For the past 25 years, people have been obsessed with strengthening their “core” to fix or prevent low back pain. And I’ll admit it—25 years ago, fresh from Australia, I was fully on board the “core” bandwagon. How could I not be? I had trained under world-renowned “core” gurus like Paul Hodges, Peter O’Sullivan, and Julie Hides (whom I still admire).
Looking back, I cringe at the way I used to diagnose nearly every patient with low back pain as having “clinical instability,” convinced that the right core exercises were the magic solution. And when some patients improved, my belief in core stability was only reinforced—classic confirmation bias at work!
But after a decade of prescribing endless core exercises and diving into newer research, I had to face the truth: I had been fooling myself—and worse, I may have been unintentionally harming some of my patients. By telling them their spines moved “too much,” I might have planted the idea that their backs were fragile, leading them to become overly protective and fearful of movement. Ironically, that fear could have made their pain even worse.
Don’t get me wrong—strengthening and loading the spine still has its place. But these days, I prefer to give my patients exercises without making them feel broken or weak just because their “core” isn’t up to some mythical standard.
Now, I love sharing these two quotes with my patients:
“We don’t become weak because we get old,
but we become old because we get weak.”
“You can’t go wrong becoming strong.”
More often than not, I tell my patients to stop obsessing over their “core” and simply do the activities they enjoy—playing, dancing, lifting up grandkids, jumping jacks, walking, or twisting. The body thrives on movement, and sometimes, the real harm isn’t a weak core—it’s the fear of using it.