Simplifying the Core

What exactly is the core all about? Why does every fitness instructor tell you to engage your core, why does your doctor tell you that you have a weak core, and how do they even know?  

The core is the support of your trunk, which supports the rest of your body.  It provides support for your low back with movement, supports the movements of your arms and legs and allows you to breathe properly.  All of this is possible, but only when you have a properly functioning core.  

What exactly is the core?  Well that’s a great question. Think of your core like a cylinder. The top is your diaphragm, the bottom is your pelvic floor, the front is your transverse abdominis muscle (your deepest layer of abdominal muscles) and the back is your multifidi, (your deep back extensors) .  The good news is that your core muscles work together as a team, so you can activate one and get the others to kick in as well.  The diaphragm functions on it’s own so we don’t get to control the actual strength in the diaphragm, but with proper techniques we can improve how well it moves and how efficiently we breathe. The other good news is once we teach our core how to engage, it won’t require as much effort to keep it that way. During normal functional movement, our abdominals only need to engage 10-12%, so it doesn’t require a huge effort to stabilize our trunk with daily activities. 

So why does the core get weak? And how can you effectively strengthen it?

The core weakens over time because it is not a large mover muscle, like a bicep. It does require attention to make and keep it strong. It can become inhibited, or “turned off”, with low back pain and it requires conscious effort to turn it back on.  It’s also really easy to compensate with other muscles, like our lats or back extensors which can also exacerbate back pain, further inhibiting the core and continuing the cycle.  The core can also weaken with life events, hello childbirth, and again requires consistent exercises to help get it back.  Following childbirth, you are dealing with not only weak core muscles, but also elongated core muscles, which does require some healing and tissue change. So when you’re trying so hard to “get that core back”, after a surgery or childbirth for example, you do need to wait on your body.  

There are several effective ways to address strengthening the core.  Pilates exercises are one of the best to incorporate for core strengthening. However, if you can’t figure out how to engage your core properly, just like anything else, it won’t be effective and you can set up yourself for injury.  I typically recommend Pilates based exercise once my patients are done in Physical Therapy.  Here are a few simple ways to start to engage your core:

1. Diaphragmatic Breathing:  This technique focuses on abdominal breathing and taking a full breath to allow your abdomen to fill with air.  Many of us are shallow breathers and don’t fully activate our diaphragm while breathing.  To properly perform this technique:  
   

• Lay on your back with your hand on top of your stomach
  
• Take a deep breath in through your nose, feel your abdomen fill and rise into your hand
  
• Slowly exhale, out through your mouth, slowly like you are trying to blow a bubble
  
• As you exhale you should slightly tighten your abdomen, like you are trying to draw in your belly button toward your spine 
  

1. Transverse Abdominis Activation:  the most important thing is to not over activate your muscles.  To engage, lay on your back, place your hand on your pelvis bones (the ones you can feel in the lower part of your abdomen), move your hand just in from the bone toward your belly button.  
   

• Take a deep breath in, exhale and as you breathe out, draw your belly button in toward your spine. 
  
• As you do this, you should feel a muscle “push out” into your fingers, this is your deep core muscles, your transverse abdominis, tightening up
  
• Repeat this exercise 10 times, progression is to hold the contraction for 5 seconds and then relax
  
• If you feel pain in your low back, relax the contraction just slightly
  
• If you feel your glutes kick in, relax the contraction slightly
  

It is important to work on both of these exercises in sitting, standing and during functional activities such as walking, lifting, rolling in bed, rising from sitting and doing stairs.  If you’re an athlete or participating in a fitness routine, these exercises will need to be incorporated into those activities as well.  You will know you are ready to progress when this exercise feels easy and you can engage without much effort.  It is a good idea to try and engage during activity as soon as possible.   Some examples of exercise progressions include:

• Bird Dog
  
• Bent knee fall outs
  
• Hooklying marches
  
• Planks (forearm, full arm or sidelying)
  

It truly is “simple” to support your spine during functional activities.  It’s important to realize that strengthening your core really can be done while sitting at a red light, watching your son’s soccer game or doing the dishes. In fact, this is exactly when you should be making time for this! Here are some other simple ways to engage and strengthen your core:

• Engage your abdominals while strength training
  
• While taking a walk, tighten your abdominals and count to 10, relax and repeat this cycle 5 times, several times throughout your walk
  
• Pick one or two of your favorite core exercises and perform them during a commercial break
  
• Add one or two core exercises to the end of your workout 
  

If trying to tackle a 30 minute pilates class seems overwhelming right now, start small and work your way into something bigger. Use these tips to make time for your core,  Most likely this is what your body needs most anyway.  

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Katie Larsen, DPT

Katie is a Physical Therapist, wife and mom to 3; she lives in Alpena, MI and loves to be outdoors and spending time with family and friends.