How to train the core | Total Performance Physical Therapy

How to train the core

May 8, 2013

Since summer season is approaching and everyone is working to have that flat stomach to show off at the beach, I thought it was a good time to talk about your core.  It is common to hear someone say that they are “doing abs” at the gym or working out their core.  When people do abdominal workouts it usually includes a lot of sit-ups and crunches.  Yes, this will help strengthen the abdominals that create your six-pack, but it is entirely different than strengthening your core.  Having a strong core is critical for injury prevention and efficient movement. 

What is the core?

Your core specifically consists of 4 stabilizing muscles in your mid-section; these muscles are the transversus abdominus, lumbar multifidi, internal obliques, and quadratus lumborum.  More generally, you can think of your core as ranging from your upper mid-section to the middle part of your thigh.  The core’s job is not to flex at your stomach to perform a sit-up so you can have six pack abs, but it’s job is to stabilize your spine and mid-section.  Proximal or core stability allows for pain free and efficient distal mobility of one’s limb.

If you do not have a strong and stable core, you are making yourself more prone to injury.  Before we can initiate any sort of movement, as small as lifting our arm or as big as throwing a baseball, our core muscles should be the first to fire.  The core muscles must fire first to create a stable base for our body to generate movement from.  If these muscles do not fire first there is increased instability in our spine and midsection leading to the loss of potential energy and overcompensation of our more distal musculature. 

For people who cannot activate their core prior to movement, research shows that they are more likely to sustain a lumbar spine injury (low back injury or pain).  Vice versa, it is shown that those people who have low back pain or injury have a difficult time activating their core muscles to create a stable spine and strong foundation.  You can see how the core muscles and back injuries are closely related.  For those individuals with chronic low back pain, it is shown that their lumbar multifidi are atrophied (decreased in size & strength) by about 30% compared to an individual without back pain.  For these same individuals fat infiltrates the muscle, visualized via MRI, which is a similar change that occurs in individuals with rotator cuff tears.  The core is vital to creating energy-efficient movement and preventing injuries such as low back pain. 

How do you strengthen your core?

Now that you know that sit-ups and crunches are not the exercises you want to be doing to strengthen your core, let’s discuss how you create a strong and stable core for yourself.  As stated earlier, some people have a difficult time even activating and contracting their core.  If you cannot contract the muscles of your core, then you cannot properly strengthen them.  As musculoskeletal experts, physical therapists can teach you techniques and give verbal and tactile cues to help you learn how to contract the core muscles.  Once you have the ability to contract and control your core muscles individually, it is important to be able to utilize all of your core muscles to create a stable center from which your creating movement.  Physical therapists can teach you exercises that specifically target your core after having learned how to contract your core.  Some of these exercises include:

Physical therapists have the ability to alter these ‘core’ exercises (no pun intended) that build up your core musculature by increasing or decreasing the difficulty depending on your individual ability.  In addition, the exercise prescription for these muscles needs to reflect their use.  Since these muscles should contract every time we move, these muscles need a high endurance threshold.  To create this endurance these muscles need to be trained in such a manner, something a physical therapist can prescribe for your individual skill level.  Once you have a strong core, the use of these muscles needs to be integrated into the daily movements that you perform, whether it be sports-related, work-related, or recreationally-related, to prevent injury and maximize your performance.

For exercises and a specific exercise regimen to build core strength and endurance, visit Total Performance Physical Therapy.