Functional Core

There’s more to the core than just the deep muscles of the spine. Our previous blog post discussed the inner unit muscles and the role they play on spinal stability. But is that all that you need?

Functionally, there are more muscles involved in controlling our movements and improving our sports enjoyment and day to day activities. These additional muscles involve local muscles of the trunk and those connecting the trunk to the limbs.

How do the superficial muscles help me?

A commonly used example that the exercise kinesiologist Dr. Stuart McGill uses is comparing your spine to a fishing rod.  Imagine that you’re trying to make this fishing rod stand up on its end. If you let go, the rod will fall over because there’s nothing to support it. If you wanted to make it stand on end, you could use ropes tied from the tip of the fishing rod to the dock below.

If you were to do this, where would you attach them?

If the ropes were very close to the base of the fishing rod they wouldn’t provide very much stability. You would want ropes that attach further out.

The big 3 core exercises

Similarly, by themselves the deep inner unit muscles are not sufficient to support our spine during functional movements. For our spines, the larger ropes attaching further away are the more superficial muscles of our trunk. They include your abdominal muscles (internal obliques, external obliques and rectus abdominus) and your quadratus lumborum muscles.  Dr. McGill is a proponent of the big 3 exercises to train the outer core. These exercises are:

1. Sideplank
2. Bird dog
3. Curl-up

Side Plank

The beginner side plank or side bridge starts with the hips in a neutral position with the knees bent to 90 degrees.  The object of the exercise is to raise your hip and thigh up on the support of your knee and elbow.  Though this is a beginner exercise, if these muscles are deconditioned you may find that you cannot raise up.  Alternatively, you may find that you experience discomfort in your neck or shoulder.  There are modifications that your therapist may prescribe to ensure that this exercise is right for you. 

Progressions may include performing arm or leg movements during this task or progressing you to straightening one or both knees.

Bird Dog

The bird dog can be a more challenging exercise engaging your hamstrings and gluteus maximus muscles in addition to the lumbar erector spinae. One of the biggest challenges of this exercise is ensuring that you’re starting in a neutral spine position. If a stick is placed along your back, it should be touching your sacrum, midback and the back of your head.

While performing the full version of the exercise you will require sufficient control of rotational forces trying to pull you out of position. If you find yourself falling over or unable to hold the position the exercise can be modified in a number of ways. This may include:

1. Sliding a limb without losing contact with the ground
2. Lifting only one limb at a time 
3. Using an exercise ball under your abdomen to assist with proprioception and to take some of your body weight

Curl-up

The curl-up exercise is meant to engage the rectus abdominus muscle.  Unlike crunches, the goal is not to perform large amplitude movements of the spine.  Emphasis is placed on maintaining neutral spine posture during the exercise and bracing the abdominal wall.

How would I know if these exercises are right for me?

These larger core muscles play an important role in supporting our spines in neutral postures during day to day and in higher level activities. Painful movements during day to day activities can be in part related to poor control of spinal movement resulting in excessive flexion or extension of your spine.  Proper activation of these muscles will allow you to keep a neutral and supported spine whether you’re getting up from a chair, carrying the groceries in one arm or while you’re at the squat rack in the gym.

Why can’t I do these exercises properly?

Chronic postures at home and work, sedentary lifestyles and previous injuries are all factors in how you progress with these exercises.  In some cases the first symptoms are stiffness with attempts to increase your performance in sports or performing activities that you don’t normally do. Ignoring the problem doesn’t resolve it and can lead to future problems that are more difficult to treat.

Which are the right exercises for me?

If you’re recovering from low back pain, the first step is to get an appropriate assessment by a physiotherapist experienced in treating spinal conditions is key. Part of the assessment should include ruling out more serious problems that may need further investigation. During the assessment, your physiotherapist will check your strength, neurological system and patterns of movement; for example, they may use different cues to elicit movements that produce or alleviate your symptoms. This is done to piece together an individualized program tailored to your needs.

Family Physiotherapy, assessing and treating persistent injuries and pains for the residents of Thornhill, Markham and Vaughan

The physiotherapists at Family Physiotherapy have been providing high quality assessment and treatment techniques using safe and evidence based techniques to the residents of Thornhill, Markham, Richmond Hill, Woodbridge, Vaughan and Toronto. Our therapists are continually upgrading their skills and take the time to provide you with the one on one care necessary to quickly get you back to the activities you love doing.  Comprehensive assessment and treatment techniques are always one on one without the use of assistants or double booking patients to make sure that you achieve your functional and sports goals as soon as possible.  Our therapists would be happy to help you to achieve your goals, contact the clinic to schedule a consultation to get you back on track.  Don’t let pain ruin your day!