You may have thought your back pain was due to a weak core. So, naturally, you started doing ab exercises to strengthen it. But instead of relief, your back pain got worse. You might be asking yourself: if core exercises are supposed to reduce back pain, why are they bothering mine?

The main reason this happens is that the ab exercises you are doing—or the way you are performing them—replicates the very movements that caused your pain in the first place.

Here are the three most common examples I see:

1. Rounding Your Back During Sit-ups or Similar Exercises

For many people, rounding their back under load is their primary pain trigger. For example, bending forward or lifting objects often causes discomfort. Performing sit-ups or similar exercises reproduces that same motion, essentially guaranteeing aggravation. Think of it like trying to fix a stubbed toe by stubbing it again—it is counterproductive at best.

2. Sucking Your Belly Button Towards Your Spine

Some people are taught to “draw in” their belly button while exercising, based on outdated ideas about core activation. However, doing this actually makes the spine less stable. Think of it this way: your abdominal muscles act like guy wires stabilizing a tower. The further away these “wires” attach from the tower’s base, the more stable the tower becomes. Pulling your belly in brings those “wires” (aka. muscles) closer to the spine, reducing their stabilizing effect and leaving your back more vulnerable to pain and injury.

3. Flattening Your Back by Tilting Your Pelvis

Sometimes people are told to tilt their pelvis to flatten their back against the floor while exercising. This forces the spine into a rounded, rather than neutral, position. For many people, rounding the back triggers pain, so exercising this way will provoke discomfort. If sitting and bending forward bother your back, forcing it flat during exercises will likely do the same.

Safe Ab Exercises for People with Back Pain

Ab exercises themselves are not inherently bad though. They are a valuable part of a comprehensive core-strengthening program. The key is choosing the right ones and performing them correctly so you can strengthen your core without aggravating your back.

Two examples of safe, effective exercises are:

  • The Modified Curl-up: As taught by Dr. Stuart McGill, this maintains a neutral spine.
  • The Front Plank: This builds endurance without repetitive bending.

As with any exercise, proper intensity, frequency, and technique are essential. When combined with proper spinal hygiene, these exercises can be a critical part of successfully overcoming back pain.