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Dr. Allison Andre, DPT

Beyond Six-Pack Abs: Understanding and Strengthening Your Core

Have you ever heard the term "core" being thrown around in fitness and wellness circles, but wondered what it really means? The core is often associated with having six-pack abs or a flat stomach, but in reality, it's much more complex than that. Your core is a group of muscles that work together to provide stability, support, and movement for your entire body. Understanding your core and how to properly strengthen it can not only improve your physical performance but also your overall health and well-being.


In this blog post, we will dive deeper into what your core is, why it's important, and how to properly strengthen it for optimal health and performance. So, let's get to the core of the matter and find out if you really know what your core is!





MUSCLES THAT MAKE UP YOUR CORE

So, what exactly is your core? At its simplest, your core is made up of muscles that wrap around your midsection, from your ribcage to your hips. These trunk muscles include the transverse abdominis, the diaphragm and pelvic floor, the erector spinae, and the multifidus. The "six-pack" muscle - the rectus abdominis is the superficial layer over (fitness expert and aut hor)s less important to the overall stability and strength of your core.


Your core is like a can, with the bottom being the pelvic floor, the top being the diaphragm, and the sides being the transversus and other muscles that wrap around. If any area of the can is weak, it can collapse under pressure. The same is true for your core.

Neglecting the pelvic floor and diaphragm muscles or focusing solely on the rectus abdominis can leave your core weak and unstable. This can result in poor posture, compensations, and even pain or injury. That's why it's essential to engage all the muscles in the trunk, and the muscles that make up the core. Give them the attention they deserve! Let's dive into the core anatomy.



 


Diaphragm muscle

1. TRANSVERSUS ABDOMINIS


The transversus abdominis is the corset of muscle that surrounds your midsection, and it's essential for spinal stability and preventing low back pain." - Dr. Stuart McGill, spine biomechanics researcher

This inner girdle deep muscle that wraps around the torso like a corset and is a key player in core stability - providing support and stability for the spine and pelvis. Not only does it help maintain proper posture and alignment, but it also plays a role in breathing and can help prevent lower back pain.


Research has shown that targeted exercises for the transversus abdominis can help improve core strength and stability. A study published in the Journal of Orthopedic & Sports Physical Therapy found that women who performed exercises specifically targeting the transversus abdominis had significant improvements in core stability compared to those who did not perform these exercises.



 

Diaphragm muscle

2. DIAPHRAGM


Most people don't think of their diaphragm when it comes to strengthening their core, but it plays a very important role in stabilizing the core. The diaphragm is a large, dome-shaped muscle that separates the chest cavity from the abdominal cavity; think of the diaphragm as the top of the can.


"The diaphragm is the unsung hero of core stability." - Dr. Stuart McGill
"Diaphragmatic breathing is an important part of core stability and overall fitness." - Kelly Starrett, physical therapist and CrossFit coach

A study published in the International Journal of Sports Physical Therapy found individuals with weaker diaphragm muscles also had weaker core muscles, as measured by electromyography (EMG), suggesting that strengthening the diaphragm is beneficial for improving core stability and preventing injury.


Another study published in the Journal of Bodywork and Movement Therapies found specific diaphragmatic breathing exercises to improve diaphragm muscle strength and activation, as well as increased core muscle activation during other exercises.


 

Pelvic Floor Muscles

3. PELVIC FLOOR


The pelvic floor is a group of muscles that span the bottom of the pelvis (the bottom of the can). These muscles help to support the bladder, uterus, and rectum, as well as improve sexual function. In the can analogy, the pelvic floor is the bottom of the can.


"Strengthening the pelvic floor is essential for optimal core function, especially for women." - Julie Wiebe, physical therapist and women's health expert

Incorporating pelvic floor muscle exercises into your core strengthening routine isn't just for your bladder's sake. Research has found that individuals with weaker pelvic floor muscles tend to also have weaker deep core muscles, including the transversus abdominis and multifidus. So, if you're looking to improve your overall core strength and stability, it's time to give your pelvic floor some love. Not only can these exercises help prevent pelvic floor dysfunction, but they can also enhance your pelvic floor function.


 


Erector Spinae Muscle

4. ERECTOR SPINAE


The erector spinae muscles are a crucial part of the core muscle group that runs parallel to the spine on either side. These deep muscles of the back are often overlooked when it comes to core strengthening exercises, but they play a vital role in maintaining good posture and spinal health. The erector spinae muscles help to extend and rotate the spine, as well as provide stability and support for the core during movements like lifting, twisting, and bending. Think of the erectors as the back of the can.


