The phrase “Core Stability” is used a lot by all disciplines involved in health and wellness. In our twenty years of experience as physical therapists we have seen that the definition of “the core” is highly variable but most often includes the abdominals. The core muscles attach to, and stabilize, the spine, the rib cage and the pelvis. The muscles combined are thought to construct a cylinder that allows for pressure to be built in the abdominal region that provides stability.
The definition of the core from our perspective is as follows:
Comprised of the following muscles:
Injury, pain and habitual posture all affect the speed, strength and endurance of core muscles so it is important to take care of and be aware of anything that may affect them.
The theory of instability of the lumbar spine and pelvis rests, in some part, on the inefficient contraction of core muscles that allow the vertebrae to move excessively and in a relatively uncontrolled fashion causing shearing, compression or tearing forces on the tissues of the spine including the ligaments, muscles, fascia, nerves and blood vessels that provide support and nourishment to the spine. If spinal instabilities are left unaddressed for even short periods of time, degeneration of the spine may occur. Pain and weakness often follows but it make take weeks, months or years to manifest. Nagging, persistent little aches and pains in the back, hips and legs are often associated with these dysfunction.
The theories of stabilizing the spine focus on strengthening the core muscles so that they can prevent the excessive movements of the spine and the “wear and tear” associated with it. Across the spectrum of physical therapy and personal training one can find a wide variety of exercises directed at strengthening the core. The difficulty is choosing the appropriate exercises to be done at any given time in a training program.
Research is now demonstrating that the core is effectively contracted when our parts (head, neck, rib cage and pelvis) are stacked on top of each other...again, posture is King! When muscles are either stretched or shortened from posture habits such as standing with the back hyperextended and, most commonly seen, sitting like “a boiled shrimp”, they are unable to contract at the correct time, with enough force or long enough to stabilize the spine when we sit, stand or perform daily tasks, much less when we play a sport. Standing straight, as many of us were told to do by our parents, may actually place the rib cage in a slight backward tilt rendering the core less responsive. Learning to stack the rib cage appropriately over the pelvis is one small step to improving the core response. Remember that habits are often deeply ingrained and require frequent corrections. Depending on the severity of the habit, those corrections may be every few minutes, hours, days and weeks. Even when we think that the old habits are broken, we may find ourselves lapsing into the old habitual postures, especially when tired or under stress.
When training efficient posture for sitting, standing or during sport or exercise, building strength and endurance of the muscles is important. This is the reason that exercises are performed. Exercises should be performed with appropriate form and to the point of fatigue of the target muscles. However, when proper form falters the exercise should be stopped. Depending on the severity of the habit, those corrections may have to be performed every few minutes, hour, day and weeks to implement.
A well trained Functional Manual Physical Therapist can help guide you through the morass of posture changes and exercises that you will need to make your core muscles responsive and strong so that you are able to do what you want with better strength and endurance and reduce the potential for injury.
Massage Therapy for Core Stability
When most people think about massage therapy the first word that comes to mind is: relaxation. The idea of massage therapy as a tool for muscle strengthening seems counterintuitive but is in fact not. Massage therapy is actually a form of passive exercise which means your muscles get a work out while your therapist does the work. Therapeutic massage sessions can help to improve the tone and texture of muscles over time, enhancing your strengthening efforts outside of the treatment room.
Addressing core stability with massage therapy begins with posture. How can massage help with your posture? Poor posture can sometimes be the result of an old injury and scar tissue build up that often leads to compensation in other muscles and muscle groups. By addressing these compensating muscles and muscle groups through massage therapy, along with softening scar tissue build up, we begin a chain reaction of communication within the muscle fibers. The muscle fibers begin to reorganize and slowly find their way back to their original purpose.
Most often, poor posture is the result of old habits that do not serve us. As Dr. Mike mentioned in the previous article, “the inefficient contraction of core muscles allow the vertebrae to move excessively [causing] compression or tearing forces on the tissues of the spine“. This spinal compression can be aided in relief with focused therapeutic massage; helping to create space within the muscle fibers and between the vertebrae while alleviating compressed tissues allowing for better blood flow to nourish damaged and fatigued muscles.
Commitment is the key. True results can be achieved by following the exercises and frequency assigned by your physical therapist, dedicating time to a results driven treatment plan with your massage therapist and committing to the work that needs to be done outside of treatment. It is the combined efforts of you and your therapists that make change possible. While most of the education happens during treatment most if the work happens outside of the treatment space.
Written by Jessica Pink, LMT
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All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.