Saturday, February 6, 2016

What is 'the core' and how do we strengthen it?

The core: it's the buzzword in rehab and fitness circles. Everyone talks about how important it is for treating low back pain and for athletic performance. But what is it really and what are the most effective ways to strengthen it?

What is 'the core' and how do we strengthen it?

0 comments
iStockphoto

The core: it’s the buzzword in rehab and fitness circles. Everyone talks about how important it is for treating low back pain and for athletic performance. But what is it really and what are the most effective ways to strengthen it? 

It is important to know that the core is not just your abs. To date, there is no definitive definition of what truly is the core. A May 2010 study by Escamilla et al. described the core as “the lumbopelvic-hip complex, which involves deeper muscles, such as the internal oblique, transversus abdominis, transversospinalis (multifidus, rotatores, semispinalis), quadratus lumborum, and psoas major and minor, and superficial muscles, such as the rectus abdominis, external oblique, erector spinae (iliocostalis, spinalis, longissimus), latissimus dorsi, glute maximus and medius, hamstrings, and rectus femoris.” 

As you can see, that covers a lot of muscles including ones that directly affect the upper and lower extremities as well as the lumbar spine and pelvis. These muscles are important for both movement and stabilization of the pelvis and spine.

Which muscles are most important to strengthen and which exercises are most effective? There is still great debate on all of this. Research is starting to show that it is important to strengthen the core as a stabilizer versus a mover. This means exercises where the trunk is stable and static (ie. planks vs. sit ups). A 2002 article by Cholewicki and VanVliet in the journal Clinical Biomechanics reported that “no single core muscle can be identified as most important for lumbar spine stability” and “no one muscle contributes more than 30 percent to overall spine stability.”

How do we contract/activate the core? There are numerous techniques used to facilitate activation of the deep core musculature: abdominal hollowing, abdominal bracing, draw-in maneuver, and posterior pelvic tilt just to name a few. None of these has been shown to be the most effective at core activation, even with EMG studies. The key is to contract the deep abdominals, including the pelvic floor. You should feel your abdominals tighten above and below your belly button as well as in your love handle region (obliques). The Kegel exercise, which is used to contract the pelvic floor, is another good way to activate your core musculature. However you achieve this core activation, you have to maintain it throughout the repetition/exercise duration. If you’re holding your plank for 2 minutes, you probably lost your core control at about 30 seconds.

So, let’s put it all together.

  • The core consists of your abdominals, low back, and pelvis as well as all of the muscles that move or stabilize this region.
  • To date, there is no magic exercise to perform. The key is to contract your deep abdominal musculature and maintain this contraction as well as correct form during the duration of the exercise.
  • Start with the most basic exercises as even these can be challenging when maintaining core activation and correct posture.
  • Don’t advance to more difficult exercises if you can’t maintain control of your core or correct form and alignment with the exercise.
  • Lastly, if you have a history of low back pain or are experiencing pain with any of your exercises, please see a rehabilitation specialist to develop an exercise program specifically for you.

The following link is a beginner core program that I use with many of my athletes. If it makes you feel better, some of these world-class athletes have trouble even with this basic program.

http://www.justinshaginawptatc.com/exercise-programs.html


Read more Sports Doc for Sports Medicine and Fitness.

Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
0 comments
We encourage respectful comments but reserve the right to delete anything that doesn't contribute to an engaging dialogue.
Help us moderate this thread by flagging comments that violate our guidelines.

Comment policy:

Philly.com comments are intended to be civil, friendly conversations. Please treat other participants with respect and in a way that you would want to be treated. You are responsible for what you say. And please, stay on topic. If you see an objectionable post, please report it to us using the "Report Abuse" option.

Please note that comments are monitored by Philly.com staff. We reserve the right at all times to remove any information or materials that are unlawful, threatening, abusive, libelous, defamatory, obscene, vulgar, pornographic, profane, indecent or otherwise objectionable. Personal attacks, especially on other participants, are not permitted. We reserve the right to permanently block any user who violates these terms and conditions.

Additionally comments that are long, have multiple paragraph breaks, include code, or include hyperlinks may not be posted.

Read 0 comments
 
comments powered by Disqus
About this blog

Whether you are a weekend warrior, an aging baby boomer, a student athlete or just someone who wants to stay active, this blog is for you. Read about our growing list of expert contributors here.

J. Ryan Bair, PT, DPT, SCS Founder and Owner of FLASH Sports Physical Therapy, Board Certified in Sports Physical Therapy
Brian Cammarota, ATC, PT, DPT, CSCS Physical Therapist at Good Shepard Penn Partners, Partner at Symetrix Sports Performance
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Brittany Everett Owner, Grace & Glory Yoga Fishtown
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Jon Herting, PT, DPT, CSCS, HFS, USAW Physical Therapist, Partner at The Training Room
Eugene Hong, MD, CAQSM, FAAFP Team Physician for Drexel, Philadelphia Univ., Saint Joe’s, & U.S. Lacrosse
Brian Maher, BS, CSCS Owner, Philly Personal Training
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Gavin McKay, NASM-CPT Founder/Franchisor, Unite Fitness
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Chief of the Division of Sports Medicine at Drexel University
Robyn Weisman, ACE-CPT B.S., Exercise Science & Physiology, Certified Personal Trainer, Fitness and Lifestyle Coach
Sarah M. Whitman, MD Sports Psychiatrist; Clinical Assistant Professor, Drexel University College of Medicine
Latest Videos
Also on Philly.com:
letter icon Newsletter