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Stabilization Training

Peer Reviewed
Lumbar Stabilization training is widely used by physical therapists to treat low back pain. It involves strengthening the trunk and pelvic musculature to address the imbalances and deficits that develop in people with chronic LBP. It is also designed to help patients resume their normal activities.

Research indicates an association between chronic low back pain and muscle weakness. The trunk and pelvic muscles are most affected. Stabilization training can improve the strength, endurance, balance and control of these muscles.

The patient first learns how to find the "neutral" posture. The neutral position is somewhere between an arched back and a flat back. Ideally it is a position that minimizes pain. With the neutral spine posture, the patient performs a series of exercises. During the exercise the arms and/or legs are moved while the trunk and pelvic muscles work to hold the neutral position. A variety of exercise positions are utilized including on the stomach, back, all fours, sitting and standing. As the patient improves, the exercises are modified to make them more challenging.

Recent research has demonstrated the importance of two muscle groups in particular. The Transversis Abdominis and the Multifidi muscles perform critical functions during spinal stabilization. Therapists can employ stabilization routines that selectively emphasize control of these muscles. In studies, patients have demonstrated superior outcomes in programs that emphasize these muscles.

Stabilization training is used for a variety of low back pain diagnoses and is generally safe for most patients. For more information, please consult a qualified physical therapist.

Updated on: 01/12/10
Harry N. Herkowitz, MD
Strengthening of spinal muscles is paramount in the treatment of spinal pain. The deep spinal muscles (multifidi) may be significantly atrophied in those with chronic low back pain. Furthermore, rehabilitation of these muscles after surgical intervention may take months to years before their maximal strength is obtained. The importance of the abdominal muscles (obliques and transversus) on their ability to increase intra-abdominal pressures and thus relieve stress on the spine should not be overlooked. Although stabilization exercises are effective in treating low back pain, one must remember that disc and joint nutrition are aided through movement of the spine and thus, always holding the spine in one position may be deleterious if taken to an extreme.
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