The Importance of a Strong Core

Recently a patient of mine, Adam, was diagnosed with an inguinal hernia. A hernia is the protrusion of an organ or tissue through its surrounding walls, in this case the lower abdominal wall towards the groin. Patients typically present with pain or discomfort when coughing, exercising or during bowel movements.

Mechanical causes of this condition include improper heavy weight lifting, hard bouts of coughing, sharp blows to the abdomen, and incorrect posture. Furthermore, conditions that increase the pressure of the abdominal cavity may also lead to hernias such as obesity, over-straining during bowel movements or urination, and chronic lung disease. Hernias are also more likely to occur in people with weakened muscles as a result of poor nutrition, smoking and overexertion. Sometimes hernias can be left alone, but in this particular case, Adam required surgical repair to avoid untreated complications.

Adam returned for chiropractic care two and a half months post surgery. I was surprised to hear from him that he had received no recommendation to undergo any exercise or core strengthening program. With my understanding that hernias almost always co-exist in individuals with compromised abdominal and core strength, it seemed vital that some sort of rehabilitation should be undertaken.

I was concerned for Adam as he clearly did not have the knowledge of the seriousness of his condition, and how engaging in some sort of corrective strengthening program should be mandatory in order to prevent future complications. Adam’s experience, emphasises that the treatment aspect of a condition, be it surgical or conservative therapy, is really only a small part of the process of healing a patient. Educating patients about their conditions plays a central part in healing. The more patients understand their conditions, the more the mode of treatment of their condition makes sense to them, and most importantly, the more likely they are to comply with any post-treatment advice (exercise prescription, nutrition, rest, etc).

In Adam’s case, it was clear to me that he should be engaging in core strengthening exercises to tighten up his abdominal wall and thus prevent any future hernias or complications thereof. My first challenge was to help him understand what exactly the core is, and why a strong core would be the best remedy.

For me, the best definition of the core musculature, is that of Dr Stuart McGill’s, professor of spine biomechanics, University of Waterloo, Canada. He describes the core musculature as all the muscles that exist between the shoulder and hip joints. The core thus comprises many muscles and is not simply just your abdominal muscles. Its function is to create stiffness along the length of the spine. Sometimes I refer to the core as the “seatbelt of the spine”. It’s a useful analogy when explaining to patients the core’s function, which is to brace the spine for any impact it is about to experience. This might be resisting movement throughout the spine when bending over to pick up an object, landing after jumping, or even fending off an annoying sibling trying to poke you in the stomach.

Do you remember the famous Olympic sprinter, Michael Johnson? One of my favourite video clips demonstrating one application of core strength is some footage of Michael sprinting. You can watch it below, take extra special note of his running form from 1:00 to 1:12.

People often recall Michael’s running style to be unorthodox, or at least, very distinct. Today our understanding of the core’s function however, helps us realise that it was this distinct style that enabled Michael to run so fast, so efficiently. I know from my own limited experience in sprint training, that the faster you want to move your legs, the faster you need to pump your arms. It is impossible to run [with any efficiency] in such a way that your arms and legs move non-synchronously.

Remaining completely stiff through the torso whilst sprinting as fast as you can, sees the least amount of energy leak between the arms and legs, thereby improving efficiency. In other words, if you want to run really fast, you need to develop the skill of maintaining a very stiff core whilst moving your arms and legs as fast as you can. There is of course, a lot more detail to coaching sprinting and running technique, the point here is simply to illustrate where the core’s function fits in.

A stiff core essentially provides a stable foundation from which to operate other parts of your body safely and efficiently. In sport, a strong core is always beneficial as it enhances your ability to move, jump, throw, swing, lift, etcetera. If youre not a sportsman however, a strong core is still essential. Daily activities like lifting, dressing, cleaning, sitting and climbing and descending stairs, often see us moving our bodies into awkward and compromising postures and positions. If we do not have the ability to adequately brace and protect our spine, we can cause injury to this region, if not our other appendages.

Adam is a desk worker, and doesn’t exercise a great deal. He acknowledges this aspect of his life needs some attention, so I decided to set some achievable goals for him. It can be daunting for someone who isn’t in the habit of exercising, to suddenly embark upon a full exercise program. I gave him two core exercises to practice every other day, for two weeks: the plank and the side plank. These two exercises require absolute stiffness throughout the core in order to be performed properly, they also work the vast majority of muscles between the shoulder and hip joints, and so are very applicable to the objective.

Adam reported back to me two weeks later. His feedback was that whilst he could manage the exercises, performing them for the recommended duration was more challenging than he thought. More importantly though, doing the exercises combined with a deeper understanding of hernias, and their relationship to the abdominal wall and core strength, he is now motivated to integrate exercise and core strengthening into his weekly routine.

