal wall in which helps to stabilise the trunk during movement.
Transverse Abdominis is therefore crucial in lower back pain management and prevention as it takes a major load off the spine when engaged correctly. We know that most people who suffer from lower back pain have a TA that does not “fire” (or activate) at the correct time. Your entire “core” helps stabilise the trunk but if TA activates first it sets the foundation for the rest of your core to be effective.
If TA is not trained in isolation initially, it won’t fire correctly resulting in other, weaker structures taking more of the load. They therefore fatigue or become damaged and inform your nervous system of this by sending pain signals.
Enough of the Anatomy lesson, how can I solve this issue?
Although I’ve ignited a severe hatred towards your troublesome TA, don’t break up with it yet. There is still hope. TA, like any muscle in our body, can be trained and improved with the tender love and care that it deserves. Hooray!
TA training requires a persistent focus. We need to train our nervous system to unconsciously fire TA during movements. Additionally, since TA needs to be active for a large part of our day, we need to build it as an endurance muscle. That’s why a large part of the advice below is simple enough for you to partake in it throughout the entire day.
Step one – Learn how to activate Transverse Abdominis
Pull your bellybutton in – As we learnt in our mini anatomy lesson above, TA brings the abdominal wall in. In order for your bellybutton to be “sucked in” TA will need to fire. This might be very easy for some people, but if its not it will get better.
- Lie on your back and pull your bellybutton in.
- Go into a 4-point kneeling position and suck your belly button in (now its against gravity).
Dig your thumbs into your side and push like you would on the toilet (sorry, but I’m serious)
TA is also the “toilet muscle.” Although this may be an inappropriate label, its 100% true. And this information can help us train it. Put your thumbs on your hips and push softly like you were going to the bathroom. Hopefully, you can feel something pushing back out on your thumbs as you “push.” Hello, TA!
- Try to increase the amount of force that the TA can apply back against your thumbs
- Perform this contraction a few times throughout the day.
Step 2 – Breathing and talking while TA remains contracted
After training your TA to activate, the next step is to build the muscle’s endurance. As we said earlier, the TA definitely needs to be an endurance muscle if it is going to help reduce lower back pain.
Endurance is this case does not mean repetitive contractions. But rather, the ability to hold a contraction for a prolonged period of time.
- Perform the TA activation exercises in step 1 (bellybutton in and pushing back against your thumb) for as long as you can while maintaining normal breathing and talking – this can take weeks to perfect. But with constant attention you will be amazed at TA’s ability to seamlessly remain contracted.
I used to perform this style of TA activation during elevator rides, at traffic lights and whenever I had to wait for some reason. Its a great one to throw into your daily routine and keep practicing in order to perfect. Your back will appreciate it.
Step 3 – Advanced exercise therapy to improve TA activation
The recommended protocol regarding exercises for lower back pain is to maintain a neutral spine while performing challenging tasks that activate the TA as well as the entire core.
Remember that the below tasks should be trained as endurance muscles (longer holds) while increasing the difficulty of the task if it becomes too easy.
- 4 point kneeling -> 4 point kneeling while raising one limb -> 4 point kneeling while raising two opposite limbs (arm and leg)
- Glute bridge -> glute bridge with one leg just off the floor -> glute bridge with one leg extended
- Plank on the knees -> plank on the toes -> plank on one leg
- Compound movements while contracting TA (Squat, lunge, push up, kettle bell swings)
Training TA is a lifelong process for most of us unfortunately. Like all our muscles, detraining effects can be rapid. Ignore TA for a while and those nagging pains will return. By making a real focused effort to improve TA activation, lower back pain can be reduced, relieved and prevented. Our Exercise Physiologist & Physiotherapists specialise in helping you activate your Transverse Abdominis once and for all.