The term “core” gets thrown around quite a bit, and one we at Elite Sports Medicine & Physical Therapy are not very fond of. Many individuals assume that it means the abdominals, and maybe even muscles included in the glutes, back muscles, or other muscles within that area.

However, “the core” itself is a term that really implies globally, the stabilizers of the spine and the pelvis. This includes muscles within the...

• Spine
• Neck
• Shoulder blades
• Low back
• Pelvis
• Hips

Let’s look specifically at the core within the area of the Lumbar Spine, or the lower back.

There are five vertebrae within the Lumbar Spine, which stack on top of a triangular base, the tailbone (sacrum).

In between the vertebra are the discs. The discs are structures that create a shock absorber between the bones of the vertebra.

The deal is that the vertebra and discs are essentially no different than any other stack of blocks. We have the blocks that sit on top of the base.

There are ligaments which connect bone-to-bone which help form some stability. There is the connection and the pressure that is around the area just from the stacking itself, but one of the things that really controls the ability of your spine not to move too much is your core musculature.

There are four specific areas of muscles that connect to control stability within this area:

1. Abdominals
2. Back muscles
3. Pelvic floor
4. Diaphragm

Why is core strength important?

If any of these four areas are disrupted because they're either too tight, too weak, torqued an odd way, or not firing correctly, you have a potential disruption in the stack of blocks, which is very unstable inherently.

As a result, we have decreased control of our core, and are more susceptible to pain and injury.

So what do we do?

There are thousands upon thousands of exercises we can do! However, sometimes we think our exercises are helpful for building a core-strengthening program, but may actually do a lot of harm to our lower back.

The importance of core strength cannot but understated!

How do we identify what is a safe exercise, versus what might be causing our body harm?

In general, if you are doing an exercise that requires you to arch your lower back, whether you are rounding it forward or overarching backwards, or if you're doing an exercise that requires you to twist a lot at the lower back, those would be things to avoid.

We actually want our lower back to be pretty stiff and stable, so we aim to engage our abdominal muscles and do those other motions at our hips and at our shoulders. Those are the parts of our body that are really meant to move a lot.

Here is a list of common core exercises that you might think to avoid at the gym to save your lower back, and truly build a strong core:

• Crunches
• Sit-ups
• Russian twists
• Superman (performed laying on the stomach)

Building A Successful Core Strength Program

Answering The Question, "How To Build Core Strength"

True or false: Our core needs to be trained DAILY

TRUE!

Our core is essentially the entire midsection of our body -- our stable center -- and it is meant to be functioning 24/7. That is why it is critical to build up a core strengthening program, even with just a few exercises, and do them daily. It might only take you five minutes, but it can be really effective for building up that core strength.

Here are a few exercises you might consider including in your Core Strengthening Program:

• Abdominal Bracing
• Bird Dogs
• Chin Up
• Side Plank

Abdominal Bracing

So the first one seems really simple, but it can be pretty hard.

What we want you to do is take your hands on the side of your waist and then imagine you are in a boxing match and you are bracing for a punch to the stomach.

The best way to protect ourselves if we're bracing for a punch is to tighten everything.

This does not mean sucking in the stomach, think of it more as tightening all the way across your midsection. With your hands placed on the side of your waist as you try to brace.

What you should feel is that by bracing or tightening these muscles is that your hands are kind of pushed away by your abdominal muscles.

ABDOMINAL BRACING:

What you want you to do next is see if you can maintain that tightness, or that brace while you breathe.

They call this “Breathing Behind The Shield” and it is actually really hard.

So first to try to take a couple breaths without letting go of that tightness. As you get comfortable with that, see if you can take more and more breaths while maintaining that bracing.

One thing to keep in mind is that it's not supposed to be as hard as you can brace, so if 10 out of 10 is as hard as they can go, for this think two, because we ideally would be doing it 24/7, and a lot of times without even thinking about it.

Bird Dogs

The next exercise we love is called the Bird Dog.

