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Core Strength: Beyond the Six Pack

“Show me a six-pack and I will show you dysfunction.” -Dr. Brett Winchester, DC, DNS Instructor, MPI Board

As the summer has been in full swing and every one is hitting the gym doing 45 minutes worth of crunches, this quote will hit home and confuse many people. We as a society have been taught to believe that a thin stomach and walking around with a 6-pack is ideal. Unfortunately, I am here to tell you that it is not.

Although pleasing to the eye, a tight stomach and abs actually show a lot of dysfunction. In order to accomplish getting a perfect six-pack, the oblique muscles actually start to waste away creating a hollowing effect on each side. While walking around and maybe even right now as you read this, most people suck in their tummies trying to create the appearance of a flatter stomach. As you suck the stomach in, you recruit the muscles in your lower back which increases overall tone leading to dysfunction in the joints. In order to breath, the muscles of your neck will start to be used which causes large trigger points between the shoulder blades and at the base of the head. Desk Jockies almost always complain of neck and lower back pain because they are using big muscle to stabilize their core and to breath. These larger muscles fatigue much quicker and have to work harder to perform these tasks.

The core is made up of several muscles, not just the six-pack like most people are lead to believe. The rectus abdominis is the most superficial muscle and will create the 6 pack that most people are looking for. Next are your external and internal oblique muscles that run like an X on top of one another. The deepest layer of your core is created by the transversus abdominis muscle which is actually the biggest lower back stabilizer in the body. It’s fibers runs side to side and acts like an internal back brace- if you know how to use it! Just under your rib cage is the diaphragm, a very important muscle used to help facilitate a stable and fully functioning core. All of these muscles are designed to work together to stabilize the spine and body during movement. It has been shown in studies that improper activation of the core can predict injury to the lower back in overhead and kicking sports. When these muscles are not used correctly and movement of the arms or legs begins, extra stress the back endures which can result in a strain of the muscles or injury to the joints.

So when doing traditional crunches, you are training only the rectus abdominis. This creates a shortening effect of the muscle and fascia. When tone is held in this muscle all the time, other muscles will begin to turn off and we begin to see a hollowing effect or “gutters” begin to form in the abdomen. While the transversus abdominis is the biggest lower back stabilizer, it is also the most commonly weak or inhibited in terms of the core.

The diaphragm plays a large role in the proper activation of the entire core. This dome shaped muscle will flatten towards the abdominal contents as it contracts, increasing the pressure inside the belly wall. As the pressure increases, it forces the transversus abdominis and oblique muscles to eccentrically contract or lengthen and tighten as they contract. This eccentric contraction is what creates stability in the lumbar spine which prevents injury with various movements of the arms and legs.

Proper motion the the thoraco-lumbar junction and in the pelvis also helps create an ideal environment for these muscles to properly activate. Most of the muscles of the core have attachments in both areas so with increased tone or fixation, there is increased pull and stress on the core which does not allow for the most effective activation.

What is the best way to train these muscles?

Through several take home exercises! Dynamic Neuromuscular Stabilization or DNS is a rehab treatment that was founded at the Prague Institute of Rehabilitation. Some of the leading experts in conservative care of low back pain and stabilization came from this school and created extensive research in which exercise progression are the best for facilitating an ideal environment for activation of the entire core. Much of my training and exercises have just been stolen from them!

During school and my internship, I was able to study along side some of the instructors for this technique and actually teach patients under their supervision using these concepts. I believe that proper exercises that promote core strength should be at the key of all treatments, including things like shoulder pain and ankle pain. When the proper base is taught, trained and understood, the progressions through other training go much smoother. This includes squat form, over head throwing mechanics and even kicking. With a strong, properly activated core, the muscles of the rest of the body begin to also activate more efficiently, decreasing the risk for injury.

My favorite place to actually see this proper activation at work is in the UFC arena.

If you took a photograph of a fighter mid punch, as seen above in Chuck Liddell, you will notice their rib cage is stack on top of their pelvis similar to a barrel through their mid-section. There is also no tone held in the six-pack and there are no gutters seen on either side. This is because in order to create the most efficient and powerful blow, there must be very efficient core activation to create a stable base! Although most of these fighters will suck in for photos, you will notice a relatively relaxed core as they are bouncing around inside the ring.

Keep this in mind as you train your core next time! Think in terms of functionality instead of just looks.

-Dr. Kylie


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