Obviously, there are a multitude of exercises available to facilitate a stronger core. The plank and the side plank are two simple-to-teach exercises which I feel most people should be able to perform well. In practice, if I find people are unable to hold a front plank for at least 30 seconds, and a side plank for at least 15 seconds, it is my opinion that they may be in danger of injuring their spine.

The topic of core strength is very detailed and there is much debate as to its definition, function and methods for training. The purpose of this article is simply to provide the lay person with a basic understanding of why core strength is important, and a starting point for training. Please refer to some other useful information on Core Strength and Sit ups are bad for you.

If you suspect you have a weak core and/or have been suffering any pain throughout your spine, book online with one of our therapists NOW.

Sit ups are bad for you

If you had a wire coat hanger, and you wanted to break it, one way would be to bend it back and forth continuously. With each cycle of load, the stress strain reversal, you would fatigue the metal and eventually break it.

The same can happen to the intervertebral discs in your back. You only have so many bending cycles in these structures, and when you perform traditional sit ups, you will be approaching a level of fatigue in the discs that will eventually cause them to break.

The number of cycles you have is determined by many factors. In particular, your genetics will determine the quality of your discs. You could think of different gene pools like you would the difference between a BMW and a Toyota. Some genes just make better quality anatomical structures than others.

Other factors include alcohol, smoking, occupation and probably more. Both increased alcohol in the diet and smoking will effectively dry out the discs thus rendering them less able to perform their function. Depending on whether your occupation involves prolonged sitting, or a more physical role, how you use your body in terms of posture during the day will also influence the lifespan of these structures.

Just why are you doing sit ups anyway? If it is to lose weight and show your six pack, then you are not utilising your time effectively. You will burn calories by doing sit ups, but their are more efficient ways – running for example.

Is it to get strong abdominals? Sits ups will exercise your abdominals thus making them stronger, but it will be at the expense of disrupting the integrity of your lumbar spine. There are better ways to strengthen your abdominals.

Consider what athletes really use for performance (other than banned drugs). Try to think of an activity where someone tries to take their torso through the full range of flexion under load, in the same way you would when doing a traditional sit up. There are very few, particularly in sport.

Think of an MMA fighter about to throw a punch. The fighter will load the abdominal wall with a “pulse” and a “spring” to create a stiffness around the belly and torso. Following this, the power is generated by activating the hips. The “pulse” of energy is transmitted through the core which has been turned into a very stiff “spring”. There is a storage and recovery of elastic energy but the core is not flexed, it remains neutral. From here, more power is added through the shoulders etcetera.

The point is that when you measure most athletes in high performance situations, they are using the abdominal wall as a spring, or a medium through which the force generated from the hips or shoulders is transmitted. They are not using what would be trained when doing a sit up. Why then would you train it, damage the disc, and not get performance? The spine should remain neutral and you should train the stiffening “pulses” in the abdominal wall. This reduces the risk of injury and enhances performance.

On a more practical level, the average Joe can train their abdominals, together with the rest of the core musculature, with a series of safe and scientifically proven exercises. Watch the video in the article Core Strength for some suggestions.

*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.

Core Strength

Understanding what constitutes core musculature and tips on how to strengthen it safely and effectively.

“Core strength”, has become part of everyday vernacular but probably with less understanding than what most people think. The phrase was most likely born out of a need to simplify the complexity of the inner workings of the muscles surrounding the spine, so crucial to us during movement.

As the word suggests, “core” refers to the trunk of the body. More specifically, it is a collective term for a further sub-division of muscles known as the pelvic floor muscles, abdominal muscles and the erector spinae muscles. Essentially, the core muscles are used to stabilise the trunk during movement such as walking, running or playing sport.

Stuart McGill, a professor of spinal biomechanics at the University of Waterloo, describes the core as, “functioning to stop movement rather than to create it”. This is a fantastic one-liner that will aid people in determining whether their so-called, “core strength training”, is achieving what it claims to be doing.

In the following video, Stuart McGill provides some understanding of core strength, its relationship to low back pain, and some suggestions on the safest and most effective way to exercise your core.

Figuratively, your core is the seatbelt for the segments of your spine. When you move, your core braces the spinal segments, holding them in safe positions. When you slip, or perform a sudden unguarded movement, your core muscles must act instantaneously or else the joints between these spinal segments suffer the perils of injury – acute sharp and debilitating pains.

Whilst your core is active all the time during movement and exercise, your desk job or increasingly sedentary lifestyle, may be causing it to become a little slow or deconditioned. For this reason, it is highly recommended to spare some time to training your core frequently.

With a well-trained core, these muscles are always at the ready, so that in the instance where your body anticipates a compromising posture or accident, your core is activated and supports your spine.

*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.