Begin by getting on your hands and knees into a tabletop position. You want to have your hands underneath your shoulders, and your knees under the sides of the hip -- so both your hands and knees should make a 90 degree angle with your torso.

The Bird Dog itself means you are going to raise your opposite arm and leg straight out in front and straight out back, while keeping your spine, neck, and head in a neutral position. For example, if your right arm is straight out in front of you, your left leg is straight out behind you.

BIRD DOG:

If the full position of the Bird Dog is too difficult, or you are not yet completely stable, you can make it easier by just moving a leg or just moving an arm, one at a time. This is a great modification as you work towards building true core strength properly.

MODIFIED BIRD DOG - OPTION 1:

MODIFIED BIRD DOG - OPTION 2:

AVOID THIS MISTAKE:

What you will commonly see people do is they try to raise up to the ceiling, which we do not want, because that tends to make our lower back arch or twist too much.

We actually want the lower back to be really still, and almost like a tabletop throughout the exercise.

So think about like you're punching straight in front, and you're leading the heel, like you're kicking straight back.

Once you are in that position, you want to hold it for about eight seconds, then switch sides, doing about five rounds each side.

Take a long break. Come back. See if you can do it a few more times, and then one more time. Ways to build up the endurance, rather than trying to hold for a longer and longer period, is to add on a repetition each set.

Modified Curl-Up

We mentioned that crunches and sit-ups are not ideal exercises to be included in a core strengthening program. What can be really helpful for the core, that is also safe for low back pain, is a modified curl-up.

Here’s what this looks like:

• Lay on your back with one leg straight, and one leg bent with your foot flat on the table/mat/floor. This position will keep your lower back happy!
• If you can with your shoulders, place the hands just to the side of the curve of your lower back.
• Gently, and subtly, lift your head and shoulders; hold it for about 10 seconds.
• Relax & repeat

This motion is really subtle. Here is an analogy you want to think about with this exercise:

Picture you head as if it is resting on a scale, so when you raise your head and shoulders up off the table/mat/floor, as if you are trying to move that scale to zero. So barely lift up.

MODIFIED CURL-UP:

Side Plank

A core exercise that really works nearly the full body, and is very helpful for low back pain is called the Side Plank.

To get into the proper position…

• Lie on your side. You want to have your feet in a straight line, with the top leg in front of the bottom.
• Make sure the elbow is right underneath the shoulder.
• Then, lift the hips off of the ground or off of the table.

SIDE PLANK:

The whole idea is you want to maintain that position, keeping the lower back as still as possible, by imagining a straight line from the head all the way down to the feet.

If the full expression of the side plank is too difficult or it irritates the shoulder consider the following modifications:

• Bend the knees and then lift up the hips up from there.
• If that still bothers the shoulder, you can cross your arms. Extend your legs into that straight line, and keep the feet glued together. Then only raise the legs up.

MODIFIED SIDE PLANK - OPTION #1:

MODIFIED SIDE PLANK - OPTION #2:

No matter what version of the side plank you practice daily, keep in mind that you can build up your endurance with lots of repetitions rather than for holding for a really long time. Start with five times for about a eight-second hold, switch to the other side, take a break.

Then do three more.

Then one more.

Each set you're doing a little bit less to make it easier so that you can maintain proper form.

Spend A Lot Of Time Sitting? We Have Core Exercises For You!

Are you unable to stand? To move? To get into a plank position? To get into some of the other positions that you can use to work the core? Or maybe your job requires you to sit for long periods of time throughout the day…

Regardless, you should understand that exercising your core daily is critical, which brings us to our three favorite seated core exercises.

These are basics but they are fundamental movements that can be good to help retrain your body if you're either unable to stand, if you have balance issues, you cannot tolerate typical positions of core exercises, or if you wanting to get some abdominal exercises in while you're sitting over the course of your day.

