We always hear that core strength and activation is important for our health. But what makes it so? There is a misconception about core strength which has been floating around for eternity. Often we think about the ‘core muscles’ as being our ‘six-pack’ – something that we need to develop by doing 100 situps per day. But this is not quite correct. Creating a strong core is much more than developing a six-pack or a flat stomach. In actual fact, it is the deeper muscles of the abdomen, and not the ‘six pack’ muscles (Rectus Abdominis), which we need to be active and strong for core strength.
This blog is going to introduce what muscles actually form the core, their function, and why they’re so important for back pain.
MUSCLES WHICH MAKE UP THE CORE
There are 3 main local muscle groups around the lumbar and pelvic region which make up the core. These include:
– Lumbar multifidus – runs along the lumbar spine through your back
– Transverse Abdominis – orientated across the front and sides of the abdomen, forming a ‘corset’
– Pelvic floor – provides a muscular floor for your pelvis
Other ‘global’ core muscles which help support our abdomen include:
– Quadratus Lumborum
– Rectus Abdominis
– Obliques (External and Internal)
FUNCTION OF THE CORE MUSCLES
The two key words for core muscle function is to provide STABILITY and PROTECTION.
The Lumbar spine, the bones in your low back, is essentially a stack of vertebrae (bony segments of the spine) sitting on top of each other. This bony stack needs to receive all the weight of the thorax, upper body, head and neck. It’s then required to transmit forces from the lower body when we are moving. That is some big responsibility! There are some passive structures which help stabilise the lumbar spine (including the ligaments and discs) but this is not enough. This is where the core muscles become essential.
The core muscles are active structures which contract to support the spine throughout all different movements. Anything from walking and running, jumping, even to sitting and standing. When the muscles activate and engage effectively, this provides a stable base for limb movements and other movements of the body.
WHY IS THE CORE IMPORTANT FOR BACK PAIN?
The importance of core strength in back pain comes down to the second function of the core muscles we mentioned above: PROTECTION.
A strong and supportive set of core muscles allows a stable base which can spread force as its acted on the Lumbar spine. This allows a reduction in the amount of force being placed on some of the smaller joints in the spine which can often lead to inflammation or injury.
Good support allows you to move without exacerbating stress on small joints in Lx spine and protects them from getting injured.
In healthy people with no back pain, the core muscles contract before movement of the trunk or limbs occurs. Research has shown that in those with chronic low back pain, there is a delay in this contraction of the core muscles, leaving the smaller joints more susceptible to injury.
Therefore, if the core muscles engage before movement occurs, and provide a strong contraction, your back is best equipped to move and be loaded with weight.
It’s important to note that people that suffer low back pain will generally have their pain settle spontaneously over time. However this is not generally the case with core muscle function. Re-engaging the core muscles after injury is therefore a critical step in the rehabilitation process.
CORE MUSCLE ACTIVATION AND EXERCISE
The last step is HOW to activate the core muscles. Transverse Abdominus, the wide ‘corset’ muscle across the abdomen, can be engaged through a series of cues and positions.
- Lie on your back with your knees bent and feet flat on the floor.
Your legs should be hip-distance apart. Place your index and middle finger equal distance between your lowest rib and the point of your hip. Move your fingers toward the middle of your body (roughly 2-3cm).
- To activate your core muscles (Transverse Abdominus), you can either:
a) Try to draw your belly button to your spine
b) Imagine your belt buckle is hot and you are trying to take your lower abdominals away from the heat.
c) Pretend you are stopping yourself from urinating.
d) Here is a video explanation if you are having trouble with the above cues.
- If you are activating the deeper core muscles effectively, you will feel the muscles tighten gently under your fingers. Your fingers should not be pushed upwards, as this means you are using the more superficial muscles (rectus abdominus, obliques).
- Once you are activating the muscles with control, focus on activating AND relaxing the muscles 10-15 times. Remember to continue breathing while you practice this control.
- Finally, once you have mastered control of the core muscles, you can start to instil the contraction into different movements throughout your day.
This blog post is an educational tool only. It is not a replacement for medical advice from a registered and qualified doctor or health professional.
If you have any questions on how core strength can be effective for your pain, or low back pain in general, please get in touch with one of our Osteopaths at the clinic.