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The Elusive Core

Lets talk about the term “the core” and what it means.

I first came across this term in my initial Pilates training. At that time, it was (and continues to be) a rather vague term that generally refers to abdominal strength. It is still thought that ab strength directly relates to back stability. If you have chronic lower back pain (CLBP), you are often referred to a Pilates studio to strengthen your core. Pilates is designed to provide all planes of movement within the spine during your workout. For example, a one hour session will cover flexion (forward bend), extension (backward bend), side bend, and rotation or twisting. It is thought that by covering all these movements, the muscles that create those movements would get an even and balanced workout. But it is an unfortunate truth that Pilates involves far more flexion than other movements. Of course, when Pilates the man developed his Method, he was not dealing with chronic sitters (as we do today) as much as he was with elite movers.

Thanks to Dr. Stuart McGill’s work at the University of Waterloo, we know that training for a flexible spine that can perform crunches is not the way to a healthy pain free spine. Watch this short video to hear Dr. McGill dispel many of the myths of current back care:

During my training with Master Teacher Dianne Miller, I was taught that the core included not only the ab muscles, but also the diaphragm, the pelvic floor, and the deep spine muscles, specifically multifidus. At that time, we were recommended to cue contraction of the pelvic floor by “closing the space from sitbone to sitbone” (side to side) and “pubic bone to tailbone” (front to back). A strong pelvic floor contraction was the key to stabilizing the lumbar spine and avoiding extreme compression during advanced extension exercises such as Swan Dive and Grasshopper. While this method of pelvic floor contraction is more than the standard Kegel, it is still treating the muscles of the pelvic floor as weak and flaccid, when we now believe that most pelvic floor issues come from an issue of chronic shortness or tightness.

Still taught in many circles today (including medical circles), the Kegel is starting to lose its status as the one-and-only pelvic floor exercise. We know it works short term, but it will eventually cause your pelvic floor to fail, just as crunches will eventually cause your lower back to fail. (For more information on pelvic floor issues, please refer to this link to an interview with Katy Bowman, who is among the few people today revising the treatment approach to Pelvic Floor Disorder. Here is another interview with KB.)

Let’s examine the multifidus. These deep, thin spine muscles span 1-3 vertebrae from the sacrum to the top of the neck (C2) and are thought to stabilize the vertebra relative to each other, or as a relatively small lumbar extensor. Faulty motor control of multifidi was singled out as a possible cause of CLBP pain and core instability. Since they span only a few joints, they affect only local areas of the spine. Studies have shown people with low back pain issues have low function in the multifidus, which led to physiotherapy and strength training isolating the multifidus in an attempt to get these local muscles to fire and regain their role in spine stability. This pre-supposes that we can isolate these muscles from larger surrounding neighbours longissimus and iliocostalis, and also does not take into consideration other factors that could contribute to the lack of function such as sacral counter-nutation, prolonged sitting, and poor hip joint mechanics. In other words, is the multifidus the creator of low back pain, or the harbinger? If so, simply strengthening one muscle might result in short term relief, but does not address the cause and will eventually fail.

From Ultimate Back Fitness and Performance, by Stuart McGill:

“Over the last few years, there has been enormous effort directed towards enhancing the function of single muscles, such as transverse abdominis. This was motivated by the research from Australia showing perturbed motor patterns in the transverse in some people with back troubles. However, athletes focusing on single muscles are creating dysfunction in spines! Newer studies have shown that virtually all muscles demonstrate perturbed patterns of activation following back troubles in athletic populations and in workers. … The task and motion must be trained — not a specific muscle.”

(Bolding is mine.)

Katy Bowman, founder of Restorative Exercise™ calls the core “everything that your arms and legs attach to.” McGill calls the core everything between the four ball/socket joints. In other words, the entire trunk is the core, and if the muscles that attach the limbs to the trunk also attach to the limbs, where does core musculature begin and end? In other words, is it really desirable to think of one part of your body as separate and having a separate function from the rest? Does the human body really have a separate unit that is responsible for providing stability to mainly the lumbar spine?

The term “the core” is a man-made one (invented primarily to market gym classes in my opinion). There is no official area or musculature that is labelled “the core” in any anatomical book. The core as a term is growing outward to include the whole body, and that’s really how we should be thinking about our bodies. Everything is co-dependent and only when everything is working correctly can we have whole body health. If I may quote Dr. McGill from his book Low Back Disorders, “…exercises to isolate the lumbar muscles cannot be justified from an anatomical basis or from a motor control perspective in which all ‘players in the orchestra’ must be challenged during training.”

It is very difficult to give up this notion that if we can isolate a problem area, and only work on that problem area, we can solve the problem. That is how our fitness paradigms and our medical paradigms are constructed.

So if the core is something more than the abs, and is in fact something more than the musculature surrounding and supporting the abdominal cavity, what is the best core exercise? Well my friends, the answer is the one I always seem to come back to during my research travels: WALKING!

Another quote from Low Back Disorders: 

“Recent investigation into loads sustained by the low back tissues during walking confirms very low levels of supporting passive tissue load coupled with mild, but prolonged, activation of the supporting musculature. Callaghan, Patla, and McGill (1999) documented that fast walking with the arms swinging results in lower oscillating spine loads. When tolerable, aerobic exercise, particularly fast walking, appears to enhance the effects of back specific exercise.”

 Fast walking in this context is relative to “mall walking” or strolling. Note the importance of arm swing! Get yourself a backpack and don’t hold anything in your hands while you are out walking. So walking can enhance back specific exercise, and walking in alignment can improve the mechanics of your hips, leading to more ROM in the hip joint sparing the lumbar spine from compensation patterns (which could be the reason multifidus has no endurance in CLBP sufferers), and glute activation in this enhanced ROM can stabilize the sacrum from counter-nutating, increasing the length of your pelvic floor musculature and improving its tone.

So there you have it. The core is a made-up term. Your whole body is the core, and walking is the best core exercise. What are you waiting for?

Comments

One thought on “The Elusive Core

  • Excellent information, Carol. It’s interesting how we spend so much time and energy segmenting the body and developing isolated exercises when it really can be as simple as walking! Thanks for the motivation.

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