Yes, you can do core exercises while sitting! Here are three:

• Abdominal Drawing In Maneuver (ADIM)
• Bracing
• Arm diagonals

Abdominal Drawing in Maneuver (ADIM)

So ADIM is an acronym for Abdominal Drawing in Maneuver. What we do is…

• Place one hand on your chest and one on your stomach
• Using your abdominals, pull your stomach in. You do not want any motion to occur in the hand over your chest.
• Hold this position, and breathe. You can do it as short as 10 seconds, or aim to do it as long as a minute or two. You are trying to build up strength and control of breathing in this position.

ABDOMINAL DRAWING IN MANEUVER (ADIM):

The reason why we recommend putting one hand on your chest is because when many people are told to suck their stomach in, they take a big deep breath and everything moves from their chest, not from their abdominals.

However, we want to reinforce that you want your chest to stay soft and quiet, and to have everything come from the movement of the lower hand, which is over the abdominals.

Mastering this exercise takes some practice for some people. Some people have a tough time breathing when they are doing it, because they have difficultly with really being able to control that position of drawing in.

In terms of sets and reps, you want to do this multiple times a day as often as you can.

Seated Abdominal Bracing

With seated abdominal bracing, what you are going to do is create compression around the abdominal area that is a little more similar to if you were going to get punched in the gut how would you control your stomach position.

What you want to avoid with this though, is crunching.

So we do not want you doing is pulling your shoulders forward, thus yourself down, flexing your core down in that position. That actually creates more compression at the spine not more stability.

So what you want to do is put the hands at the side of the waist and think about pushing your hands out to the outside.

SEATED ABDOMINAL BRACING:

It's a tough trick to get to because you're going to want to move -- you're going to want to shift and do other things. This exercise will take some practice, but can be perfected over time.

It is an essential core stability exercise that you can do to work on every single day.

Arm Diagonals

With Arm Diagonals, understand that it takes a little bit more coordination, but it's a nice exercise to do in sitting.

What you are going to do is…

• Position an arm across the body, with a straight elbow, and your hand towards the opposite knee, hip, thigh, or somewhere in that area there.
• Think about either doing one of these two positions: Either abdominal drawing in or bracing. You do either or both.
• Once your core position is established, you are going to work on bringing yourself across the front of the body in a diagonal motion, opposite of where you started. As you do this, ideally you ant your eyes to follow your hand.
• The final position of your hand will be towards the sky, as if to make half of a “Y”
• The, follow your hand (with your eyes) all the way back down to the starting position, across the body.

ARM DIAGONALS - POSITION 1:

ARM DIAGONALS - POSITION 2:

This exercise can be performed with no weight, or you can add a light dumbell into your hand.

Note: As you come up, you do not want to not let your back arch or move. You want to keep your spine in a stable position to really challenge your core.

By doing so, you it will be a challenge to your core that you can do in sitting, and an exercise that does not require any sort of balance or any higher level control of your body.

You want to make sure you definitely do Arm Diagonals on both sides, provided that your shoulders are free from any pain, injury, or limitations.

Key Takeaways For True Core Strength

• Having true core strength will provide overall stability and help you move better in all areas of your life
• Core strength is fundamental for building strength in other areas throughout your body
• A six pack does not indicate true core strength
• A Core Strengthening Program should be practiced every day
• Remember to BREATHE while performing core exercises
• You can improve core strength even while sitting
• The lower back should remain neutral during core exercises. It should not be twisted, arched, or crunched during core exercises to reduce strain on the low back

As always, please be safe when performing these exercises at home. None of them should cause any pain or discomfort.

If you have additional questions about developing a Core Strengthening Program that is specific to you, ask your Physical Therapist for assistance.

If you do not have a Physical Therapist you can give Elite a call at 816-943-2550 to schedule a free 30 minute consult with Michael. During that time you can discuss your specific body -- including strengths, weaknesses, and limitation. Then together, you can begin to see what a successful Core Strengthening Program looks like for you!