100% of IHS patients are assessed for core stability. Low back pain? Knee pain? Neck pain? Shoulder pain? Believe it or not, the core is usually involved.
To begin with, let’s briefly touch on what the “core” actually is. The majority of people think that strengthening the core means strengthening the abs. If that is you, you are on the right track but the abs are just a part of the core, specifically the front and sides. Think of the core as being your entire torso, plus a few more muscles you may not have realized. In addition to your abdominals, the erector and multifidi muscles of your back, the lats, the psoas (hip flexor) and even the glutes are all a part of your core! All of these muscles need to be firing properly in order to keep your spine stable – the key to pain free motion.
The core musculature is responsible for providing spinal stability. Without the muscles, the spine would bend and turn in undesired ways. This is what we call compensation. If some muscles are “turned off” while others are “over-firing,” the spine is being pulled in ways that create instability and pain. Picture tug-of-war: when the teams are balanced, the rope does not move, it’s stable! Now let’s say we take 10 people against 1 person, that rope (spine) is going to be yanked and pulled away from the weaker side. Now that we know our core involves our hip flexors too, what do you think happens when you sit at a desk all day with your hip flexors constantly contracted? The low back muscles will seize up in response, the glutes will be turned off to try to compensate, and your stability (notice here, I did not say strength) will be all out of wack.
Furthermore, think of building a house with a weak foundation. Will the walls be stable? How about the roof – will it have issues? Obviously, a weak foundation is a sinkhole for the rest of the stability of the house. This is the same with your core. A weak core will lead to issues in the arms, the neck, the legs and so on and so forth.
Some quick examples you may come across for core stability here in the office will be based off of Stuart McGill’s “Big Three” that are scientifically proven to be superior in reducing back pain and improving function. Dr. McGill is a master at treating back pain and he emphasizes the importance of finding the cause of the pain, which is typically poor movement patterns. He designed the “Big Three” in order to appropriately build core muscle endurance. What are the “Big Three?” The Curl up, side bridge, and bird dog. Before these can be implemented into care, breathing and bracing of the core must be accomplished in order to properly engage the targeted muscles. After coaching for a few visits, our patients are able to work on these exercises at home so that the proper core engaging becomes second nature.
Hopefully, this clears up why we at Integrated Health Solutions are so passionate about maintaining a stable core. Any activity of daily living requires stability in order to remain pain free and active for the best quality of life. Now, go breathe and brace!
Content provided by Jennifer Brenneisen
References: www.livestrong.com/article/98988-core-muscles-body/; www.livestrong.com/article/392341-stuart-mcgills-big-three-back-exercises/; Ghorbanpour A, Azghani MR, Taghipour M, Salahzadeh Z, Ghaderi F, Oskouei AE. Effects of McGill stabilization exercises and conventional physiotherapy on pain, functional disability and active back range of motion in patients with chronic non-specific low back pain. J Phys Ther Sci. 2018;30(4):481–485. doi:10.1589/jpts.30.481