Core Strengthening: An Overview

High JumpI am often asked by patients, “What are the best core strengthening exercises?” While it might seem like a simple enough question, the answer is actually quite layered. First, one must understand what exactly “the core” is. Then, one must consider if the goal is to address a medical condition, because different exercises are used to address different dysfunctions, or if the goal is merely to gain core strength in general.

 

When people think about “the core” of the body, most generally consider the abdominals primarily. Some may include the back musculature in the description. However, “the core” can include everything from the shoulders to the hips, as “the core” basically includes everything except for the extremities (i.e. the arms and legs). So, perhaps a better word to describe “the core” would be “the trunk.” It is the foundation for the body’s stability, and its strength and mobility is vital to normal and pain-free movement and function.

 

There are many muscles and joints that make up “the core.” More obvious muscles include the abdominals, of which there are 4 layers, but muscles that surround the shoulder blade, upper, mid and lower back muscles, muscles found between the ribs, and hip (or gluteal) muscles also help to make up “the core.” Joints, which are connections between bones, found in “the core” include those between the many vertebrae, or pieces of the spine, those between the ribs and the spine, those between the shoulder blade and upper arm bones (i.e. humerus), and those between the spine, the pelvis and the upper leg bones (i.e. femur). All of these muscles and joints require attention in order to maintain a good balance between strength and stability and mobility and flexibility.

 

If the goal is to increase overall core strength, then a mixture of strengthening and stretching exercises addressing all of the previously mentioned muscles groups is essential. However, if the goal is to increase core strength for a person with a medical condition, then it is important to consider what that condition is and how it responds to particular exercises. For instance, back pain has many origins, but two of the most common include spinal stenosis (i.e. a narrowing of the openings in the spine where nerves exit the spine to serve various body parts) and disc disorder (i.e. abnormal breakdown of discs that sit between each vertebra, or segments of the spine, that can lead to pinching on nerve roots). For spinal stenosis, flexion based, or forward bending, exercises are recommended because that direction of movement helps to open up the narrowed spinal openings, thus alleviating pressure on nerves. Basic flexion based exercises include sit-ups or curl-ups, which can be done in various positions. For disc disorder, extension based, or backward bending, exercises are generally recommended because that direction of movement promotes proper repositioning of disc material. Basic extension base exercises include press-ups done on the stomach (often called “cobras” in yoga) and standing back bends. If you are unsure whether to do flexion or extension based exercises, then it is always safe to stick to neutral, isometric exercises. Isometric exercises cause muscle contraction but require no visible movement. For “the core,” one popular isometric exercise is the plank, which can be done in various positions.

 

Hopefully, this helped you to better understand what “the core” is and how to properly strengthen it. In the end, I would recommend finding exercise that you enjoy doing and to do just that, because if you try to force to do exercises that you do not enjoy, it is unlikely you will keep consistent with it. And, of course, if you need one on one pointers or addressing of physical dysfunction, we’re always ready to help here at Advanced PMR. Happy exercising!

 

Dr. Rob Kohutanycz, PT, DPT

Posted in: Fitness, Health & Wellness

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