Hi guys, this is my first entry into a blog, and feeling quite nervous!
This context is mainly for the general public rather than specific to other therapists / professionals within the
industry, so it will be written in terms everyone can hopefully understand.
What is the core?
Mostly it’s a passing comment, but over the last 5+ years I keep hearing this more and more:
“My Personal Trainer told me to work on my core”
“But I’ve been working on my core, so don’t understand why I got injured”,
“He had a bad back, so I told him to train his core...”
“She had a weak core since having a child, I referred her for Pilates to stabilise her core”
“I know I need to do more core strengthening and stability to help with my[insert here...]”
Does this sound familiar?
Quite often a prehab / rehab / performance prescriptive programme consists of many weird, wonderful and ‘core-related exercises’; abdominal Crunch, Russian twists, Leg raises etc. a lot of individuals are refer to this as ‘the core / core training’.
Admittedly I think all of us it may be a little bit guilty about referring to strengthening or stabilising ‘the core’ without a clear description of our interpretation towards ‘the core’.
Looking at various popular websites and good old you tube, I have come across some of my favourites!
There is no unanimous decision when it comes to what defines the core, there are soo many definitions ranging from; everything except the limbs, to just the lower back muscles, pelvic floor muscles as well as many more concepts.
One of the major muscles that stabilizes and controls the pressure inside the
trunk; these are the pelvic floor, abdominal wall, back, and diaphragm muscles.
Medical Dictionary 2009, Farlex and Partners
I don’t just talk about the core being the abs, I also talk about it being the abs, the obliques also known as the side abs, and also your back.” “It’s kind of the muscles going from just below your chest to your waist line.
You Tube, Robbie Knecht, 2017.
In most physiotherapy circles it is defined as the most intimate muscles that act directly on the spine and pelvis, and the 4 generally accepted are the diaphragm, lumbar multifidus, transverse abdominis and the muscles of the pelvic floor. I’d say this, it could be extended to the erectors of the spine, as well as the iliopsoas, internal oblique, lower part of the lats, and the gluteus maximus.
BNC training, December 2016
As you can see these differ a lot from one another, and what I have learnt to understand is that everybody therapist, client, lecturer and member of the public will interpret the core differently. However, this models how we work our prescriptive exercises and modalities of treatment to help us with performance, prevention, injuries, niggles and movements.
By now, I assume many of you would have heard of connective tissue, also known as the fascia. The fascia has no beginning and no end; it is wrapped and surrounds all of our muscles, organs, tendons, ligaments and around the bones, the concept originates from Anatomy Trains by Thomas Myers.
The history of the anatomy trains shows the body as a whole system and working as one, this has then also been adapted and interpreted by many different therapists with sports backgrounds, physiotherapy backgrounds, Osteopathy backgrounds, Chiropractic backgrounds, Coaches backgrounds and many more.
This is more widely known as the myofascial slings.
pictures taken from prehab guys, 2017 & Drummond education 2016
Myofascial Trains by Thomas Myers has helped set the vision for myofascial slings; this is a group of muscles linked through connective tissue that demonstrate they work with each other to obtain functional and optimal movement.
This is becoming increasing more popular as a concept of training and showing many positive results for Strength & Conditioning in a rehab, prehab and performance.
Myofascial sling movement mechanics work similar to a catapult effect, we have to add tension into the fascia by preloading (stretching) in order to get that release and rapid contraction through the chain to give a rapid release.
Emma’s Interpretation of the core
Okay... So getting your opinion out there can be quite daunting, but it isn’t really any different to what I do in clinic on a daily basis; so I’d like to give a short explanation of my interpretation of what ‘the core is’. The Muscular Core as it is widely known does not exist.
The published adjective for the core
“central importance; basic; fundamental:” Dictionary.com, 2018
The above adjective is the closest published definition that I can relate with. Whatever we do with our lower half affects our upper half, we are 3 dimensional living mammals, who can go through 3 planes of motion using energy transfer to execute this quick and effectively, and the is crucial to continue to tick each principle of fitness.
In my opinion, what we need to do is train the body within these myofascial slings, with body weight alone, we need to re-correct the movement and create new neuroplastic pathways. Then we can progress, test the body against uneven weights, strange shaped objects, adding in balancing factors and placed under fatigue and all of these will translate overtime into our Proprioception and corrective ability.
If we have to think about bracing the core (and compressing the spine) the ‘so-called core’ each time, the lift or move this will never become integrated into our strength and mobility system, this will always remain a conscious effort and not become part of our natural movement, our functional movement.
In Practice I adopt this training method a lot, I look at the myofascial chain and look for dysfunction patterns as well as screening the history of the individual and look at primal movements such as Squat, Lunge, Gait, Bending, Balance, Rotation, Pressing. This works very well for many clients and we can also start to see the history behind a dysfunctional movement pattern.
To conclude, balance is important, strength is important, mobility is also important, if you work these things effectively and worked throughout the myofascial slings surely this will make us stronger than ‘isolated trunk muscle strength and stability’ when we are working them so instead of just doing a crunch or just doing a Russian twist why not try woodchop, then why not then try woodchop standing on one leg.
Make the most out of our myofascial slings, these are what help provide strength, stability, power to movement efficiently as well as having the best prevention/ reduction tools to injury.
Food for Thought
When we are training in what we call ‘isolated movements’ are we really isolating them? When we already know that muscles work in pairs?
E.g. A bicep curl; to contract the biceps, the triceps have to relax.
What if there is a restriction within the triceps, how can the biceps have full control?
If you hold this out to 90degrees and perform a biceps curl, will it be the abdominals which will support the lift from your arm, or will it be the shoulder joint?
If somebody has to lift a heavy box, or have to throw an object a long way, do they choose to do this on one leg or two legs?
What would you do? How do you stand to throw? How do you stand to lift the heavy box?
image from evolutionalmovement 2017
Is it just your ‘abdominal/trunk muscles’ working? Do you think that to complete the tasks above you could just train or use your abdominal/trunk muscles, or does it depend on your shoulders, legs, knees, grip strength?
Having a strong and stable trunk is a good thing, however it cannot relate to functional activity (what we do in our everyday life).
If you can't move your legs properly, and your shoulder movement has restrictions, how will building the trunk make you lift or throw, or even sit up correctly? Just because you're strong around the trunk will this help me to lift a heavy box when the movement comes from all of the hips the bending of the knees and the control within the shoulders?
Play around with myofascial slings movements and think about how you'd maybe work them? Think about what daily movements, what activities can you think of that would require the whole sling? You don't have to look far to find the things which we do naturally.
Emma Burgon.MSTA, AAI, ST, FHT