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Core stabilization — not fiction, nor a fad, but good fitness

[1]Your Personal Trainer:
By Olivia C.  Rossi, RN, MSN, ACSM

There’s a concept in the fitness and exercise physiology field called “Core Stabilization.”  That sounds like a pretty “out there” term but it is a really, really important concept.  I’m going to explain it to you but first let me tell you something about myself.  I love anatomy and physiology.  Each year, I attend two conferences sponsored by the American College of Sports Medicine (ACSM) so I can keep up on the latest research in the field of exercise physiology.  I want to learn it so I can pass it on to my patients at work in cardiac rehabilitation and to you because it is really important for you to know.  It was at one of those recent meetings that I had what I like to call an “ah-ha” moment.  That is a moment in which something becomes totally clear and understandable.  In this case, it gave me a clear picture of a difficult concept that I can pass on to you, and that brings me back to the concept of “Core Stabilization.”

What exactly is it?  Simply put, core stabilization refers to how the muscles of your trunk keep your spine and body upright and stable.  These important muscles help to keep you balanced when you stand and walk.  When your core muscles are strong, they contribute to better posture, better balance, more efficient movement and less chance of injury.  A strong core can help you prevent and recover from low back pain.  I have to get into a little anatomy lesson here and then I’ll tell you about my “ah-ha” moment.

Your spine, or vertebral column, is composed of individual bones, or vertebrae, with cushions in between them called discs.  They are all connected by fibrous tissue, cartilage, ligaments and muscles.  This gets a little complicated, so if you love anatomy as I do, I am listing some references for you to explore in more depth at the end of my article.  There are two basic units that comprise the core muscles:  the inner and the outer system.  “The inner (or deep) muscles are not responsible for specific movement but provide stability during joint movement.  The outer muscles mainly perform movement of the trunk and limbs and provide support of the spine.”1   Think of the inner, or deep muscles (one of them is the transversus abdominis), as an “inner corset.”  That’s the muscle that helps you to hold in your stomach.  Some of the outer muscles, those closer to the surface, are the ones that help you move, such as the rectus abdominis, aka, your “six-pack!”  They also include the muscles of your back, your buttocks, your pelvis and those that wrap around your waist and help you turn, the abdominal obliques.

Two exercises for your inner and outer core muscles are:  for the deep, inner muscles, sit on a chair and contract, or pull in your abdominal muscles as if you wanted your belly button to touch your spine.  This is an isometric exercise.  You shouldn’t see anything move except your stomach going in.  Don’t bend your back.  Just tighten your abs.  To help strengthen your outer muscles, doing a bird dog, either standing or on the floor, helps both the abdominal and back muscles.  You may recognize the bird dog.  If you are on all fours, lift your right leg off the floor, straight, and your left arm, keeping your back in neutral and your abdominal muscles taut.  If you are standing, hold onto the back of a chair and lift your right leg straight behind you and your left arm up so that your back, your leg and your arm are all at a 45-degree angle in a straight line.  Hold for 3-5 seconds on each side.  Do about 10-15 repetitions on each side.  And while I’m on the subject of core exercises, you might want to explore Pilates, named for its founder, Joseph Pilates.  It includes specific exercises designed to help strengthen the body’s core, such as the abdominal, gluteal and back muscles with the intent of improving posture, balance, coordination and overall quality of life.

Why is all of this so important?  It’s because as you travel through time and space, the more efficiently you do it, the less pain and injury you will experience throughout your life, whether you are doing the activities of daily living or engaging in athletic pursuits.  There are a few primary things to keep in mind.  First, keep your back in its neutral position, its normal curvature.  Good posture will help to keep you free of back pain.  Keep your ears over your shoulders and your head and neck in line with your spine.  When you reach down to pick something up, bend your knees and keep your back in neutral.  In other words, don’t bend from your waist.  If you want to stretch your hamstrings, the backs of your thighs, sit on the edge of your chair, keep one leg straight and the other at 90-degrees Bend forward from your hip joint until you feel a mild stretch in the back of your thigh.  Don’t bend from your waist or your shoulders.  Hold the stretch on each leg for 15-30 seconds.

Now for my “ah-ha” moment.  It is said that a picture is worth a thousand words.  Now that I’ve written almost that many, let me give you a mental picture that I hope will pull together all of the anatomy and exercises above.  This is a core concept.  Quite literally, it’s an “apple” core concept.  It was at an ACSM lecture I attended last March that all of the intricate musculature was explained and illustrated in a Power Point presentation, and that’s what I took away with me and presented to my patients at work and now to you.  The speaker superimposed a graphic of an apple core over the muscles of the spine, the abdomen and the back.  It made it all so simple.

Picture a large apple core.  Now, envision the top of it fitting under your ribs where your diaphragm is located.  The middle of the apple core is your spine and the bottom of it fits into your pelvis between your hip bones.  Now, with that picture in mind, stand up straight, ears over your shoulders, shoulders back, spine in neutral, abdominal muscles firm and your head high.  Whether you’re walking, running, swimming, riding a bike or sitting at your computer, think about the apple core and see if it doesn’t help you keep your posture just a little bit more upright and your low back pain just a little less apparent.  An apple a day applies in more ways than one!

References:  1 Women’s Health and Fitness Guide, Kettles, Cole, Wright.  Human Kinetics, Publisher,  2006
THIEME:  Atlas of Anatomy, Lawrence M. Ross, M.D., PhD., Edward D. Lamperti, PhD. Thieme. Stuttgart, New York

Yours in fitness,

Olivia C.  Rossi, RN, MSN
Certified Clinical Specialist, ACSM
Certified Personal Trainer, ACSM