Core Strength
The endurance and control of the trunk muscles that stabilize the spine.
Last revised
Key takeaways
- Evidence: general exercise works about as well as specific core training for back pain
- Most useful quality: endurance and control rather than maximum strength
- Most useful single change: Train the whole body; general exercise works as well for back pain.
- Commonest mistake: Bracing your abdominals constantly through the day.
- See a doctor if any of the signs under "When to get help" below apply to you.
Why it matters
It supports back health, and the evidence does not support the idea that weak abdominals cause back pain.
The numbers, in one place
| Measure | Figure |
|---|---|
| Evidence | general exercise works about as well as specific core training for back pain |
| Most useful quality | endurance and control rather than maximum strength |
| Recommended for adults | muscle-strengthening activity on at least 2 days a week |
| Bracing constantly | not recommended; it increases stiffness |
What helps
- Train the whole body; general exercise works as well for back pain
- Include anti-rotation and carrying work, not only sit-ups
- Build endurance with holds and controlled movement
- Progress gradually and keep it going long term
What to avoid
- Bracing your abdominals constantly through the day
- Repeated loaded sit-ups if they cause back pain
- Expecting core work alone to resolve back pain
In depth
The "core" refers to the muscles that surround and support the trunk, including the abdominal muscles, the deep muscles along the spine, the diaphragm, the pelvic floor and the muscles around the hips. They work together to control movement, transfer force between the upper and lower body and support the spine during everyday tasks and sport. Rather than one muscle, think of a team that coordinates.
For many years, weak core muscles were thought to be a main cause of back pain, and specific exercises to activate deep muscles were widely promoted. Research has since found that general exercise programs work about as well as specific core training for back pain. This suggests that being active and building overall strength and endurance matters more than targeting one muscle precisely.
Core training is still valuable. It improves endurance and control, which help you perform daily activities, lift and carry, play sports and maintain balance. Rather than maximum strength, the most useful quality is the ability to hold positions and control movement for a sustained period, adapting to the task at hand.
Causes and risk factors
- Long periods of inactivity and sitting
- Recovery from injury, surgery or illness
- Pregnancy and childbirth, which stretch the abdominal wall and pelvic floor
- Aging and loss of muscle mass
- Training programs that neglect the trunk
How it is checked
There is no single test for core strength. A physical therapist or trainer may assess how well you control your trunk during movements, such as a squat, lunge or single-leg stand, and how long you can hold positions like a plank or side plank. These help identify where to focus.
If you have back pain, pelvic pain, leaking urine or a visible bulge along the middle of your abdomen after pregnancy, see your doctor or a physical therapist. These may need specific assessment, such as for pelvic floor dysfunction or diastasis recti, a separation of the abdominal muscles.
Related topics
- What the Guidance Really Says About Exercise in Later Life (Fitness)
- Pelvic Floor: What the Evidence Actually Says (Women's Health)
- Strength and Balance in Later Life: What Published Guidance Supports (Healthy Aging)
- The Evidence on Exercise with Persistent Pain, Without the Hype (Chronic Pain)
Where to go next
- Core Strength in Five Minutes
- Core Strength: Sorting the Evidence From the Noise
- Back and Posture: The Complete Guide
- Lifting Safely: Sorting the Evidence From the Noise
- Posture: What the Evidence Actually Says
When to get help
Stop and see your doctor for sharp back pain during exercise, pain radiating down a leg, or any numbness or weakness. Go to the emergency room for numbness around the genitals, buttocks or inner thighs, bladder or bowel changes, or weakness in both legs, and call 911 for chest pain or fainting during exercise.
Where this comes from
- Office of Disease Prevention and Health Promotion — Physical Activity Guidelines for Americans, 2nd edition
- National Institute of Arthritis and Musculoskeletal and Skin Diseases — Back Pain
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.