The Power of the Inner Core

The Power of the Inner Core

Back, hip, and knee pain are so common in this day and age because many of us have major weakness in our inner core muscles. We spend so much of our time sitting that many of us have lost the ability to properly stabilize our spine and hips. The inner core is made up of 4 components; the multifidi muscles, diaphragm, pelvic floor and transverse abdominis (TA). The multifidi attach on your lumbar spine to help keep your back erect, the diaphragm is the main muscle used for breathing, and the pelvic floor is important for keeping many of your organs in your abdominal space. The TA muscle is the one I will be focusing on, since almost everyone has trouble getting them to contract properly.  It is the deepest of your abdominal muscles, therefore making it the most important in stabilizing the hips and spine making it a key factor in protecting you from external forces. The TA muscles do this by helping you brace yourself for impact.

Many people know they need to have a strong core to keep up with daily activities, making most people focus on exercises such as planks, bird dogs, and sit ups, to name a few. These types of exercises are useful to help strengthen your outer core muscles. The difference is that the outer core, or as I like to call them your “6-pack” muscles, are used to help you perform simple or complex movements or exercises, such as lifting yourself up, rotating to the side, or bending  from side to side; movements that are all very important in daily activities. The inner core is very crucial in performing these exercises properly, providing stability to the spine and pelvis to prevent you from injury. This being said, one of my main focus’ in rehabilitation is strengthening the inner and progressing to the outer core.

To get your inner core to activate lie on your back with your knees bent. With two fingers, find your hips bones, slide your fingers in about an inch and cough gently. With the cough, you should feel a small muscle bulging into your fingertips. That is your TA muscle! Finding it is easy, but getting it to activate (contract) is a different story. Here are a few tricks to help you contract your TAs:

  1. Pretend you are walking into freezing cold water

  2. Pretend you are putting on a really tight pair of jeans

  3. For women only – try holding in your pee

  4. Pretend there is a string running through your belly button and I’m pulling it towards the floor

  5. Rock your pelvis backwards

Once you are able to find this contraction, hold it for 10 seconds, and repeat 10 more times. It is generally a slow progression to more complicated exercises, however, one that is definitely worth it in the end! Here is the exercise progression I recommend:

  • Sliding your heel down, one at a time and alternating each side

  • Marching – with knees bent lifting one leg off the table about 2 inches, alternating each side

  • Single leg raise with legs straight, alternating each side

  • Dead bugs – lying on your back with arms held out and legs up and bent at 90 degrees, bring one arm back and straighten opposite leg

  • Bird dogs – kneeling in table top position, lift one arm up and kick opposite leg back

In order to progress from one exercise to the other, you need to ensure that your hips are stable during the exercise. You can do this by keeping your hands on your hips bones during the easier exercises, or by having someone spot you to make sure you are performing the exercise correctly. So get moving and get that core nice and strong!

Want to learn more about how to strengthen your core muscles, or other problem areas? Book an appointment with Phoebe to get a personalized program!

All About that Booty

Suffering from low back, hip or knee pain?

Maybe you should blame your booty!

With an increase in desk jobs, and a more sedentary lifestyle, our core and glutes have become inactive, and are less able to
protect our spine and low back from external forces. There are three gluteal muscles – gluteus minimus, medius and maximus. Gluteus minimus and gluteus medius work together to abduct your leg, meaning it works to bring your leg out to the side of your body. Gluteus maximus on the other hand is the main hip extensor in your body, working to extend your leg backwards. Your glutes are the largest and strongest muscles in your body! If they aren’t activating properly, excess stress is being put on your quads, hamstrings, and low back. This doesn’t mean your glutes aren’t strong, they just don’t want to kick in when they need to because other muscles are doing the work for them. For example, if a team leader isn’t pulling their weight at work, the team can pick up the slack for a while, but eventually the system starts to break down causing issues in the workplace.

Here’s an exercise for everyone to try!

Lie on your stomach and simply try to lift up your leg. What muscle do you feel kick in first? Your hamstring, glute or low back
muscles? On most individuals it’s usually hamstring or low back and then glutes last. The correct firing pattern for this exercise is glutes, hamstring then low back! So how can you fix this? It’s simple – contract your bum! If you can isolate one glute at a time, your brain will recreate the pathway from your brain to your glute max making it able to fire again. This is such a simple exercise that you can do anytime throughout the day.

So get that booty firing again!

Muscle Energy Techniques (MET)

Hey Everybody!

Not long ago, I took a course on muscle energy of the pelvis and lumbar spine. Throughout my athletic therapy career the most common injury I’ve come across are low back injuries. In my experience, hip alignment has a huge impact on the occurrence of low back pain because it can cause different types of imbalances and weakness. Hips can come out of alignment from either your daily posture combined with a weak core/glutes, or it can happen with a sudden stress to the back. An example of daily posture could be a soccer player who only kicks with their right foot, is always rotating and stressing their body in the same way, or sitting with your legs crossed in the same way. On the other hand, a sudden stress to the body could be a fall, slipping on ice, or stepping off a curb awkwardly, to name a few.

Muscle energy is a manual therapy technique that involves bringing the patient into a position of joint realignment followed by a muscle contraction. This muscle contraction helps realign the position of the joint. Therefore, if someone is presenting with an anterior rotation in their pelvis (i.e. the hip is rotating forward) it would be important to get the person in a posterior rotated position (rotated backward, such as knee to chest). I would then ask the patient to contract their hamstring by pushing down towards the ground, which would cause the hamstring to help put that anteriorly rotated hip back to its normal alignment. Keeping the hips in proper alignment is very important for the low back because if they are not aligned the body is putting more stress on the low back. It may also cause glute and inner core weakness, which could mean the individual is unable to correctly brace themselves from external forces. Realigning hips is very important in rehabilitation of the low back, however, in order to get rid of your back pain you also need to focus on home exercises. Examples include glute activations, inner core strengthening, and stretching. Pelvis alignment was a major focus during this course, however I also learned about the alignment of the sacrum and lumbar spine, and the application of MET for them!

Book your appointment with Phoebe to find out more and experience the benefits of Muscle Energy!