I have seen some strong patients in my twenty years of practicing medicine: bodybuilders, professional athletes, Pilates instructors, laborers and others who depend on strength for their work.
“Weak” is not a term we would associate with them, but the longstanding back pain they suffer is the result of a weakness in a particular set of obscure muscles. The weak muscles in these very strong patients are the bracing muscles, which are unique muscles that require a particular approach to strengthen.
I introduce the concept of bracing muscles in my book, UPRISE–Back Pain Liberation by Tuning Your Body Guitar, which will have a major impact on the future care of back pain. In my book I promise to develop a set of exercises targeting these muscles that can improve the stability of everyone, not just people with chronic back pain.
Over the coming months, that promise will be fulfilled here as we release a series of videos to demonstrate these exercises.
In a few weeks local gyms will fill with new members on a New Year’s resolution bender, trying to get in shape for that spring vacation they’ve already purchased. Many will focus on “core” training, which has become an industry in itself. And yet an extraordinary number of people who are working on their core still experience back pain.
This is because you have to get the spine stabilized before you can “get in shape.”
Six-pack abs boost your ego but not your stability. Stability is the role of bracing muscles.
Trying to exercise heavily when your spine is not yet stable is like trying to build a second story on a home with a cracked foundation. It is an invitation to injury.
So which muscles are the bracing muscles?
Truthfully, they can be hard to find. They aren’t muscles you can flex and impress yourself with in the mirror. Exercising them doesn’t build their size, it builds their endurance and circulation.
There are six bracing muscles that pull your hip into a stable position in the socket, which collectively I call the gluteus stabilizers. They work in conjunction with the psoas muscle and the pelvic floor muscles to suspend the hip in “mid-air” inside the hip joint, providing stability while allowing movement.
When these bracing muscles weaken, the psoas spasms, the hip is pulled up into an impinged position and the pelvic floor weakens, leading to pain and dysfunction. That’s the theory, anyway.
Stability Exercise #1: The Clamshell
The first exercise appearing in the video above is called a clamshell.
The important points of technique are to keep the body rotation closed, stay leaning forward, and to keep the knee low. As with any exercise, rushing through it is not helpful.
Try to do 30-50 reps on each side every day for the next week until I introduce the next exercise.