CORE STABILITY – HOW DO YOU ACHIEVE IT AND SHOULD YOU EVEN TRY?

Why do you need to think about exercising your core?

When you have injured your back, the deep muscles that support the back structures become inhibited by pain and the longer the pain goes on, those muscles also atrophy, which means that the muscle fibres become infiltrated with fat. Fat is obviously not going to be able to react to movements you make to be able to help with stability so your core will be weaker as a result.
Furthermore, this inhibition does not just disappear when the pain goes. Therefore after you have injured your low back, you need to exercise in order to restore those muscle fibres and therefore restore strength.

Basic muscle facts to consider

There are two types of muscle in your body.
Type 1 which are tonic muscles and they are made for endurance and maintaining posture. They are the deeper muscles.
Type 2 A muscles – which are faster ‘phasic’ muscles which perform movements more superficially.
Type 2 B muscles – which have more ‘explosive’ muscle fibres.
Whether you are going to excel at a sport or are more prone to develop problems does depend on your genes though – and how many of these fibres you are actually born with. Usain Bolt for example was born with a lot of Type 2 B fibres so he is brilliant at an explosive, short burst activity.
Chiropractors need to know what you want to do with your body in order to give you the best advice regarding what type of exercise you should be doing.

What exercises should you do?

Those deep, type 1 muscle fibre filled muscles for example multifidus create compression of the joints in the spine and are therefore important for stability in the spine. The outer type 2 filled muscles of the abdomen are more designed for movement than stability. Although exercises that train the outer muscles will help to compensate for weakness in the deeper ones, those outer more dynamic muscles will still be working from a weaker ‘base’ and thus your overall function will be compromised, also the outer muscles fatigue quicker than the deeper stabilising muscles. This means you will be more likely to injure your back again if you fail to try to restore strength in your deep postural muscles.

ABDOMINALS AND BUTTOCK MMS
The question is and has been for many years, how specific do these exercises need to be? Do you need to focus on those muscles that have atrophied? Indeed is it even POSSIBLE to be selective in what you do enough to be able to focus just on those muscles?
It is certain from research that if you perform an exercise that is thought to be more specific to those atrophied muscles then the brain neurons that feed those muscle fibres are ‘woken up’ and it is easier for the brain to ‘find’ those muscle again. This is called ‘neural drive’. The nerves feeding the muscles are more easily activated and need a lesser impulse to cause muscle movement, so the more exercise you do the easier it is for your brain to recognise and activate the muscle.
Research both supports and questions core stability exercises. It is still not clear whether core exercises are really more effective than just doing any exercise but you do need to restore strength in your deep stabilising muscles. They need to activate quickly in order to provide a strong ‘base’ from which the more superficial ‘phasic’ muscles can derive support.

How to activate the type 1 tonic muscles

You need to understand that to develop strength in these muscles you need to hold a position that loads the muscle for between 3 and 5 minutes. Performing repeated short bursts of exercise will not be as effective – this type of exercise is best for developing the type 2 fibres.
First thing to consider if you have a low back problem is that you need to exercise with a NEUTRAL SPINE. This means that your low back is neither too flat or too curved inwards and therefore the muscles around the spine and the joints in the spinal column are not overloaded.Then you can exercise safely. Furthermore when you hold your back in a neutral position, your deep abdominal muscle (transverse abdominis) is activated, which adds to the stability of your core. If you imagine a band around your abdomen of strong, deep muscles that stop the joints and ligaments and discs in your spine from moving too far and being strained or sprained or torn, then you can appreciate the importance of a strong core.
If you are unsure whether you are able to achieve a neutral spine ask your chiropractor or if you attend a gym, ask the instructor to watch how you perform an exercise so they can tell you how well you can hold your spine in neutral.
You can do an exercise whereby you are on all fours, which makes it easier for you to feel if your back is either arched up and too rounded like a cat or dropped down into a dip. You can then be shown how it feels when your back in in the neutral position. Then you can move your arms and legs whilst maintaining the neutral position and holding these positions for that 3 – 5 minutes. There are various ways of making the exercise more demanding so that you gradually and safely strengthen your core.

QUADRUPED EXERCISE

Why do you need to try to improve your core muscle strength?

You can understand now that due to:
1. The fact that there are two different abilities of two types of muscles.
2. The fact that any low back problem quickly leads to weakness of the deep stabilizing muscles.
3. The fact that the more superficial muscles can and should be strengthened to help with your overall core strength but they do not have the ability to sustain postural control like the deeper tonic muscles.
4. To train those deeper muscles that waste with injury you need to HOLD a position that challenges those muscles if you want to strengthen them for 3 – 5 minutes minimum.
You need to undertake a series of exercises to ‘wake up’ your deep core muscles and then you can do your preferred exercises to maintain your overall core strength, having got those muscles back to being able to stabilise and support your low back. There are so many exercises that will wake up the core muscles that are not at optmal strength after a back probem. Ask your chiropractor for help or your gym instructor.