Core stability

With the increase in popularity of Pilates exercise programs, terms such as core stability have begun to pass into common language. The uninitiated may be aware that this has something to do with the abdominal muscles, but for Physiotherapists the growing awareness of core stability has revolutionized the way we look at back pain and recurrent injuries.

So what actually is core stability?

Core stability refers to the ability of certain, specialised muscles to prevent uncontrolled and potentially injurious movement of the lumbar spine, pelvis and trunk. It is important to have adequate core stability, as powerful muscles attaching to the trunk initiate practically all movements. These movements are more efficient if the power-generating muscles have a stable base from which to move.

Forces transferred up the legs or arms (e.g. from running or hitting a tennis ball) are also absorbed and transferred in the trunk. If these movements are not controlled they can lead to injury. Have you ever jarred your back when you missed a step? That’s force transfer at work.

It is for this reason that your physiotherapist may assess your core stability in a seemingly unrelated injury. For example, a hamstring strain can be caused by an inability to properly control your lumbar spine and pelvis, shoulder injuries are commonly caused by poor stability of the shoulder blade and upper body, and knee pain is often cause by poor pelvic and gluteal muscle control . In fact, most musculoskeletal injuries are either caused by poor core stability, or can lead to poor core stability if the appropriate muscles are not fully rehabilitated.

The two primary core stabiliser muscles are Multifidus and Tranversus Abdominis. These muscles comprise the innermost layer of muscles in the trunk.

The problem is these muscles become inhibited when you have back pain, and significantly, they don’t necessarily automatically switch back on once the pain settles. They lose their memory and timing, such that if they do come back on, their protective abilities can be delayed. Moreover, research has shown that if the core stabilisers don’t work well, the back can be predisposed to further or recurrent injury. This has been studied and well-documented in physiotherapy literature.

Physiotherapists are skilled in the teaching of core stability exercises, and today they are used as an important component of rehabilitation from back pain and injury. Your physiotherapist can prescribe some specific core stability exercises to help with your problem. A very effective way to rehabilitate core muscles is through Clinical Pilates.