Hey, Chain Reaction fam,

If I had a dollar for every patient who came in convinced their back pain was just a matter of weak abs, I could probably retire. I do not have those dollars. But I do have a lot of opinions about why that simplistic approach doesn’t work and why we need to have a more comprehensive approach.

Here's the thing. People use "core" and "abs" like they mean the same thing.

They don't.

Your abs are one wall of a much bigger system. Your core is more like a soda can: it has a front, sides, a back, a top, and a bottom. All of those walls have to work together to create a pressurized system that supports your spine and lets your limbs generate force. Crush one side of the can and the whole thing loses integrity.

So what are the other walls? I’m so glad you asked.

The diaphragm is the top of the can. It attaches to your rib cage and your spine. When it's not working well, it pulls on your ribs and abdominals and starts a chain reaction that affects how your whole trunk moves. (See what I did there.)

The pelvic floor is the bottom. Wildly underrated, wildly undertreated. Most people think it's only a women's-during-pregnancy thing. It is not. Turns out, we’ve all got a pelvic floor, which means we all need to pay attention to it.

The multifidi are the back wall, the deepest spinal stabilizers you have. They run all the way from your sacrum to your neck. When they're not doing their job, your back can pay the price.

And here's another thing worth knowing: most traditional ab work, like crunches, targets the rectus abdominis, which is the most superficial layer. The deepest layer, the transversus abdominis, and the layers on top, the obliques are often fairly ignored. Those other three layers are what wrap around the trunk and actually provide lateral and transverse support.

Only working on your abs to fix your back pain is like only replacing one brake rotor in your car and expecting to drive across the country. You've addressed something. You haven't addressed the full problem.

If you want to see some exercises that actually target the full system, I put together a quick resource here. And if you want to go deeper on what's actually driving your pain, you know where to find me.

Yours in fearless movement, Jessie

Know someone that would benefit from more fearless movement? Please forward this info along, and have them click here to join my newsletter!

Dr. Jessie Duppler, PT, DPT​
​Owner & Physical Therapist
Chain Reaction Physical Therapy
​www.chainreactionpt.com​
​​
621 Miller Valley Rd
Suite A
Prescott, AZ 86301
​(928) 379-6390​

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