Core stability: A myth?

Despite its enduring popularity, the concept of “core stability” may be misleading. Robin encourages replacing it with the term “motor control,” as relying on “core stability” as a treatment modality implies an inherent spinal instability that requires correction. This belief can lead to overprotection, rigidity, and potential detrimental effects in the long-term. Robin argues that low back pain is far too complex to be addressed by a singular focus on core stability—a term she contends the fitness industry has capitalised on! Rather than emphasising isolated activation exercises for muscles like the Transverse Abdominus (TrA) by using things like ultrasound or pressure cuffs, Robin encourages adopting a broader approach with a focus on motor control.

A broader perspective: Motor control

Effective low back pain treatment requires a multifaceted, individualised approach grounded in the biopsychosocial model. Motor control, as Robin defines it, encompasses all sensory and motor processes involved in controlling spinal movement and stability. This includes everything from muscle activation and mechanoreceptor feedback to brain and spinal cord coordination. Research indicates that individuals with chronic low back pain may experience “cortical smudging”, which is a reorganisation of the motor regions of the brain, leading to altered motor control of the lumbar area (1). A recent study (2) also identifies that people with low back pain display a spectrum of changes in motor control, and categorises patients into two motor control subtypes:

1 – Tight control: This includes those patients who constrain movement, which may be useful to reduce pain in the acute stages, but sustained muscle contraction can cause fatigue, changes in muscle morphology, and altered activation