"The erector spinae are the most important muscles in the back for spinal stability. They run the entire length of the spine and are responsible for maintaining proper spinal alignment and posture during movement. Strong erector spinae muscles can prevent lower back pain and injury and are essential for a strong and stable core." - Bret Contreras (fitness expert and author)

Studies have found that these muscles play a crucial role in maintaining core stability, with athletes boasting stronger erector spinae muscles performing better in tests of core strength. On the flip side, those with low back pain have been found to have weaker erector spinae muscles compared to those without pain. Incorporating exercises that specifically target these muscles into your core strengthening routine can help bolster overall core strength and stability, keeping those pesky back pains at bay.


 


Multifidus muscle

5. MULTIFIDUS


The multifidus muscles are often referred to as the "hidden gem" of the core muscles, as they are not as well-known as other muscles such as the rectus abdominis or obliques. However, they play a crucial role in maintaining proper spinal alignment and stability.


These deep back muscles run along the spine from the sacrum all the way up to the base of the skull. They are responsible for extending and rotating the spine and provide support for the vertebrae, helping to prevent excessive movement and instability.


When the multifidus muscles are weak or inactive, it can lead to poor spinal alignment and stability, which can contribute to back pain and other related injuries. Research has shown that incorporating exercises that specifically target the multifidus muscles into a core strengthening routine can improve overall core stability, reduce the risk of injury, and improve spinal alignment.


So, while the multifidus muscles may not be the most well-known or talked-about muscles in the body, they are certainly an essential part of a strong and stable core.


"The multifidus is a small but mighty muscle that plays a critical role in core stability, especially for athletes and active individuals." - Dr. Kelly Starrett, physical therapist and CrossFit coach
"The multifidus muscle is often undertrained and underappreciated, but it's a vital part of overall core strength and spinal health." - Dr. John Rusin, strength coach and physical therapist


 


Handstand demonstrating core strength

THE IMPORTANCE OF CORE STRENGTH AND STABILITY


Your core is not just about having toned abs or a tight waistline. It's also about having a strong and stable foundation for your entire body to move from. Proper core strength and stability can improve your posture, balance, and coordination, as well as reduce your risk of injury and back pain:


1. Improved posture, balance and coordination

Think of your core as the foundation of your body, like the roots of a tree - a strong and stable foundation that allows you to stand tall. When your core muscles are strong and stable, they can provide a solid base for the rest of your body to move from. This can help you maintain proper alignment and prevent compensations that can lead to pain or injury.


2. Reduced risk of back pain and other injuries

Back pain can be a real pain in the back, but a strong core can help you avoid it. When your core muscles are weak, your posture can suffer, leading to extra stress on your spine and increased risk of injury. A study in the Journal of Orthopedic and Sports Physical Therapy found that people with chronic low back pain had weaker core muscles compared to those without pain.


3. Enhanced your athletic performance

If you're an athlete or enjoy any physical activity, you know that having a strong core is essential for optimal performance. Whether you're running a marathon, lifting weights, or practicing yoga, your midsection is your body's power center. By building a strong and stable core, you can generate more power and transfer that power more efficiently throughout your body, resulting in enhanced athletic performance and a lower risk of injury.



Extreme core strength



THE LIMITATIONS OF JUST DOING CRUNCHES FOR CORE STRENGTH

The elusive six-pack may be the holy grail of many fitness enthusiasts, but the truth is, having a visible six-pack doesn't necessarily equate to a strong and stable core. Unfortunately, this is just one of the many misconceptions surrounding core training. While crunches and sit-ups can certainly give you that coveted six-pack look, they don't do much for the deeper muscles that are crucial for proper core function. Don't fall victim to the myth - focus on building a strong and stable core from the inside out.


In fact, focusing too much on these superficial muscles can actually contribute to imbalances and even back pain, as the deep stabilizing muscles are not being engaged in the same way.

A study published in the Journal of Strength and Conditioning Research has shed light on the effectiveness of traditional abdominal exercises like crunches and sit-ups. According to the study, these exercises may not be sufficient to engage and strengthen the deeper core muscles essential for core stability. In contrast, exercises that target the transversus abdominis and multifidus muscles were found to have significantly higher core muscle activation.


Another study published in the Journal of Back and Musculoskeletal Rehabilitation highlights the relationship between weak deep core muscles and chronic low back pain. The study found that individuals with chronic low back pain had weaker transversus abdominis and multifidus muscles than those without back pain.


Taken together, these studies emphasize the importance of engaging the entire core, including the deeper stabilizing muscles, for improved core strength and injury prevention. Incorporating exercises that target the transversus abdominis and multifidus muscles can be beneficial in achieving this goal.


 

HOW TO STRENGTHEN YOUR CORE MUSCLES

To achieve a truly strong and functional core, it's important to target all of the muscles that make up the core. To get you started, here are a few examples of exercises to help strengthen each of these muscles:


 

1. TRANSVERSUS ABDOMINIS EXERCISES


Plank and Plank Variations

Planks are a great way to engage the transversus abdominis. Try variations such as side planks, forearm planks, and plank with knee taps to challenge the transversus abdominis. Begin in a push-up position and hold your body in a straight line with your arms straight and your forearms on the ground. Engage your transversus abdominis by pulling your belly button in towards your spine and holding this position.


