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Does anyone actually enjoy doing sit ups?




Personally, I hate them. I've never liked them. Even worse are sit ups on a decline board. I've never felt any real benefit while doing them and more often than not, my low back would tighten up as well as my hip flexors.


This is largely due to the fact sit ups place a significant amount of shear force on the low back, specifically the intervertebral discs. And the hip flexors are the primary mover as opposed to the abdominal muscles. They're inefficient, ineffective, and just flat out annoying.

When I have a patient tell me they do sit ups, I always ask “How do they feel while you’re doing them?”. A lot of the time, the response is either "meh they're okay" or actually "You know what? They do bother my back”. It's at that point, I explain why they are a poor option for core strengthening and begin going through some alternatives that will not put as much stress on the low back. Now there are a myriad of core exercises that I recommend, but some of the easiest ones for patients to grasp is just simply stiffening their core. It sounds funny, but one of the easiest ways to get patients to grasp this idea is to have them mimic the action of trying to pass gas. Immediately, everyone knows exactly what to do. This queue engages the obliques, the transverse abdominis, multifidus, etc.


Now that the patient understands engaging their core musculature properly, we introduce movements to challenge this stiffened position, such as the dead bug, bird dog, or even simply a plank to build endurance. This stiffened core always for more movement to happen through the extremities, without sacrificing the low back. Once they have become more proficient with this basic movements, we will progress to more challenging movements, or postures. We might add resistance to certain exercises as well, all with the idea of maintaining core stiffness.


It's a simple maneuver, but very effective.



Bird Dog exercise



Dead Bug exercise



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