The Inner Core
Deep to our superficial muscles are a group of muscles that are frequently referred to as the deep core or “inner unit”. This unit can be thought of as a can deep within us. It is made of the diaphragm at the top, the pelvic floor at the bottom, the transversus abdominus at the sides and front and the lumbar multifidus at the back. These muscles have been shown in some studies to have a feed forward activation. In other words they contract before the muscles that create our spinal movements and regardless of how we move when functioning normally. When they are not functioning properly, they may contract too late resulting in low back pain with light tasks.
Is Inner Core Training Right For Me?
Several clues will let your health practitioner know if inner unit training is right for you. Your provider should be taking a detailed history including the location of your pain, its nature and what brings it on and improves it. A detailed physical examination should include active movements as well as range of motion of neighbouring regions. If you are able to contract the muscles, you may be cued to contract them during limited or painful movements. If you are unable to contract them, your physiotherapist may apply pressure to certain regions to mimic the action of these muscles.
If active or passive cueing of your muscles improves your symptoms of stiffness or pain then inner unit training may be appropriate for you. The exercises are not painful to do and the emphasis is on low level activation and building up endurance of the muscles in neutral positions.
As you improve the exercises should be progressed to functional positions and movements with the goal of maintaining a neutral spine while performing other exercises. Poor progression of these exercises is one of the reasons that you may have experienced a recurrence of your symptoms or didn’t feel like you returned back to full function.