Core Muscle Retraining
The "core" refers to the muscles that surround our abdomen. Unfortunately, "core" training means different things to different people and this has lead to some confusion between disciplines and in the general public.
At Kamloops Physiotherapy, when we talk about the "deep core" we are referring to the muscles that have a direct impact on control of shearing and movement of your spine and pelvis during "low-load" tasks. The muscles of the "deep core" are called, transversus abdominus, multifidus, the pelvic floor muscles, and the diaphragm. When these muscles are working properly they will turn on at a low level before you move your body in order to impart stability to your spine. It has been demonstrated in many research studies that the timing and bulk of these muscles is impacted by injury. If these muscles do not work properly, you are at higher risk for recurrent pain and dysfunction as your body loses its ability to use the best strategy for the tasks that you are trying to perform.
The "outer core" refers to the muscles that we more commonly think about in the abdomen. These include the rectus abdominus (the 6-pack muscle) the obliques and the big extensor muscles on your back collectively referred to as the erector spinae. These are the muscles that are most commonly targeted in "core" classes and abdominal exercise programs. Sometimes after injury these muscles will get tight and contribute to back pain as they try to compensate for the loss of the normal timing and function of the deep core muscles. It was commonly thought for several years that using an unstable base (like sitting on an exercise ball or standing on a BOSU ball), or forcing your spine to maintain a position (like "the plank") would automatically recruit the "deep core" muscles, but we now know from the research that this is not the case, and that it is possible for our bodies to do all sorts of difficult exercises with the wrong muscles therefore reinforcing our compensatory strategies after injury.
All of the therapists at Kamloops Physiotherapy have had training in the use of real-time ultrasound imaging (RTUSI) to assess the function and recruitment of the core muscles. For more information please refer to the real-time ultrasound section of the website.