Inner Core

When you hear the words “core training” what do you think? Most would automatically say sit ups, planks, or some other variation of exercise designed to work our rectus abdominus or our “six pack” muscles. We hear it all the time — people want to “strengthen the core” or “flatten that stomach” and they automatically train the rectus. Today, we’re going to propose a new definition of core. One that is often talked about in our “physio world,” but not something the general public necessarily knows much about (unless you’ve been to physio in the past!) These are muscles that run very close to your spine from one spinal segment to the next, and give our spine stability. Stability from which all other healthy movement should occur. So, before you begin those sit-ups or start lifting those weights, make sure you can do these simple exercises first.

Inner core is a general term we can use to describe many of these stabilizing muscles. Have you ever wondered why so many people have “bad backs” or have had neck pain on and off for so many years? Most of these cases aren’t actually attributable to major structural damage, but much more likely, an inner core deficit and the associated sequela.

These inner core muscles are actually inhibited by back pain. Meaning, if you have had back pain in the past, even if relatively short lived, these muscles quit working. When they shut down, our body still craves stability and has to find another way to compensate to achieve this. This is when our outer power muscles step in. These are the big, powerful muscles that span multiple segments of our spine and were built to move our body, not actually stabilize things. With the power muscles trying to perform a role they aren’t built for, they end up tightening, compressing the spine, and increasing pain. This can then cause a viscous cycle between pain and muscle spasm. The back hurts, so these muscles tighten up, making it hurt more, so they tighten more. So, those with a history of any back pain may find it especially difficult to find and use these muscles. This also means it is so important for these people and/or anyone wanting to train their core to be able to activate these muscles first.

So how do you find these muscles? The following are a couple examples to test yourself with at home:

1. Transverse Abdominus – This muscle is part of a group of inner core muscles that support the lower back. In order to find it, lay relaxed on your back with your knees bent and feet resting comfortably on the floor. Find the bony part on each side of your lower abdomen (this is actually part of your pelvis). Bring your fingers slightly down and in just off of these bones. When this muscle group is relaxed, your fingers should be resting on a soft part of your abdomen. When performing this exercise right, you will feel this area “tauten up.” This would feel similar to plastic wrap being pulled tight over top of a bowl. It won’t bulge way up into your finger, it won’t sink down in — just tighten up. One of the most difficult parts of performing this exercise, is that your body isn’t actually going to move when you are tightening the right muscle. If someone else was watching you, they shouldn’t be able to tell that you are doing anything. Throughout this exercise, your large stomach muscles, your glutes, and your inner thighs should stay completely relaxed. There are many different cues you can think of in order to find and activate this muscle group.

The following is a list of examples that you can try:

1. • Think about slowly and gently bringing your belly button in toward your spine.
   • Think about your spine with each vertebra stacking one on top of the other. Imagine lengthening the spine and creating space between each vertebra.
   • These muscles often activate along with the pelvic floor as they all function as part of our inner core. Perform a kegal exercise where you are lifting from the bottom up, a similar sensation to if you were trying to stop the flow of urine.
   • Imagine your abdomen being a hotdog bun open lengthwise from your bellybutton to your pelvis. Try to close the hotdog bun.

2. Deep Neck Flexors – In order to find this group of muscles, start by laying comfortably on your back with either a small towel roll or pillow under the neck. Imagine a pencil stuck through both your ears and try to do a very small “chin tuck” from this axis. This is a small movement; if you are lifting your head off the pillow or getting a double chin you are going too far. This motion should actually feel really easy – almost like you’re not accomplishing anything at all. The difficult part is doing this exercise with the right muscles. If you are in fact using the deep neck flexors, you won’t be able to feel any external muscles tightening up and working. Place your hand on the outside/front of your neck. These muscles should remain soft and relaxed throughout the chin tuck.

When attempting to locate either of these muscle groups, remember that they are endurance muscles. This means that you need to activate them slowly and gently. If you try to bring on the contraction too fast or too strong, the outer, power muscles will do the work instead. Don’t try too hard. Only use about 50% of your effort— you actually get to be lazy when doing this exercise.

Again, with these being endurance muscles, they are meant to work at low levels all day long. It can be difficult to tell when they are fatigued. You will never “feel the burn” when using these muscles like you would if you performed a bunch of squats. But, what you may notice is that once you seem to get the hang of things and can do a few reps, well, all of a sudden you just can’t seem to make it work anymore. This is a very good indication that those muscles have fatigued. Take a break and then try again later.

It is common in our society to seek treatment in order to loosen our neck or back when they are painful. Typically, people are looking for stretching, soft tissue release techniques, acupuncture, etc.  And while these are definitely valuable treatments that we use daily, don’t forget about strengthening! It will be impossible (and actually not very wise at all) to have an area “loosen up” without having the proper muscles then step in to stabilize and protect.

Do you feel you could benefit from this type of core training? A skilled Physical Therapist can ensure you are performing these exercises correctly and provide you with the proper progressions to move you away from chronic back and/or neck pain toward a healthy, pain-free life.

-Laurel