Core Muscle Strength and Spine Health: It's Not Just About the Abs

Orthopedic physicians and fitness trainers agree that even those who do regular strength-building exercises often overlook the so-called “core muscles” that make up the abdomen and lower back.

It’s not just about getting those sought-after “six pack abs.” Strengthening core muscles can contribute to improved spine health, better protecting amateur athletes or weekend warriors from lumbar stress fractures or other serious back injuries. When these core muscles contract, they stabilize the spine, pelvis and shoulder girdle  — and create a solid base of support. And that’s important for performing everyday activities, not just organized sports.

Even seasoned young athletes can suffer lower back injuries, says Roger Saldana, M.D., pediatric orthopedic surgeon with Miami Orthopedics & Sports Medicine Institute at Baptist Children’s Hospital.

“I have seen gymnasts with six packs and really strong cores that still get lumbar stress fractures,” says Dr. Saldana. “So even with a strong core and flexibility, if you stress this bone enough (in the lower back) it can certainly cause a stress fracture.”

Nonetheless, everyone can benefit from core muscle exercises, the most prescribed by fitness trainers being “plank” routine.

“Planks recruit a better balance of muscles on the front, sides and back of the body during exercise, compared to sit-ups, which target only the front muscles,” says Georgelena Saborio, exercise physiologist with Baptist Health South Florida. “The only equipment needed for the plank exercise is your own body and enough floor space to lie down on.”

If you have no current back issues, or if you got the go-ahead from your doctor if you’ve had back issues, then there are a few exercises you can do at home.

“If your back is healthy, you can do crunches or planks,” says Dr. Saldana. “For your lumbar muscles, there is also the ‘superman’ exercise, when you’re lying flat on your stomach and lifting your back up and trying to use your extensor muscles. Your physical therapist, with certain machines, can add to those exercises. All those exercises help maintain a strong core.”

There are many exercises that work the core muscles, such as variations on crunches and leg raises. The traditional sit-up doesn’t do an effective job for working out the full core. Here’s two of the top core muscle exercises (Reminder: you should clear these routines with a doctor or physical trainer before attempting, especially if you’ve had back problems.):


  • Lie flat on your stomach. Bend elbows to 90 degrees, and rest your body on your forearms with your palms flat on the floor. Align shoulders directly over your elbows. Legs are straight behind you with your ankles, knees and thighs touching.
  • In a push-up motion, raise your body off the floor, supporting your weight on your forearms and your toes. You should have a straight line from your feet to your head. Tighten your abdominal muscles, and do not let your stomach drop or allow for your hips to rise up. Keep your body in a straight line. Remember to breath.
  • Hold the pose. To start, aim to hold this position for 20 seconds. Repeat 3-5 times. To make it harder, as you advance try to hold the position a little longer each time.
  • Bend your knees. To make it easier, bend your knees so instead of balancing on your toes you are in a modified plank position with your lower body supported by your knees.


  • Begin by lying straight and face down on the floor or exercise mat. Extend your arms fully in front of you.
  • Simultaneously raise your arms, legs, and chest off of the floor and hold this contraction for 2 seconds. Try to squeeze your lower back. Exhale during this movement. (When holding the contracted position, you should look like superman when he is flying.)
  • Slowly lower your arms, legs and chest back down to the starting position while inhaling.
  • Repeat for the recommended amount of repetitions prescribed by your trainer.

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