Plank Exercise for Transversus Abdominis

Vacuum exercise (Isometric transversus holds)

Stand or sit up straight and exhale all the air out of your lungs. Pull your belly button in towards your spine and hold for several seconds before releasing. Repeat for several repetitions. I love to do these frequently throughout the day...when I'm at a stop-light, watching TV, cooking dinner, walking...whenever...they are so easy to incorporate into your daily routine!


 

2. EXERCISES FOR THE DIAPHRAGM

Diaphragmatic breathing

This is a simple exercise that involves focusing on breathing deeply from the diaphragm, rather than shallow breathing from the chest. Lie on your back with your knees bent and your feet flat on the floor. Place your hands on your belly and breathe in deeply through your nose, filling your belly with air. Exhale slowly through your mouth, letting your belly deflate. Repeat for several minutes.


Inverted Diaphragmatic Breathing

Inverted diaphragmatic breathing

This exercise is performed while lying on your back with your legs elevated, such as against a wall. Take deep breaths and focus on expanding your belly as you inhale and contracting it as you exhale.


 

3. PELVIC FLOOR EXERCISES


Kegels

These are the most well-known pelvic floor exercises. To do Kegels, simply contract the muscles you would use to stop the flow of urine. Hold the contraction for a few seconds, then release. Repeat for several reps throughout the day. These are another great exercise that can be performed whenever!


Pelvic tilt and Pelvic Clock

Pelvic tilts can help strengthen the pelvic floor and lower back muscles. Lie on your back with knees bent and feet flat on the floor. Gently tilt your pelvis forward and upward, then back and downward, engaging your pelvic floor muscles as you do so. For a more advanced movement, shift your pelvis along with the face of the clock.


 

4. ERECTOR SPINAE EXERCISES


Superman exercise

Lie face down on the ground with your arms and legs extended. Lift your arms, legs, and chest off the ground simultaneously while keeping your neck in a neutral position. Hold for a few seconds before lowering back down.


Back extensions

Lie face down on the ground with your arms by your sides. Slowly lift your head, chest, and shoulders off the ground as high as you can while keeping your feet flat on the ground. Hold for a few seconds before slowly lowering back down.



 


5. MULTIFIDUS EXERCISES

Cat-Cow Stretch

Start on all fours, with your hands under your shoulders and your knees under your hips. As you inhale, arch your back and lift your head and tailbone towards the ceiling, engaging the multifidus muscle. As you exhale, round your spine and tuck your chin to your chest.


Bird Dog

Begin on all fours with your hands under your shoulders and your knees under your hips. Engage your core muscles, then extend your right arm and left leg out straight. Hold for a few seconds, then return to starting position and repeat on the opposite side.




 

The core is much more than just a six-pack. It's a complex network of muscles that work together to provide stability and support for the entire body. While traditional abdominal exercises like crunches and sit-ups can help to strengthen the rectus abdominis and oblique muscles, they may not be enough to fully engage and strengthen the deeper, stabilizing muscles of the core, such as the transversus abdominis, erector spinae, and multifidus.


Whether you're an athlete looking to enhance your performance, someone recovering from low back pain, or simply looking to improve your posture and balance, taking the time to strengthen your core can have a significant impact on your overall health and well-being.


So, go ahead and channel your inner "inner girdle" and start working on that strong, stable core today!


 

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REFERENCES

  1. Pelvic floor muscle strength and deep abdominal muscle thickness in female low back pain: A cross-sectional study. Journal of Back and Musculoskeletal Rehabilitation. https://www.medicaljournals.se/jrm/content/abstract/10.3233/BMR-2010-0271

  2. Abdominal muscle strength and pelvic floor dysfunction in women. International Urogynecology Journal. https://link.springer.com/article/10.1007/s00192-008-0724-y

  3. Pelvic floor muscle exercises and core exercises in women with stress urinary incontinence: A randomized controlled trial. Journal of Physical Therapy Science. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040159/

  4. Erector spinae muscle size and trunk stability in male athletes. Journal of Strength and Conditioning Research. https://journals.lww.com/nsca-jscr/Abstract/2013/02000/Erector_Spinae_Muscle_Size_and_Trunk_Stability_in.9.aspx

  5. Lumbar erector spinae fatigue and surface electromyography during a sub-maximal isometric endurance test. Journal of Sports Rehabilitation. https://journals.humankinetics.com/view/journals/jsr/20/2/article-p191.xml

  6. The effects of core stabilization exercises on the lumbar stability and pain of patients with low back pain. Journal of Physical Therapy Science. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846009/



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