Monday, November 28, 2011

On the Fitness Front...Core Stability: Not Just For Athletes

This week's guest post is by physiotherapist and yoga expert Shelly Prosko. Visit Shelly at http://www.physio-yogatherapy.com/



BITL founder, Ginger, in a typical core stability
yoga pose - boat (navasana) pose,
as pictured in her medical yoga manuals.
Most of you have likely heard the term “core stability” and have been told that it is important to have a strong core and to be able to engage it during certain activities in order to protect your spine.  However, if you are like the majority of my clients that I’ve seen over the last 14 years as a physiotherapist, you may not know what true core stability is or how to correctly engage it.  In fact, I commonly see clients who claim they already have had extensive ‘core stability’ training which they have incorporated into their exercise regimes, but, when we review what core stability really is, and how to correctly engage it, it is discovered that they were not engaging it correctly at all, and in some cases, were actually performing the exercises so incorrectly that they were at risk for doing more harm than good (which may be the reason why they were seeing me for their back pain in the first place)!

So whether you are preparing to hit the ski hills this season, performing fall yard work, interested in back pain prevention in general or during pregnancy, currently suffering from back pain or pelvic pain, or just wanting to continue to walk and perform all your household chores without experiencing back pain, it is important to be knowledgeable about core stability and how to apply it while participating in all activities of daily living or recreational sports or activities. 

The ‘core’ is a group of muscles that surrounds the back and abdomen and is best described as a cylinder of muscles.  The main function of the core is to stabilize and protect the spine and pelvis when the rest of the body is in motion.  There are 4 main muscle groups that make up the inner core:  Transversus Abdominus (TA), Multifidus (MF), Pelvic Floor muscles (PFM), and the diaphragm.  TA is the deepest abdominal muscle that wraps around your abdomen like a corset, and is connected to tissue surrounding the spine.  When TA contracts, it is similar to the corset being tightened, therefore assisting in increasing the pressure inside the abdomen which provides increased stability to the spine.  MF is a deep lower back muscle which makes up the back part of the core.  It is an important postural muscle that helps keep the spine erect.  The PFM’s are the bottom part of the ‘cylinder’ or core.  The diaphragm makes up the top part of the cylinder.  When all of these muscles contract simultaneously, they help to maintain the pressure in the abdomen which then provides the stability to the spine and pelvis.  It is important to note that the timing of these muscles is mandatory for effective core stability.  For optimal core stabilization, all the muscles will activate together and just prior to any body movements and are ideally maintained throughout all movement, all day!

A common misconception is that “strong abdominals protect the spine”.  In fact, as described above, the abdominal muscles make up only one part of the core.  Furthermore, only the deep abdominal muscle, TA, is involved in protecting the spine.  The famous “6-pack” or Rectus Abdominus muscle that many fitness fanatics train actually plays no role in protecting the spine.  If you are currently performing ‘core stability’ exercises, you may not be activating your TA correctly.  Instead, there is a chance you may be using the Rectus Abdominus (as evident by the abdominals ‘tensing’ and popping out and up) to compensate for the TA that you aren’t quite sure how to find.  This is a very common mistake and can lead to back pain or worsening of your current back pain problem.  Therefore, it is wise to ensure you are performing your core exercises correctly and safely by seeking out a qualified fitness or healthcare professional such as a physiotherapist or kinesiologist.  Research has shown that core stability training with a physiotherapist is recommended to prevent and treat back pain as well as pelvic pain during and following pregnancy (Britnell, et al 2005).  This is important, considering that 50-70% of all pregnant women experience back pain (American Pregnancy Association, 2007) and about 45% of all pregnant women suffer from pelvic pain (Meijer, 2004).

Adequate core stability not only reduces strain on the spine, but also helps maintain optimal postural alignment which will help reduce risk of injuries whether you are participating in regular activities of daily living such as housework or yard work, playing sports, or even just sitting on the computer or driving.  Core stability is also an important part of any rehabilitation program.  Even injuries such as hamstring or shoulder strains should incorporate core stability as part of the rehab process.  A strong core means a strong foundation from which our limbs can move more safely with more power and efficiency, and consequently, with less risk of injury to the limbs. 

Core stability exercises are addressed in Pilates and in many types of Yoga practise.  It is wise to invest in a few private sessions with your health care professional prior to attending these classes to ensure you are engaging the core safely, whether you have a back pain issue or not.

So remember that core stability training is not only important for athletes or ‘active’ people who like to work out at the gym and play recreational sports.  Effective core strengthening is an essential part of EVERYONE’S regular health maintenance regime.

About the Author
Shelly Prosko, RPT, PYT-C, CPI
Shelly is a Registered Physiotherapist, Yoga Therapist and a Certified Pilates Instructor. She received her Physiotherapy degree at the University of Saskatchewan, Canada in 1998, her Yoga Therapist training through Professional Yoga Therapy Studies in North Carolina (www.professionalyogatherapy.org) and her Pilates certification through Professional Health and Fitness Institute in Maryland (www.prohealthandfitness.com).

She has treated a wide variety of musculoskeletal, neurological and cardiorespiratory conditions while working in private orthopaedic clinics and long term care facilities across Canada and the United States. Shelly was the physiotherapist and clinic manager at The Morris Center For Sports Medicine in Watkinsville, Georgia for 7 years. In 2006, she relocated to Alberta and continued to work in the private orthopaedic clinic setting and was actively involved in the occupational rehabilitation programs at CBI Health.

In 2009, Shelly settled in the Okanagan and continues to follow her passions at Sun City Physiotherapy by offering private Physio-Yoga Therapy sessions and by incorporating Yoga Therapy and Pilates into her physiotherapy treatments (www.physio-yogatherapy.com) She also teaches specialty Physio-Yoga Therapy classes in the community. She believes that bridging the gap between Western and Eastern healthcare philosophies is essential in order to achieve optimal health. Consequently, her treatments are individually based and are a unique blend of both approaches.

In addition to her many skills as a health care practitioner, Shelly is also an accomplished figure skater and has traveled the world with many professional ice shows. She is also passionate about music, dance, acting, trapeze, and spending quality time with her family and friends.

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