What is lumbar stabilization?
Lumbar stabilization or core strengthening helps the patient focus on supporting and strengthening the trunk of the body (the muscles around the spine). It teaches patients how to move in a manner that protects the spine – including safe methods of carrying or transferring heavy loads – and how to separate movement of the extremities from the spine.
A lumbar stabilization program includes education and exercises. It is designed to help patients with everyday functionality, as well as teach preventative measures to maintain good health.
Physical therapists work with patients to be aware of their posture, movement, and positioning, with the goal of performing safe movements that reduce pain or symptoms. Exercises start at a basic level and become more advanced as the patient gains stability. To condition the muscles and achieve endurance, exercises will need to be performed on a daily basis.
Overall, a lumbar stabilization program addresses balance, coordination, flexibility, endurance and strength.
There are three basic phases of lumbar stabilization:
- Phase 1: Localized conditioning where the patient practices neutral positioning, and focuses on the abdominal area as well as the multifudus muscle of the spine
- Phase 2: Building on holding neutral positions in Phase 1, the second phase adds more challenging exercises to maintain spinal position control and strengthening of the trunk
- Phase 3: The transitional phase where the exercises begin to incorporate work or sports specific movements and training; phase 3 is an important phase for prevention of symptom re-occurrence and successful long-term outcomes
Neutral position is key to lumbar stabilization as it minimizes stress to the spine. Exercises focus on and depend on the patient’s ability to maintain neutral. Find neutral by rotating the pelvis and slightly curving the spine until it feels the most stable. It should feel as pain-free as possible, and there should be a sense of proper balance. Neutral is different for each person due to body type and symptoms, but it should be based on a properly aligned posture.