Does chronically contracting the abdominal muscles, specifically the transverse abdominis, contribute to the development of Lower Back Pain (LBP)?

From the Guidelines

Chronically contracting the abdominal muscles, specifically the transverse abdominis, can potentially contribute to the development of Lower Back Pain (LBP) due to muscle fatigue, altered breathing patterns, and changes in posture. This habit, often called "stomach gripping" or "abdominal bracing," creates constant tension in the core muscles, leading to overworked and tight muscles that can pull on the lower back and create imbalances in the body's natural alignment 1. The provided evidence from the American College of Physicians and the American Pain Society suggests that a focused history and physical examination can help place patients with low back pain into broad categories, but it does not directly address the role of abdominal muscle contraction in LBP development 1. However, it is essential to consider the potential consequences of chronic muscle tension on the lower back. To address this issue, practicing awareness of this unconscious habit, relaxed breathing, and incorporating gentle stretching and mindfulness techniques can help release chronic tension patterns and potentially reduce lower back discomfort. Regular movement breaks and exercises that promote proper core engagement can also help restore healthier muscle patterns.

Key Points to Consider

• Chronically contracting the abdominal muscles can lead to muscle fatigue and altered breathing patterns
• This habit can create imbalances in the body's natural alignment, potentially pulling on the lower back
• Practicing awareness, relaxed breathing, and gentle stretching can help release chronic tension patterns
• Regular movement breaks and exercises that promote proper core engagement can help restore healthier muscle patterns
• The evidence from the American College of Physicians and the American Pain Society provides guidance on evaluating and managing low back pain, but does not directly address the role of abdominal muscle contraction in LBP development 1.

Recommendations for Patients

• Practice becoming aware of the unconscious habit of holding tension in the abdomen
• Periodically check for tension in the abdomen and release it through relaxed breathing
• Incorporate gentle stretching for the abdominal and back muscles
• Use mindfulness techniques or body scan meditations to release chronic tension patterns
• Take regular movement breaks during prolonged sitting and engage in exercises that promote proper core engagement.

From the Research

Chronically Contracting Abdominal Muscles and Lower Back Pain

• The relationship between chronically contracting the abdominal muscles, specifically the transverse abdominis, and the development of Lower Back Pain (LBP) is complex and has been studied in various research papers 2, 3, 4, 5, 6.
• A study published in 2021 found that an 8-week program of hypopressive abdominal gymnastics (HAG) had beneficial effects on patients with chronic non-specific LBP, including increased diaphragm thickness and strength, as well as reduced pain intensity and disability 2.
• However, another study published in 2008 found that the transversus abdominis (TrA) preferential activation ratio, which is used to assess the effectiveness of abdominal hollowing exercises, is too imprecise to be of clinical use 6.
• Other studies have found that exercise interventions, such as Pilates, strength, and core-based exercises, can be effective in reducing pain and disability in adults with chronic LBP 3, 4, 5.
• The most effective interventions for reducing pain and disability in chronic LBP were found to be Pilates, mind-body, and core-based exercises, with Pilates having the highest likelihood of reducing pain (93%) and disability (98%) 5.

Key Findings

• Chronically contracting the abdominal muscles, specifically the transverse abdominis, may not be a direct contributor to the development of LBP 6.
• Exercise interventions, such as Pilates and core-based exercises, can be effective in reducing pain and disability in adults with chronic LBP 3, 4, 5.
• The transversus abdominis (TrA) preferential activation ratio is too imprecise to be of clinical use 6.
• Hypopressive abdominal gymnastics (HAG) may have beneficial effects on patients with chronic non-specific LBP, including increased diaphragm thickness and strength, as well as reduced pain intensity and disability 2.