Why my back pain isn’t going away even though I always use my core?

When working with patients with back pain, they often want to know how they should do certain things or what they should pay attention to (during movements) to help themselves. One of the things that always surface is the core.

Understanding how your brain and memory works.

In order to adequately explore this topic, we have to first understand how memory works.

Motor skills are stored in your brain as “procedural memory”, which is a type of implicit memory. In short, movements are performed at a subconscious level. For example, you don’t have to conscious think which foot to start walking with first and which part of your foot you should land on first. It kinda just happens!

HM brain surgery
HM had his hippocampus (part of the brain involved in long-term memory) removed as treatment for epilepsy. Despite having no real long-term memory, he can still develop motor skills.

To demonstrate this, psychologists use the example of an amnesic patient called HM. Henry Molaison is an epilepsy patient who underwent brain surgery to remove part of his brain as treatment for epilepsy. When he woke up, he had lost his ability to form new memories!

Even though he couldn’t form new memories, he was able to learn new motor skills.

In Brenda Milner’s experiments, HM was taught how to trace between two lines of star through a mirror. The end result was that HM got better and better with more practice. However, he was unable to recall actually having practised before!

He is not the only one. Clive Wearing is a different example of how motor memories are implicit. Clive was unable to remember the smallest of things after a brain infection. However, his motor (and musical) skills are still largely intact.

This is because motor skills is stored as implicit memory in the brain.

*In memory research, long-term memory refers to any memories that are more than 30 seconds old. If you can still remember how you got to my website, that piece of information is part of your long-term memory.

You don’t need to think about using your core for your core to work.

philosophy phenomenology cup
Phenomenology (branch of philosophy)tells that what we experience is not always a true representation of reality. This is why feeling more core exertion during core exercises does not mean that your core is indeed working harder.

This seems like a shocker but your core just works based on the demand on the activity!

In a study that compared the activation of transverse abdominis muscle across exercises, researchers were unable to find a single exercise that was better at eliciting more core activation!

While we like to believe that our core works harder when we do core exercises, this is simply not true.

Yes, you may feel more sensations at your core. However, this doesn’t always mean that your core is actually working harder.

What you feel may not actually be what actually happens!

Your core may not actually help you with your pain

enactive pain model
We like to think that pain = damage. However, pain is a lot more complex than that. The Lancet has super clearly stated that chronic pain is NOT because of on-going tissue damage! 

Many trainers, chiropractors, physiotherapists, etc like to talk about the importance of using the core.

They will may suggest that you will get back pain if you don’t brace your core. Research, again, tells us that this is not true.

A paper published two years ago on core stability and low-back pain clearly established that there is no cause and effect relationship between core stability and lower back pain.

It is true research can demonstrate an association between core stability and pain. However, this relationship is unlikely to be causal.

Do you need your TrA muscle to contract 0.15-second faster?

If you think your transverse abdominis muscle needs to contract 0.15 second faster, then a 4-week core activation training may just be what you need.

Based on the study, participants who undergone their 4-week programme contracted their TrA muscle in 2.07 seconds while participants in the control group took 2.23 seconds.

For perspective, that’s a 6.7% improvement.

While analysis shows that it is statistically significant, it is unclear if it is clinically meaning.

Does being able to active your core 0.15 second faster makes you healthier?

To core or not to core?

My advice? Do more of what works for you.

If you enjoy activating your core in your exercises, and that strategy has worked well for you, keep it up!

If not, it may be time to consider ditching it altogether.

From what we are seeing in research studies, your core activates across multiple tasks and exercises. There is also no superior exercises that are better at activating your TrA.

Furthermore, memory research is telling us that you DON’T need to explicitly remember how to do a squat in order to be able to squat. Therefore, there is no real need to focus on what to “feel” in order to perform a movement correctly.

If you are sick and tired of broscience advice and would like to seek help from an evidence-based chiropractor, book in for an appointment via the form below.


Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.