Getting back to exercise without pain: The core

Core strengthening also referred to as lumbar stabilization is used as a therapeutic exercise treatment for low back pain (LBP). In those with LBP, growing evidence suggest, that the structure and function of the deep stabilizers within the core such as the transversus abdominis (TrA) and lumbar multifidus (LM) are altered (Hodges-Richardson, 1996; O’Sullivan, et al., 1997; Tsao-Hodges, 2008). These muscles normally contract in an anticipatory manner to limb movement in healthy people Hodges-Richardson, 1996, 1998; Ferreira et al., 2004; Hebert et al., 2010) and provide a stiffen spine segment needed for accurate limb movement (O’Sullivan et al., 1997). By targeting the TrA and the LM simultaneously (Richardson-Jull, 1995; Hebert et al., 2010) in LBP patients and clients researchers saw improved strength, endurance, motor control in these muscles, improved sport performance in general and pain was successfully alleviated (Richardson- Jull, 1995; Tsao-Hodges, 2008; Akuthota et al., 2008). As a personal trainer, I have been taught that the core should be activated before the vigorous movement of training, that it is undertaken by either ‘hollowing in’ or bracing the belly button to activate the stabilizers of the spine. Research suggest that by regularly engaging the core muscles with first hollowing then later bracing clients and patients can learn to turn on and improve motor control of the TrA muscle