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Getting to the Core of the Problem

By Cara Wirt, LMT

Originally published in the Medford Sneak Preview, September 2010

 

We often hear references to “core strength” or “use your core,” but many are unsure what exactly that means.  In my practice as a massage therapist, I see examples of weak, unengaged, or asymmetrical core musculature every day.  Poor posture and a weak core go hand-in-hand.  From back pain, hip dysfunction, sciatica, to shoulder issues and headaches, the reverberations of an underutilized core can have a myriad of symptoms.

So what is “core strength,” and why does it matter?  Our bodies are made up of thousands of muscles.  Some are power or mover muscles, designed to get you from place to place or pick something up (as in the hamstrings and biceps).  Others are postural or stability muscles, meant to hold us upright or protect our joints.  Core muscles are stability muscles and can become weakened in our modern sedentary lifestyles of sitting in chairs and at desks, driving for long periods, and through general lack of awareness during activity.

When you hear someone speak about the core it can be misleading.  It is not just one set of muscles, but many.  The first is the pelvic floor.  Women often learn to engage these muscles during pregnancy by doing Kegel exercises.  They run like a hammock in the pelvis to support the pelvic organs.  You can learn to engage these muscles by stopping your flow of urine.  In addition to other problems, weakness in this area can contribute to incontinence.

The next is the deepest level of abdominal muscles (we have four layers in all), the transverse abdominis.  It runs like a corset around your midsection from your spine around the front of your belly and helps hold in your organs.  If you try to suck your belly button in towards your spine you will be engaging this muscle.

Moving to the back, in between each of the vertebrae in the spine is a group of small but strong muscles called the multifidi.  They stabilize the vertebral column, as well as help extend and rotate the spine.

There are other muscles commonly considered to be a part of the core, but those mentioned here are the more common ones that I find dysfunction in with my clients, so I will move forward from there.

Take a moment to visualize the area between your hip bones and lower ribs.  The only part of the human skeleton stabilizing this area is the spine in the back, yet the lumbar area is a fulcrum of movement when we bend or twist.  Given the lack of skeletal support in this area, it is easy to understand why back problems plague so many of us.  Also, our viscera (the liver, intestines, etc.) which perform a huge array of important bodily functions, fill the abdomen and are protected in the front only by muscles.  The core muscles are the main stabilizers for this extremely vital, yet vulnerable area. It really is the “core,” or center, of our bodies!

Through repeated poor posture, habitually incorrect movements, or when pain is present, these muscles can quit working effectively. This will cause other “power” muscles to take over the job of trying to protect and stabilize.  Power muscles are not meant for the constant long and slow contractions that protect our joints and keep us upright, so they tend to get tight and painful when repeatedly asked to take over this essential job.  Rebuilding your core gives them a break and re-balances the musculature to function effectively again.

Try this exercise:  Sit in a chair in your normal seated posture.  Now, let go of all effort and slump — chest concave, shoulders rolled forward, back rounded towards the chair.  Notice the weight of gravity bearing down on you.  You may find it is difficult to take a full breath.  When I sit in this posture, I feel an uncomfortable pull at the base of my skull.  This is a posture of defeat.  Now take a slow, deep breath and come back to what is a more normal, upright sitting posture.

Now place your feet on the floor a comfortable distance apart.  Feel the grounding and support they provide.  Take a big breath and fill your entire ribcage- front, sides, back, top to bottom-directing the top of your inhale to the space between your collarbones.  Let the breath lengthen and expand your torso.  Imagine there is a string lifting the crown of your head upward.  Now gently lift the pelvic floor, then, keeping that, slightly pull in your lower belly between your belly button and pubic bone.  The goal is to hold a gentle contraction while still being able to breathe comfortably, keeping the natural arch in your low back. Take a moment to notice how tall you feel.  You are ready to face the world!

At first this may feel like a lot of effort, but with continued practice it becomes easier and even natural.  Eventually, the core muscles will begin working on their own again, protecting your joints without you even having to think about it.

If you suffer from chronic pain in the back, hips, or torso, or even just occasional discomfort, diligent strengthening of your core can have amazing results.  It takes time and awareness, as well as a good coach, but the rewards are worth it!  I typically recommend one-on-one coaching when first learning to engage the core.  It is a subtle practice, and it is easy to unintentionally over-exert and bring in power muscles that are already overused, instead of simply engaging the core muscles.  A reputable Pilates or yoga instructor, or most physical therapists, will have a good working knowledge of core strengthening.  I also offer individual coaching, as well as therapeutic massage, in my practice.  Good luck and “use your core”!