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Spring is in the air and the pressure is officially on to get those winter bods “beach ready”. Specifically, for some, that means focusing on trimming down that stubborn tummy bulge to reveal the glorified six-pack. But those Baywatch drool-worthy abdominals should not be your main focus when working out your core. In actuality, there is a group of muscles that you should be directing your attention to in order to achieve true Lumbopelvic control and stability. This may not sound as aspirational, but true strength and stabilization in these muscles can assist those with low back pain, postpartum incontinence, and decrease the risk of injury for recreational or competitive athletes. Now doesn’t that sound more important than just looking good in a swimsuit?

Let’s start with the basics:

What are the muscles that incorporate the lumbopelvic region? Instead of unnecessarily listing off a dozen Latin based names for each of the muscles, it is more important to understand there are “local” and “global” systems of muscles that provide direct/indirect support to the lower back. These are based on their attachment points, as some directly attach to the lumbar spine, while others attach to the rib cage and pelvic girdle or your hips and sit bones. These muscles contract and relax in order to provide static and dynamic control to the lumbar spine during changing postures and functional movements with our upper and lower extremities throughout our daily lives. Without proper activation, recruitment, and coordination “clinical instability” can result. This essentially means the spine can no longer control the movement of its individual segments as a unit under different loads and external forces increasing instances of further weakness and pain.

So again, why is it important to obtain Lumbopelvic control and stability:

  • 50% of the population WILL experience low back pain; the cost to treat low back pain has been comparable to conditions such as heart disease and diabetes.
  • 20 million people in the U.S are affected by urinary incontinence (UI), the “involuntary loss of urine which is objectively a demonstrable, social, and hygienic problem”. 26-46% are women facing costs of up to $750 per year on UI management.

Both of these above conditions have been shown to be directly linked to lumbopelvic weakness and instability.

But what if you are highly active, maybe someone who has just completed the Boston Marathon?

How does working on lumbopelvic control and coordination apply to you? Proper activation of these muscles can help to dissipate the load on the spine at initial contact and push off. They can also assist in the rotational component in order to demonstrate reciprocal arm swing, which has been shown to have a direct relationship with speed. Finally, lumbopelvic control is important in maintaining pelvic neutrality and/or level hips during the single-leg stance of running. Runners with muscular dysfunction of the lumbopelvic region are more likely to demonstrate an inefficient gait cycle and an increased risk of injury due to poor management of ground reaction forces through their hips and lumbar spine.

Regardless if you have or don’t have a current condition or impairment mentioned above, reach out to POST Physical Therapy to discuss an evaluation of your lumbopelvic region and make an appointment today or contact info@postpt.com for more details!

References:

Bruno, P. (2014). The use of “stabilization exercises” to affect neuromuscular control in the lumbopelvic region: A narrative review. Retrieved April 4, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025082/pdf/jcca_v58_2d_p119-bruno.pdf.

Ghaderi, F., & OskOuei, A. (2014). Physiotherapy for Women with Stress Urinary Incontinence: A Review Article. Journal of Physical Therapy Science, 26(9), 1493-1499. Retrieved April 4, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175265/pdf/jpts-26-1493.pdf.

Hodges, P. (2003). Pain and motor control of the lumbopelvic region: Effect and possible mechanisms. Journal of Electromyography and Kinesiology, 13, 361-370. Retrieved April 4, 2019, from http://activepilates.com.br/producoes/Pain-motor-control-lumbopelvic-region.pdf

Ryan E, Lopez R, Jacobs PL. Running injuries and core stability. In Cleary MA, Eberman LE, Odai ML, eds. Proceedings of the Fifth Annual College of Education Research Conference: Section on Allied Health Professions. [online conference proceedings]. April 2006;1:36-39. Miami: Florida International University.
http://coeweb.fiu.edu/research_conference/.