What Is My Core?
By By: Meghan Dunn PT, DPT, ATC
What is my Core?
Many patients with low back, hip, or knee pain have been told by their doctor and/or physical therapist that they
would benefit from ‘core strengthening.’ What does it mean to strengthen your “core”? And how would strengthening my core benefit me?
The major muscles of the ‘core,’ or trunk of your body, can be found in the belly and mid-back regions. These muscles include the abdominals (transverse abdominous, obliques, rectus abdominus), the pelvic floor muscles, the multifidus, the erector spinae, and the diaphragm. The core muscles stabilize the spine during active movement.
They also provide pressure within the abdomen during coughing, sneezing, and excretion of substances.
The weakness of core muscles can increase your risk of pain, poor posture, and injury. Strengthening the core is
essential for functional fitness, or fitness essential for daily living and regular activities. Core strength is also important during sports in that it provides inward stability for outward movement. In other words, it provides a strong base of support for your arms and legs to move.
Core muscles have been shown to contract several milliseconds before arm and leg movements in healthy individuals. Theoretically stabilizing the spine before the movement. It takes only a small contraction of the core muscles to stiffen and stabilize the spine. It has been shown that patients with low back pain exhibit delayed contraction of these muscles.
Abdominal or Core Strengthening
Core strengthening is important for injury prevention, injury management, and postural control. Developing a strong core enables energy to be transferred from the body’s center to the limbs during active movement, including lifting.
Core strengthening begins with flexibility exercises and basic activation of the core muscles. Your therapist may have
you perform hip and back stretch along with abdominal isometrics, bracing, or pelvic tilts to accomplish this goal.
When activation of the core muscles has been mastered, exercises are progressed to include limb movement and
stabilization on the exercise ball. Higher-level stabilization exercises involve standing, balance, and coordination.
Pilates and Yoga are examples of high-level, core stabilization activities.
Core strengthening is a safe and simple way to improve the stabilization of your spine. Contributing to
decreased pain and improved functional movement.
Low Back Pain
Decreasing low back pain is as easy as opening the vanity cabinet door in your bathroom and placing the ball of
your foot inside. While brushing your teeth, shaving, and putting on your makeup, this trick will cause you to go into a hip
hinge instead of flexing or bending your spine. The overall result is less pressure or pain in your back.
Among the many patients with low back pain, one of the most common complaints is the inability to sleep well. This can be a significant problem for many reasons. The obvious problem is that lack of sleep greatly limits the ability to function during the day. The less obvious problem is that your spine does most of its healing from everyday stress at night when the discs and joints are unloaded. Without this healing time, symptoms may increase significantly.
Therefore, low back pain can worsen without proper rest, which may become a vicious cycle. The best solution to breaking this cycle of pain and loss of sleep is maintaining a neutral spine when you go to sleep.
A neutral spine in the low back is when the back is close to straight with a slight backward curve. This position enables the discs and joints to be unloaded so they can heal and receive nutrition. Avoiding rotation in sleeping posture also takes unwanted stress off the discs and joints.
How to Sleep with Back Pain
The best sleeping position is side-lying with pillow support between the arms and legs. To keep your low back in neutral, you need to keep your hips and knees bent forward approximately 60-90 degrees. Lying on your back is also a good position if you use pillow support under your knees. Lying on your stomach is not usually recommended because it puts your low back into increased extension (or arches your low back). If you can only sleep on your stomach, use several pillows under your hips and stomach to keep your low back as close to neutral as possible with one or no pillows under your head. It may take time to get used to sleeping in neutral with pillow support, but you should see an improvement in low back pain and stiffness once you have done it consistently.