Strength coaches and personal trainers have had a love/hate relationship with sit-ups for a long time. In the early years of physical culture these exercises were staples of any fitness program. At one point, people began worrying that sit-ups could cause back problems, and so the exercise was replaced with crunches, then Swiss ball crunches. Then came the generation of personal trainers and strength coaches who tried to bring back variations of sit-ups as part of their “core training” workouts. What is the truth? Do sit-ups cause more harm than good?
First, consider that an individual’s body proportions influence sit-up performance. A person with a long torso and relatively short legs has a much more difficult time performing sit-ups than someone with a relatively short torso and long legs. This could explain why some individuals can perform sit-ups with relatively no discomfort, while others continually experience problems from performing the exercise.
The truth is a real connection does exist between the sit-up and back pain. It concerns the involvement of the psoas, a hip flexor muscle that runs from the front of the upper thigh to the lower back. The contraction of this muscle not only tilts the pelvis anteriorly (i.e., forward and down), which may cause discomfort and pain by itself, but also increases the compressive forces on the disks. This problem is compounded when the feet are anchored, so this practice should be avoided.
Bending the legs and flaring the knees out are ways used to try to reduce the involvement of the hip flexors, but this simply works them through a shorter range of motion. One reason that many soft-tissue practitioners, such as those certified with Active Release Techniques®, have success with many back pain patients is that they know how to treat the psoas to restore its normal range of motion and allow the pelvis to resume normal alignment.
It has been theorized that over time, sit-ups can increase the risk of bulging disks or disk herniation. Stuart M. McGill, a professor at the University of Waterloo and author of three books and nearly 200 scientific papers on back pain, believes that the continual flexing of the spine with sit-ups could deteriorate the spine and cause chronic pain and weakness. In this sense, you might say that every sit-up performed moves the trainee one rep closer to disk injury.
Another concern relates to the cervical disks. For a non-overweight individual, the weight of the head is about 7.5 percent of their bodyweight. For the average, untrained population, holding the head off the floor with an isometric contraction of the neck muscles during high-repetition sit-ups can result in neck strain – and the risk is greater on a Swiss ball due to the increased range of motion (and it’s especially risky if the trainee allows the neck to go into hyperextension). Resting one’s head on the floor between repetitions helps, but there are other options.
One recommended solution to neck strain used to be to clasp the hands behind the head, but this can result in individuals pulling on the head for leverage and thereby possibly injuring the neck muscles and connective tissues. This method also increases the degree of flexion of the spine. Having the elbows flared out rather than tucked forward makes it more difficult to apply force, but it’s still possible to cause damage. Also, raising your upper arms causes a reflex contraction of the muscles behind the head to stabilize the shoulders.
One popular solution in the 1990s was the use of ab-roller devices, which were heavily promoted on infomercials – although the same effect could be achieved with the use of a towel. The best solution is to position your arms in front of you, elbows down, and place your hands on your forehead and apply gentle pressure. The result is that the muscles on the front of the neck will contract, causing the muscles on the back of the neck to relax.
To do sit-ups or not to do sit-ups; that is the question. Let’s make this easy: The muscular midsections of powerlifters and weightlifters are proof that simply performing total-body lifts such as squats, power cleans and deadlifts can develop impressive abdominals. Although sit-ups have been a popular exercise for the abs and some people do not experience any back or neck pain from the exercise, the fact is an individual can develop tremendous abdominals without ever performing a sit-up. Therefore, you have to ask yourself, are sit-ups worth the risk?