Our core muscles are those that form the cylinder of our trunk and include the diaphragm at the top, the pelvic floor at the bottom, the transverse abdominus at the front and sides and the multifidus at the back.
These muscles are normally pre-programmed to activate before we move to provide dynamic stability and allow efficient movement strategies. These muscles should be functioning in a coordinated way to control our trunk movement to prevent over activating our larger muscles such as the hamstrings, hip flexors and latissimus dorsi which are designed for power not stability. Like a crane, the long lever arm cannot operate properly to move a load if the base is not stable. Our bodies require dynamic stability of the trunk, pelvis neck and shoulders to allow us to perform efficiently.
There are many factors which sabotage our core control including stress; illness requiring bed rest; postural habits; pelvic floor muscle dysfunction; musculoskeletal injury and its resultant compensatory muscular adaptations and loss of movement; breathing patterns and respiratory illness; and gut disturbances. These issues usually need to be addressed before core muscle retraining can be successful. Regaining core control is important for balance control and preventing recurrence of injuries, and is an important part of your rehabilitation process. At Joint Health we work collaboratively with two physiotherapy run programmes that integrate the latest research into how best to activate and retrain the core muscles into functional programmes that relate to our everyday function and posture. These programmes are Physiocise at Willoughby and Moore Park, and The Fix Program, now just 2 doors away from us in the city. Our role is to address all factors contributing to an injury as well as the impact of an injury on the whole body, and restore movement where it has been lost. Once this is achieved a core training programme can be safely commenced. Where specific issues arise with pelvic floor control, assessment may be recommended with a specialised women’s or men’s health physiotherapist to help you achieve the best results.
Safe core training involves education and always starts with a “less is more” approach using visual imagery and gentle 20% effort muscle contractions. It takes time and repetition under careful supervision to regain the coordinated action of the core muscles with breathing before loading is added. If core training is progressed too quickly to high load exercises such as crunches the plank, the wrong muscles will be activated and your efforts will be sabotaged, possibly resulting in further injury. This is why we refer to physiotherapy run programmes who’s primary purpose is to retrain core control in a carefully progressed manner in small group classes. We liaise with your instructor via letter or email and get feedback from them regarding your progress. You can claim both programmes under physiotherapy in your health fund.
We have many clients who have benefited from this collaborative approach and continue with their programmes at a higher level as maintenance.
Safe sequencing should progress from low load exercises focusing on breathing and core muscle activation with small movements of the leg and arms, to more functional positions with two feet supporting such as short range chair squats and lunges before progressing to single leg standing with movement.
Please ask your physio about core control if this has not been addressed already.