Saturday, August 12, 2017

What Health Professionals Mean by The Core (What Do People Really Mean When They Say Core?)


     This issue has been a pet peeve of a mine for a while, and anybody who knows the true definition of “the core” has been shaking their head along with me. The core does NOT mean a six pack.  The rectus abdominis, which is the “six-pack muscle,” serves to flex the trunk forward and resist spinal extension. The core is a group of muscles with an inner and outer component. The outer core is made up of the obliques and rectus abdominis. The inner core is made up of the transverse abdominis, the multifidus, the pelvic floor, and the diaphragm.


     Diaphragmatic exercises consist of deep breathing, including pursed lip breathing exercises, belly breathing, and other forms of controlled breathing activities. Focus on breath is involved in a variety of exercise activities, including the ever so popular yoga. Pelvic floor exercises are usually not your regular Joe Schmo’s problem. However, pelvic floor exercise can be done by performing Kegels, which are easily google-able and will not be demonstrated in this post. For the average gym goer, the transverse abdominis and multifidus need attention and are pictured below in figure 1.

Figure 1: Abdominal Musculature

     These two muscles are part of the inner core, and their main purpose is spinal stabilization. The transverse abdominis acts as a corset to stabilize segments of the spine.  The multifidus, as you can see from its muscle fiber alignment, acts as a constant segmental stabilizer, connecting spinal segments up the length of the spine.  These muscles, along with the diaphragm and the pelvic floor, create pressure in the abdomen which allow for stabilization. This synchronization of core musculature helps maintain neutral spinal alignment when we move and go about our lives. Injury often occurs as a result of these muscles not being activated. When this happens, muscles like the erector spinae will take on the full workload. Stabilization via the erector spinae group is often referred to as “global stabilization,” which can lead to faulty alignment and injury.  Scientific literature has shown that the activation and stabilization of your core musculature, prior to movement, is key to injury prevention.  Static inactivation of these muscles-when sitting for prolonged periods, for example-is highly correlated with low back pain.  So, how do we train these muscles?  Perform exercises in which neutral spinal alignment is held for a prolonged period of time. Exercises like the plank and the bird dog are perfect examples of these exercises (referred to in the links below).  It is important to note that if you are able to perform regular exercise and able to maintain neutral spinal alignment with coordinated movement, proper core activation is most likely not a problem of yours. When form begins to break down and spinal alignment is compromised, this is when the integrity of this musculature comes into question.  Think about this, though: how often do you go to the gym and see poor form in every exercise? There is quite a bit of compromised spinal alignment and poor activation core musculature out there. If you would like more in-depth information, you can find it in the reference below (with link).  

Exercises Links:

 Greg Gebler, SPT, CSCS
 
References


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