If you have suffered from a back injury and visited a physiotherapist or a doctor, chances are you have been given the advice to strengthen your core. There are many misconceptions about core strengthening. If you think that having strong abdominal muscles means that you have a strong core, you may be misinformed. Having strong abdominal muscles doesn’t necessarily mean that you have a strong core, and subsequently, doesn’t mean that you are helping your back. You n
eed to be strong in the right abdominal muscles.
First, an anatomy lesson is in order. The anatomy of the core consists of 4 muscles. Transversus abdominus is a deep abdominal muscle that slings the bottom of the abdominal wall from hip bone to hip bone. This is the front of the core. The multifidus muscle is a deep spinal muscle and comprises the back of the core. This muscle is an “A” shaped muscle that has many layers and stabilizes each segment of the spine. The bottom of the core is the pelvic floor muscle group. The pelvic floor muscle group is a sling that goes from the tailbone to the pubic bone. The top of the core is the diaphragm. Tog
ether these 4 muscles make a corset-like shape around the spine and provide each spinal segment with stability.
The “six-pack” muscles and the oblique stomach muscles are not a part of the deep, inner core. Being able to preform stomach crunches and side lifts doesn’t automatically strengthen the four muscles of the core. To increase the strength of the core and help to stabilize the spine, proper recruitment of the correct muscles is essential. Once the proper muscles are isolated it is safe to begin progressively more complicated and challenging exercises.
To find your core try the following exercise. Lie on your back with
knees bent. Place your fingers just in from your hip bones. Now try very gently to pull up through the pelvic floor muscles. Do this by squeezing the muscles that would stop the flow of urine. You sho
uld feel a slight increase in muscle tension under your fingers. This is your transversus abdominus muscle contracting. You should not feel a large bulge. A large bulge means that you are contracting too hard. You should be able to breathe at the same time and holding the contraction. If you can’t breathe, you are bracing with your diaphragm. Remember, this is a subtle drawing up of the pelvic floor muscles, not a bearing down.
When there is any type of dysfunction or pain involving the spine, the core muscle group becomes inhibited. They no longer work together to provide support. Furthermore, when the acut
e injury has subsided or healed, the return of these muscles is not automatic. They need to be retrained in order to return to their stabilizing role. Failure to retrain these specific muscles is often the cause of a recurrent lower back injury. Despite the actual injury being healed, the muscles do not support the spine enough and the area is prone to re-injury.