What is Core Strength? What is the “core”? How do these muscles help protect from back pain?
Core muscular control of the body’s alignment and movement is a dance between strength, awareness and skill.
“Core Strengthening” exercises are often taught for treatment of back pain without a clear understanding of precisely the underlying problem, including identifying which muscles are overworking or underworking.
History of Core Stability
The concept of core stability originated in Australia in the 1990s with the work of Dr Paul Hodges. Dr Hodges showed that the Transversus Abdominis and multifidus turn on before, or within 50 milliseconds of, the shoulder muscles when subjects raised their arm up, ie, the body did some preparation to stabilise the body for raising the arm.
In subjects with low back pain, Dr Hodges showed that this motor control planning (feedforward mechanism) was delayed in transverse abdominus and multifidus.
What are the transversus abdominus and multifidus?
The transverse abdominus is the deepest layer of the stomach muscle. It attaches to the ribs and the pelvis. It’s fibres wrap around the abdomen like a corset. The multifidus Hodges studied was the deep multifidi, small, one-joint muscles that stabilise the movement of one vertebra relative to the vertebra above or below, depending on your reference.
The exercise industry at large made some huge extrapolations from this research, and promoted the idea that slow or weak transversus abdominis muscles are responsible for lower back pain, which has had thousands, if not millions, of people training up their “TA’s. But often incorrectly, and out of context, ie not with good body alignment in functional positions! Is it functional to keep your body rigid, as in a plank? It has its uses, yes, but it is not training “functional movement”
Why “Core stability” exercises sometimes don’t help…
Despite beliefs that core stabilisation exercises will “wake up” a stabilisation mechanism necessary to prevent low back pain, studies have shown that Transverse Abdominus (TA) training exercises do not, in fact, lead to the abdominal muscles switching on “faster” in preparation for movement. They must be trained consciously in context ie the position we need them in!
The brain learns tasks in the position the body is in at the time of training. E.g., if you train the TA muscle lying down, there is no guarantee it will work standing up and walking.
The “Core Muscles” have been traditionally
- Transversus Abdominus
- Pelvic Floor
- Multifidus
- Diaphragm
Shown here.
Physio – Yoga, taught in Milsons Point North Sydney is very effective for treating Back Pain for the following reasons relating to core stability.
- We teach whole-body movements while activating your core muscles. These poses require both strength and balance.
- We instruct you to align your body in ways that activate your transverse abdominus.
Activate your “core”, then you can do so much more! Yoga is not difficult and is great for strengthening your “core” muscles.
Combining Physio with Yoga
“Core stability“ in Physio – Yoga combines alignment, muscle control, strength, flexibility and relaxation.
Retraining alignment and muscular balance are specific to each individual’s body.
Gaining awareness of how your body feels in each position can;
- Make you feel safer when doing activities of daily living.
- Build self-efficacy and independence from helpers and therapists.
- Break habitual, harmful ways of moving.
- Experience pain-free movement in areas of the body you previously felt pain – alter pain mechanisms.
- Improve circulation through relaxation of tension and/or muscle spasm.
Recent estimates of the global prevalence of low back pain in adults showed that chronic low back pain ranges from 10 to 20% of the population and appears to be on the rise. Approximately 90% of low back pain is nonspecific, defined as pain symptoms with no specific cause. I believe there are causes; they are usually related to poor posture and repetative habitual movements.
You do not have to live with Low Back Pain – a holistic treatment approach (biopsychosocial) is the most scientifically and time proven method to reduce the incidence of back pain.
Physiotherapists here at Physio Therapy Yoga and Physio Body and Sole in Milsons Point, North Sydney treat long-standing back pain and teach people strategies to manage and/or prevent low back pain from returning.
