Many patients ask “what are the core muscles?” or “what exercises are good for core strength?”. Most fitness instructors will talk about the “six pack muscles” (rectus abdominis and obliques) as the core muscles, and show you exercises like crunches, sit ups, and planks as good strengthening exercises. While these are important muscles, their primary role is to “move” the spine, specifically flex and rotate it.
What is often neglected is the importance of the deeper muscles or stability mechanism. These lie close to the spine and act to stabilise the spine before and during movement. These muscles are the transversus abdominis, multifidus, pelvic floor, diaphragm, and psoas.
These are the true core muscles and if they are not working properly then you are at risk of long term injury to your back.
In healthy individuals these muscles engage behind the scenes to stabilise the spine whenever performing activities which load the spine. In and ideal situation, if you pick something off the floor, or reach for something from an overhead cupboard, these deep muscles will engage before you even start to move.
Recent research shows that people with lower back pain have poor activation of these deeper core muscles. The muscles either engage too late during movement, or have a poor and erratic contraction.
This problem can be rectified with specific direction and training from your physiotherapist. There are subtle exercises which focus on activating and holding the true core muscles, and once learned can be performed almost anywhere and anytime. The muscles work in synergy (together), and activating one deep muscle will turn on the entire deep core. Exercises will usually begin while lying and progress to sitting and standing with other movements, so that you have a stable core in every position. Eventually the goal is to have this mechanism engage automatically.
As well as being important for stabilising the spine, those muscles (in particular the pelvic floor) are important for continence, particularly during and after pregnancy or surgery and as we age. If you have problems in this area, are pregnant, have had a child, or are going to have surgery in this area (including prostate surgery), then it is essential that you see your physiotherapist so that you can be taught how to activate your pelvic floor.
If you have any further questions, have lower back pain, continence issues, or just want to make sure you have a healthy core, please feel free to contact Alpha Physiotherapy and book an appointment on (07) 3279 3871.
