Written by Dr. Deane Studer, DC ~ Vernon Chiropractor

What Is Your Core?

It's a group of muscles and connective tissue that forms a circumferential wall from the front to back, a roof from above and a floor from below that stabilizes your torso and spine. It's like a back support belt that?s built from within. Its primary function is to stabilize and support your lower back when moving and especially when lifting. It also allows energy and forces to move through your torso or mid-section that is generated from either your legs or arms to perform a task. Before any body motion can occur, your core muscles will activate or turn on. Compensations for a weak core will cause adaptations or faulty movement patterns and increases the risk of an injury.

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Anatomy = Muscles

In the Front (Anterior):

1. Transverse Abdominus (TrA) - deepest layer in the front; fixed to lower 6 costal cartilages, thoracolumbar fascia, & iliac crest; attaches to the mid-line Linea Alba; contracts to narrow waist slightly and flattens the stomach.
2. Rectus Abdominus (RA) - superficial & vertical muscle running from the xiphoid process and costal cartilage up high to pubic symphysis below
3. Internal Oblique (IO) - middle lateral layer; fixed to the thoracolumbar fascia in the back & inguinal ligament and the anterior iliac crest in the front
4. External Oblique (EO) - superficial & lateral layer; fixed to the lateral portion of lower 7 ribs and attaches to the linea alba, pubic bone, & anterior iliac crest

In the Back (Posterior):

Multifidus - small, intersegmental muscles attached to each vertebral segment on the left and right side (sacrum-lumbar-thoracic-cervical spine to axis or C2).

On the top (Superior):

Diaphragm: a sheet of muscle shaped like a dome; controls breathing

On the bottom (Inferior):

Pelvic floor - a hammock-like group of muscles from the tailbone (coccyx) & sits bones (ischial tuberosities) to the pubic bone in the front.

*Pregnancy/childbirth can alter recruitment patterns which can lead to leakage, painful scars, prolapse, diastasis recti, painful sex, and dry vaginas. Seek a professional knowledgable in pelvic floor dysfunction/rehab.

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What Does It Do?

Your core muscles stabilize your lower back BEFORE movement of your arms & legs occurs. It also transfers force from your upper extremity to your lower extremity or vice versa. Proper activation and function are critical to prevent wear and tear (degeneration or osteoarthritis) in your spinal joints.

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Therapeutic Goals

It's very important to remember that every person is Unique! If you have pain in your spine after training or with specific movements (ie. deadlifts, kettlebells), seek expert advice on your lifting technique. If the pain persists for more than a few days or this is a chronic condition, consult a health care professional who you know and trust. You should have a “health care team” of professionals who will work to help you learn more about the weak link in the chain or the dysfunctional motor recruitment patterns. Professional treatment of the condition should produce tangible results within the first two visits - decreasing inflammation, reducing pain and increasing range of motion. The severity of the tissue damage, your age, your nutritional and lifestyle habits, and the number of prior injuries, will dictate your timeline to rehab and recover from the injury.

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4 Core Tests

1. Flexor Endurance - supported half sit-up while maintaining good posture (ie. maintain good lumbar lordosis); ideal time ~66 sec for men ~81 sec for women
2. Lateral Endurance - side bridge using one hand and one foot on the floor, high hand on the low shoulder; ideal time ~40 sec
3. Extensor Endurance - legs and pelvis supported and secure by another person on a bench or using a GHD machine or a superman position on the floor; be careful not to curve your lumbar spine curve, try to keep your xiphoid process and pubic bone in contact with the floor; hold the body in a straight line on bench or GHD; lift chest and thighs off the floor (if doing the superman) and maintain length for as long as you can; ideal time ~60 secs
4. Postural Breathing Pattern - Your breathing pattern should NOT be vertical. In other words, if your chest/collar/neck lift vertically when you breathe in, then you are not breathing correctly or efficiently. This is considered dysfunctional. Ideally, you should be breathing down into your belly and the belly moves outward in all directions (forward, laterally, and posteriorly); this is difficult when under loads or performing many athletic movements. This takes training and years of practice and should be a focus to increase your overall performance.

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Breathing with Core Activation

Dysfunctional breathing decreases overall strength due to poor alignment of the spine. It also limits your thoracic spine's flexibility necessary for an upper right posture. Poor posture will weaken the stabilizers of the shoulder blade/scapula and limits shoulder flexion. It will also limit shoulder rotation needed for overhead movements, ie. pull-ups, overhead squat. Depending on your neuromuscular patterns and tendencies, your spine will compensate somewhere and weaken the overall structural support.

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Train Your Brain?

Rehab Principle: You must restore or “TRAIN” the recruitment patterns of the deep core muscles - meaning the order or sequential firing of synergistic muscles via your nervous system.

1. Isolate and create awareness so you can fire or activate it on command.
2. Strengthen it with specific and progressively harder exercises that target and challenge it neurologically.
3. Increasing the intensity and loads over time will increase your athletic performance.

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Why Train with Core in Mind?

With mental awareness, a wave-like contraction of muscles (diaphragm, multifidus, pelvic floor, abdominal wall) creates a safety mechanism that protects and supports your back. It's a collective integration that strengthens your internal architecture for whole-body functional movements - breathing, posture, & movement.

• Training comes before strengthening
• Core/proximal stability precedes distal/extremity mobility
• Intra-abdominal pressure (IAP) is a pneumo-muscular reflex and must be trained mentally through sensory engrams; think of it as a software program that gets hardwired, so train your brain.

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Core Exercises

1. Asymmetric Kettlebell carry “bottom-up”
2. Pallof Press - standing good posture holding rubber band close to your mid-section, create tension in the rubber band, then push straight forward with hands while maintaining a strong core, repeat.
3. Cable chop - using rubber bands and a wooden dowel, see demo
4. Stir-The-Pot - using a Swiss ball, fingers interlaced, plank position, elbows bent, slowly stir the ball in a clockwise direction and then counter-clockwise direction.
5. Wall Bug (Kolar) - on your back w/hands against the wall, legs 90/90, spine neutral core activated, alt. taping heels while pressing hands into the wall
6. Body Rolls - lying on foam roller vertical with the head free, holding a ball overhead, core activated, slowly take the ball overhead while maintaining a neutral spine and breathing.
7. Curl-up - Lift chest/shoulders over ground 1/4 off ground, keeping low back stable on the ground. The lumbar spine should not move, only upper spine. Try to prevent your lumbar spine from overarching by engaging your core.

*Youtube will have examples of all the above-mentioned exercises. Look at a few of them before trying.

Call (250) 275-7616 to make an appointment with Dr. Deane