Will the Real “CORE” Please Stand Up??

BY BETSY BAKER

PSIA/AASI-NW DCL

 By now you’ve all heard about “the core” or “core strengthening” programs, right? Hopefully you’ve already incorporated core strengthening into your fitness routine (if not, you need to be!). But, are you really using your TRUE core? Do you really know what the real core is?

Why is the core such a crucial part of training? Well, imagine standing in a canoe on a lake and trying to step off onto a dock. Now, think of standing on the ground and stepping up onto a step. Which is easier? When you move from an unstable surface (canoe), your muscles have to work harder and are less efficient. The same is true for your body. When your core is stable, then your extremities (arms and legs) can move from that stable base more efficiently, regardless of the activity or sport.

So what is the CORE? From my perspective the true definition of a core is like an apple core. It is the INSIDE of the apple (not just the midsection-the area from the ribs to the butt); as is true with our bodies. Our “inner” core, the most important part for trunk/core stabilization exercise, is inside your body, deep inside, closest to the spine and pelvis.

There are three muscle groups that make up the inner core: the Transversus Abdominis muscle, the Multifidus muscles, and the pelvic floor muscles. These are the most important muscles involved in dynamic stabilization of the lumbar spine and trunk. Not to say that the glutes (butt muscles), psoas (hip flexors) and more superficial abdominals (“six pack”-rectus abdominis and obliques) aren’t important, but read on and you’ll discover why they can do more damage than good if the inner core isn’t developed first.

Let’s take the transversus abdominis (TA) first. This is an amazing muscle that is the deepest of all the abdominals. It wraps around the lower abdominal wall, attaching into the pelvis and around back to attach directly into the bones of the spine. Because this muscle runs horizontally around the body, when it contracts, it pulls your abdominal wall inward and provides a lateral pull on both sides of the spine, applying a stabilizing force on the lumbar spine segments. The transversus abdominus helps to control the motion at the spine that is generated by the larger more superficial trunk muscles. (See diagrams)

Next is the multifidi. The multifidus group is the deepest muscle group in the lower back, attaching from the tailbone upward, segment by segment on each lumbar spine vertebrae. These muscles vary in size, but usually span one to three vertebrae. They are located deep compared to all the other superficial lower back muscles (paraspinals) and when they contract they help to stabilize each segment of the spine on each other, in a more vertical fashion. (see picture) So, hopefully by now you are picturing the horizontal stabilization of the TA and the vertical stabilizers of the multifidus.  The interaction of the TA and the multifidus creates a decompressive and stabilizing force on the segments of the spine! (See diagram). There are even more intricate details than that for segmental stabilization, but I’ll spare you the further biomechanical details.

The last, but definitely not least of the inner core muscle groups is the pelvic floor. If you think of our trunk like a cylinder, like a pop can, the pelvic floor is the bottom. If you don’t have good control and stabilization of the bottom of the can, the contents will fall out, right? You don’t want that. Not only for the obvious reasons, but also because low tone in these muscles allows the weight of your insides (abdominal and pelvic organs) to drop down, increasing the stress on your lower back and destabilizing your core.

So, by now you are saying, “okay Betsy, you tell me these are so important, but how do I strengthen these muscles?” “Should I be doing more crunches?” The answer is not a simple yes or no. The difficult part of all this is that you first need to learn how to do a small, gentle isometric contraction of all these inner core muscles individually so that you can teach your brain to actually turn these muscles on correctly. Research has shown that these muscles are supposed to be the first muscles in the body to turn on, before you even start to move your arm to grab that hot latte you just got at Starbucks. Your trunk needs to be stable for your arm to efficiently move (or your legs).

After you have learned to correctly recruit these deep muscles to stabilize from your inner core, THEN you can start doing all the fancy core stabilization exercises you read about (mat exercises, ball exercises, crunches, etc). Recent research has shown that even that good old standard, Wall Sits, (remember those burnin’ quads?) is more efficient if your deep core muscles are correctly recruited. In fact, if you recruit even just your pelvic floor muscles while you are doing a wall sit, you can stay in that “sit” position on average 20% longer. But, the crucial part is for you to learn how to integrate your inner core muscles and maintain their activity/contraction while you are doing those other “outer core” strengthening exercises. Eventually, after you practice enough with those inner core muscles, that recruitment will become a new, ingrained motor program for your body and your inner core will become more stable.

If you start by just doing exercises for the outer core muscles, you will be using strong muscles with large leverage that create motion and compression of your spine, but without the deep inner core muscles engaged, that motion will not be controlled at the segments of your spine, and your inner core muscles won’t be engaged to help control the compressive forces of those larger, outer muscles. That can cause injury and is one reason why people with low back pain have recurrent pain when they haven’t learned to integrate their inner core. Plus, using those deep stabilizing muscles of the trunk and spine will allow the nerves that exit those segments of the spine to work better, sending clearer signals to the muscles they control, thus allowing those muscles in your arms and legs to be more active and stronger! (a good way to fix and prevent those “overuse injuries”).

So, you can imagine how much more efficient we can be as skiers and riders, when we have a more well-trained inner core and a stronger outer core. In the interest of professional accuracy, I will not attempt to explain in print how to accurately recruit these inner core muscles. (It takes a skilled touch to give you accurate feedback if you are doing it correctly). But many of you who have attended the Fall Seminar and Spring Fling “Core Strengthening for Better Performance” classes have already learned! If you haven’t attended these seminars, and you are interested in learning more about recruiting these inner core muscles, feel free to contact me betsyskis@msn.com or gbaker@olympicpt.com , or any one of the therapists or exercise staff at Olympic Physical Therapy (www.olympicpt.com) , Athletic Engineering (Seattle), or Unlimited Athlete (Renton, Kirkland).

Here’s to a strong, injury-free ski and snowboard career!

Betsy Baker, PT, CMPT is a Level 3 Certified physical therapist by the North American Institute of Orthopedic Manual Therapy, a Level 3 Certified Alpine Instructor and a Divisional Clinic Leader for PSIA-NW. She is the owner/partner of Olympic Physical Therapy of Everett. Olympic Physical Therapy is proud to be an Official Medical Provider for the US Ski Team and Betsy is one of the official rotating physical therapists for the Alpine, Freestyle, Snowboard and Adaptive teams. Betsy is also a race coach for Team Lyon and a Training Director for Lyon Ski School at Stevens Pass.