Weak Core?

When I was at university in the 2000’s we were taught a lot about ‘core muscle’ activation. How to palpate it, when it needed to be activated and a series of bizarre positions to fire it up.

It seemed that every second person had a ‘weak’ core and that this weak core was causing all number of musculoskeletal maladies.

Back pain, groin pain, hip issues, urinary incontinence, hip flexor spasms and more were caused by these mysteriously weakened cores.

Thankfully science is moving past this fad as research catches up but now the problem seems to be that ‘core’ issues are more pervasive than ever.

So what is a core?

The description of the core muscles generally means the muscles that stop your guts from falling out. Either through your abdomen or through your pelvis.

The idea through the late 90’s into the 2000’s was that they should be contracted such that when someone moved to ‘stabilise’ their spines.

And so punters were taught to lie on their backs, contract their cores and then practise movement with their cores ‘turned on’.

But one of the overarching principles of body movement is that it should be easy, fluid and smooth.

If you are constantly contracting one area, be it your core or your bicep, it makes smooth fluid movement very challenging.

One of the key principles of rehab is to aid/enhance the movement that causes the problem. Lying on your back feeling for a tiny muscle is not the same as life.

And so there were obvious flaws in this concept of core contraction from the beginning and like a lot of these isolationist-type approaches the problem was poorly defined.

Do I have a core and how do I strengthen it?

Everyone has a core. If it is weak, your guts will start to fall through your pelvis or abdomen. And this is no laughing matter as it happens. Prolapses of internal organs through the pelvic floor certainly do need pelvic floor muscle activation.

And that would make sense as the exercises would be targeting the problem.

However, for the large majority of people that think they have a “weak” core, this is not the case.

For the large majority of people core exercises in no way replicate the nature of their injury nor prepare them to re-do the movement that caused their injury.

Lying on your back contracting an infinitesimally small muscle in no way replicates the varied running a netballer/footballer has to do in a game.

Actually identifying the problem that results in pain is far more important than anything else.

If it isn’t my core what is it then?

Words and descriptions are important. And a ‘weak core’ is rather scary language. As well as deeply inaccurate, most of the time.

In general biomechanical injuries occur when a region is placed under more load than it can tolerate.

Often via a rapid increase (new activity), overload (gym) or biomechanical bad luck (twisted joint).

For Example

Someone that slouchingly sits a lot. Think; bum well forward in the chair, big gap between low back and the chair, shoulders on the back of it, chin almost resting on their chin.

That person’s hips do not spend much time flexing forward, they stay pretty straight most of the time as the back does a lot of the bending.

That person is then in life, in motion, bending forward to pick something up. And ‘pop’ their back ‘goes.’

The supposition for that injury would be that because their hips do not get bent often in the day that when that person bends forward to pick something up, instead of using their hips they will bend their spine to reach whatever it is they are reaching for.

If that person was to spend the next few months learning how to contract their core it would make zero difference on the way that that person would move.

Sure they would bend forward with their core contracted but they would still be using their back to bend rather than their hips.

Does Pilates help then?

Pilates is great. I like pilates. Ten years ago I qualified as a pilates instructor. But it is much more than core training. Pilates strengthens calves, thighs, glutes, abdominal and back muscles.

It encourages good movement.

Why?

Because the movements they do in pilates are great. They teach smooth, efficient ways to move, with breath, that are more lifelike than just lying on your back.

And if you like it it is great. But if you don’t like it you can get the same benefits from gym, enthusiastic gardening, tennis or yoga.

Likewise, dance.

Likewise martial arts.

Likewise Feldenkrais.

Conclusion

You have a core. It is there. In some cases, there is a problem with it. But rarely. And prescribing core exercises just because you have back pain is an ineffective/non-evidence-based approach.