Dear Alice,

For as long as I can remember, I've been using my back muscles when I did sit-ups. In fact, I distinctly remember the first time we did them in second grade. After a few reps, it was already so painful that I was having trouble breathing properly. Being eight years old, however, I didn't realize this was a warning sign and assumed it was normal.

Flash forward ten years, and I have almost no strength in my abdominal muscles. I've tried to teach myself to do curl-ups properly, but no matter how hard I try, I can't even lift my head without using my back muscles. Exercise balls are no help either. Even when I concentrate on using my abs to keep myself steady, my back is still doing 95% of the work.

So, in short, I have two questions: Am I at risk for having damaged my back from years of abuse, and how can I work on strength training my abs now?

Dear Reader,

The truth is you might have been at risk of for straining your back muscles even if you had been doing sit-ups properly. Experts consider the sit-up to be an exercise that has only limited effectiveness in strengthening your core muscles (the muscles that make up your side, abdomen, and back). Fortunately, there are alternatives to sit-ups that are considered safe and effective for maintaining core muscle health and for building abdominal muscle.

As you mention, sit-ups have the potential to lead to back pain. Sit-ups are known to place significant strain on the spinal column, which can result in back problems. In addition to working abdominal muscles, sit-ups work the hip flexors, which attach the lower back to the spine. Overworking the hip flexors can cause back pain when the muscle pulls on the spine. Doing sit-ups on the ground can further strain the lower back because it gets pushed into the ground as you exercise. If sit-ups are performed with arms around the head, you may pull up on the neck and risk injury. Because sit-ups focus exclusively on building a single core muscle (the transverse abdominis) they also risk destabilizing the spine, which relies on a balance of all the muscles of the core to function properly. Thus, experts suggest that core exercise regiments include a balance of exercises designed to strengthen the major muscles of the side, abdomen and back.

The following strength training exercises can work the entire core without leading to the back pain associated with sit-ups:

  • Consider plank exercises. In this exercise, the body is held up by the arms. Start by lying flat on your stomach. Then, press your body up using your forearms. Stay in this position for 30-60 seconds. You can also do a side plank which focuses more on the oblique muscles. For this exercise, start by lying on your side and then pressing your body up with the forearem closest to the floor. Hang out there for a while — you’ll start to feel the burn.
  • The “bird dog” is also a great core-strengthening exercise. Start on all fours and raise your left arm and right leg and then alternate to raising your right arm and left leg.
  • Pilates: This is actually a group of exercises which place special emphasis on developing a strong core. You can look into taking a Pilates course with a trained instructor; there are also a variety of books and videos available that teach proper Pilates technique.

Instead of doing sit-ups, you could also try crunches. To do a proper crunch, lie on your back, bend one knee, and then gently lift your head and shoulders pausing for a moment; then, lie back down. When doing crunches make sure to place your hands below your lower back in order to give it support. Additionally, avoid hollowing out your stomach or pressing your back against the floor during this exercise. Still, if you opt to continue doing sit-ups, make sure to utilize the proper sit-up technique. This will help reduce your risk of injury and maximize overall effectiveness. When doing sit-ups you may also want to consider using an exercise or stability ball, like the one you mentioned, because it will limit the strain placed on the lower back when sit-ups are done on the ground.

If you are experiencing chronic back pain you may want to consider getting checked out by your health care provider.


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