Core Stability: The Exit Strategy Out of Pain

By: Lori Duncan, DPT, MTC, CPT


Pain is not awesome. There is no one in the world that wakes up and thinks: “Gosh, today I hope I’m in a lot of pain.” Unfortunately, we all get pain at some point and it doesn’t always have to be viewed as such a negative. Understanding the role of pain may give some clarity and purpose to this stigma-word.

Why do we get pain? Pain is a signal from our brain that something is not quite right. Whether that is because you stubbed your toe on the wall or have just been through surgery, pain does serve a purpose. It makes us pay attention, take stock of what’s going on and proceed with caution. Pain is not always bad information from our brain to body.

But, we’ve entered this realm where people don’t want to feel or understand their pain. So, they either “push-through” or ignore the pain, or numb it down with opiates. Neither of these are great options in the long-term. As I tell my patients: “There is no push through pain, it’s called compensation.” And as for opiates…sadly we are in the middle of an opioid epidemic that continues to worsen. We can do better.

Here’s what we know from pain research. Pain does a funny thing to our brain—it confuses it. And when the brain is confused so is our body.

The state and health of our body movement is a direct reflection of what is going on in our brain.

In a painful state, the brain tries to compensate with different muscles, altered neuromuscular patterns and anything else to keep us moving. We begin to use our big muscles for small movements. We start to employ our lifting and pushing strategies for daily function. While this is occurring, pain is quickly shutting down our stabilizing muscles.

Let’s consider someone with neck pain. The Upper Trapezius is hypertonic, tight and tender. The deep neck flexors are asleep. The brain is confused and trying to use the Upper Trap—a neck and shoulder mover—as a stabilizer at the cervical spine. Well, that’s just a hot mess.

But, here’s the good news. Our body always has the potential to feel better. Always! And, at any age. It may not be perfect, but it can be improved. If we start with a key concept we learn as children, we can pattern the body out of pain. What is this key concept? Stability with mobility.

Pilates just happens to be brilliant at teaching this concept.

Think of a new born baby. When a baby is born they are very mobile and require an adult to provide stability to their fragile body. Around 6 months, a baby will start to sit up for lengths of time, a development phase that indicates they are working on trunk stability.

A few months later (around 8-9 months old), a baby will sit and begin to reach for a toy outside their periphery. This is stability with mobility. Imagine if that baby had never worked on trunk stability for a few months. They would fall over.

As we age, we don’t fall over, we compensate. And compensation always leads to pain.

Having core stability and learning the concept of stability with mobility is THE KEY for lifelong healing, pain-free function and optimal sports performance.

Join me for my lab-based course Strengthening Core Stability. It’s an interactive and fun day to learn the true scope, power and depth of the core. Over 50 exercises are practiced and the Pilates Principles are applied to any exercise or movement. It’s a class that will help any patient move and feel better in their body. And, having core stability decreases fall risk and increases patient safety. Hope to see you at a course soon!

About the Author: Lori Duncan, DPT, MTC, CPT is a respected Physical Therapist, Manual Therapist and Pilates instructor in Lafayette, CO. Lori is passionate about preventive physical therapy and education and is a nationally recognized presenter. She can be reached at You can also follow Duncan Sports Therapy + Wellness on Facebook & Instagram for more free tips and information.

This post was inspired by October representing National Physical Therapy Month and the APTA’s #ChoosePT campaign. #Choose PT is a campaign to raise awareness of physical therapy as a safe and effective alternative to opioids for treatment of chronic pain conditions.