What is at the Core of Many Pain Problems?

Different people might suffer from different kinds of pain, yet the core of their problems is often the same. Take these four people, for example:

• Kirk had shoulder pain while doing some of his exercises.
• Gail had had 2 metatarsal fractures in the same foot in a year’s time.
• Lisa had jaw pain for the past year.
• Nancy had back pain and osteoporosis.

The key word here, is core. Upon evaluation, each of the people listed above had the same primary issue, among other issues, that led to their pain. They each had core weakness and the inability to use their core effectively when exercising or even functioning through the day.  So, they compensated and overused different parts of their body to make up for their poor functioning core and thus wound up with different injuries.  

That is how important your core is – it can affect any part of your body!

I’m sure many of you have heard of your core, but do you really know what it is and why it is important?

So, what is your core?  

The top of your core starts at your diaphragm, and ends at your pelvic floor and all the muscles in between: the abdominals and obliques, the paraspinals (back), gluteals (buttocks/hips), and the deep core: the transverse abdominus (a large, banded muscle that covers the abdomen and back down to the pelvis), the multifidi (deep back), and deep pelvic floor.  Although not technically part of the core, I include the external hip rotators, which are very deep, small muscles that rotate your hips out and stabilize your pelvis during movement.

The two roles of your core

The role of your core is twofold: 1) to stabilize your body as you move through life and 2) to transfer energy from one part of your body to another.  Not only do you need to be concerned with the strength or power of all of these core muscles but also that they are being used efficiently, activating at the appropriate time, and enough endurance to sustain the duration of the activity.

As an example of energy transfer through your core, picture a professional baseball pitcher pitching a baseball.  He winds up his body, gathering power up from his legs, which then travels through his core to his arm in order to hurtle a baseball 90+ mph to home plate.  When running a marathon the core, in particular, the deep core muscles and hip rotators, need to have enough endurance in order to stabilize the pelvis for upwards of 2+ hours and in my case 5+ hours.  When I ran my marathon, I made sure to tune in to check whether my core was engaged often throughout the whole race and luckily I came away unscathed.  If one of these pieces are not working together or if muscular fatigue of any one of these muscles sets in, injury can happen.

Core strengthening exercises

There are a plethora of core exercises you can do, but you must be able to do them correctly for them to be effective and safe.  My patients learn how to engage their core by doing exercises in a progression of positions from easiest to most challenging:

1. Engage your abs
2. Core exercises on back on mat 
3. Core exercises on back on foam roll or ball 
4. Hands and knees
5. Plank position
6. Standing
7. Standing with arms overhead

I often tailor my recommendations for women, athletes, and seniors. Here are some tips for these groups:

Core strengthening tips for women

Women must pay close attention to their lateral hip muscles, the glute medius and maximus and TFL.  Because of our anatomy, wider hips which narrow down to the knees, we tend to allow gravity to control our movements every time we squat, so our knees dive in.

A great, simple exercise you can do to engage those lateral glute muscles, is bridging:

To bridge, lie on your back with your knees bent and a fitness loop around your thighs. Pull out slightly on the loop, lift your hips up and down – you should feel your glutes and butt working — not your hamstrings (back of thigh).

Also see this video on How to Squat Properly.

Core strengthening tips for runners and other athletes

A common exercise athletes and runners use to train their core, is the plank on forearms.  To make sure you are using your core effectively, particularly your pelvic floor, put a ball between your knees and squeeze while doing your plank.

Plank variations with ball between your knees:

1. Raise your hips up and down, be sure to use your abs
2. Move your hips side/side being sure to remain parallel to the ground
3. Rotate your hips, bringing your whole body with you to almost touch the ground

Core strengthening tips for seniors

A major concern for seniors is prevention of falls.  Seniors should do the same core exercises described above for women and the first 3 steps in the core progression, but add in balance exercises as well.  

You can download these free balance exercises to help get you started.

If you want to learn what exercises you could benefit from to prevent injury, come on in for a wellness visit which includes an evaluation and a home exercise program to keep you feeling good.  Call us anytime at 847-541-7600
send an email to info@themanualtouch.com.

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