Health and Fitness: Core stabilization

Introduction

Every time we move, we depend on some muscles to hold us steady, and other muscles to actually move us. Core stabilization is the general term for how the muscles of your trunk keep your spine and body stable. This helps you stay balanced when you move. If your core muscles are strong and they contract when they should:

Your posture is better.
Your body is balanced.
Your movement is more efficient and powerful.
You are less likely to be injured.

Core stability benefits everyone, from older people to top professional athletes. Exercises for core stabilization should be part of every conditioning program, along with flexibility, strength, and aerobic training.

Core stabilization may be helpful for health conditions such as those discussed in these topics:

Low Back Pain
Tendon Injury (Tendinopathy)

What is core stabilization?

The spine itself is just bones stacked on top of one another, and in between the bones—to cushion them—are small discs. The core of each disc has the texture of cheese, and it is surrounded by tough fibrous tissue. To make the spine more stable, the parts are all connected with layers of soft tissue such as cartilage and ligaments. They are also connected by muscles. If these muscles are strong and working in the proper order, you have a solid base for movement and for absorbing the impact of the ground through your body.

The main muscles involved in core stabilization are deep muscles such as the transverse abdominus, the multifidus, and the muscles of the pelvic floor. The transverse abdominus is like a corset around your abdomen. It’s the muscle you work if you pull in your stomach. The multifidus is a muscle that lies along your spine from your neck to your pelvis, with short fibers connecting one bone (vertebra) of the spine to other vertebrae near it. The muscles of the pelvic floor are most noticeable when you squeeze to keep yourself from urinating.

Other muscles closer to the surface help with core stabilization and also help you move. These include muscles in your back and buttocks, and the muscles around your pelvis and hips in front and at your sides.

Core stabilization strengthens the muscles of the core and helps you learn to use the inner muscles before you start to move. The focus is on stability, breathing, and smooth, coordinated movement.

Why is core stabilization important?

All the parts of your body are connected to one another, directly or indirectly. Think of a chain as the connection: for example, imagine a chain starting at your foot and running through your ankle, calf, knee, thigh, and hip to your pelvis and spine. This is called the kinetic chain, and it means that moving one part of your body can affect another body part. Your trunk is where the kinetic chains come together.

Now imagine throwing a ball, and imagine that as you throw, you step on a rock and twist your ankle. When your ankle twists, your knee and hip follow along, and the smooth motion you were making with your throwing arm is disrupted. You might injure any joint along the chain from your ankle to your arm, and the ball you were throwing goes off in the wrong direction. That's the kinetic chain, connecting all the parts of your body together into a whole. A problem or weakness in one part of the chain can lead to pain or injury in another part.

The example of stepping on a rock as you throw applies to all the movements you make: your movements are all related to one another. Strengthening your trunk gives greater stability and power to the whole kinetic chain as you move.

Focusing on the core of the body as a way to promote strength and good health is an ancient idea. Yoga, Pilates, and martial arts such as tai chi all use this concept. Your trunk, where the kinetic chains come together, is the foundation for your posture, balance, and coordinated movement. The muscles of your trunk—your core—can be strengthened and trained to contract in the proper order to give you this stable foundation for movement. The benefits include:

The strong, healthy feeling that comes from good posture.
Confidence from strength and good balance.
Greater strength and power for your activities.
Less chance of injury.
Decrease in, or prevention of, low back pain.

How can I increase my core strength and stability?

Core stabilization exercises are easy to do. You can start with the simple exercises you learn here. You don't need any equipment for these exercises, and you don't need much space. You can do them almost anywhere, several times each day, to start increasing your core stability.

It's more important that you do core stabilization activities well than that you do a lot of them. For this reason, it's a good idea to have a physical therapist or exercise physiologist with training in core stabilization check to be sure you have learned to use the right muscles and breathe normally while you do the exercises. Then he or she can help you learn more challenging core stabilization exercises.

Breathing

When you exercise, you should breath mostly with your diaphragm, the large muscle that helps move air in and out of your lungs. To learn to breathe with your diaphragm, lie down on your back and put your hand on your stomach. When you breathe in and out, your hand should move up and down. Notice how it feels to breathe this way. When you start to exercise, try to get the same feeling of your chest and abdomen moving in and out as you breathe, rather than your chest and shoulders moving up toward your neck and back down.

Neutral spine

Neutral spine is the name for posture that maintains the three normal curves in your spine—one in your neck, one in your upper back, and one in your lower back. These three curves help absorb stress and impact on your body, both while you are sitting or standing still and when you move. It may seem more relaxing to let yourself slump down, but when you lose the normal curves of a neutral spine, you actually put more stress on your body. Your spine should be in the neutral position when you do core stabilization exercises.

To find neutral spine:

Stand normally in front of a mirror with your hands on your hips, just below your waist.
Allow your low back to arch so your stomach juts forward, and your buttocks stick out. Notice how your hands rotate forward.
Tighten the muscles around your stomach and buttocks so your low back becomes very flat. Notice how your hands rotate backward.
Now go halfway between the forward and back positions.
Keeping your pelvis in this neutral position, stand tall with your ears and shoulders lined up over your hips.
Practice finding neutral spine in three positions: standing, sitting, and lying on your back with your knees bent. When you can find neutral spine in each position, you can maintain good posture for daily activities and for exercise.

Simple exercises

Transverse abdominus contraction. The key to core stabilization is learning to use the deep muscles of your trunk. There are several muscles involved, but the first one to work on is your transverse abdominus. The transverse abdominus wraps around the front of your body like a corset. It's the muscle you feel when you cough. To contract the transverse abdominus, pull in your belly and imagine pulling your belly button back toward your spine. Hold this contraction for 5 to 10 seconds, then relax. Remember to keep breathing normally as you hold the contraction. You can do this exercise anywhere, in any position. Try it while you work at your desk, drive, or stand waiting for your turn at the drugstore.

Bridging. Lie on your back with your knees bent and your feet flat on the floor. Tighten your transverse abdominus, then push with your feet and raise your buttocks up a few inches. Hold this position 5 to 10 seconds as you continue to breathe normally, then lower yourself slowly to the floor. Repeat 10 times.

Next steps

After you have mastered these simple exercises, your therapist or exercise physiologist will find more challenging ways to work on your trunk muscles. For example, you might do some activities while standing up, then do the same activities while sitting on a large ball called a Swiss ball. The ball makes it harder for you to keep your balance as you do the activity.

Where can I learn more about core strengthening and stability?

Now that you have learned why core stabilization is so important, you are ready to start building your trunk stability. If you would like to learn more and add to your core stabilization program, talk to a physical therapist or a trained exercise physiologist. Many health and exercise facilities have therapists or instructors who can help you.

References

Other Works Consulted

Leetun DT, et al. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Medicine and Science in Sports and Exercise, 36(6): 926–934.

Marshall PW, et al. (2005). Core stability exercises on and off a Swiss ball. Archives of Physical Medicine and Rehabilitation, 86(2): 242–249.

Mees PD (2003). Making strides in rehabilitation. Physician and Sportsmedicine, 31(8). Available online: http://www.physsportsmed.com/issues/2003/0803/spotlight0803.htm.

Weinstein SM, et al. (2005). Low back pain. In JA DeLisa et al., eds., Physical Medicine and Rehabilitation, 4th ed., pp. 667–678. Philadelphia: Lippincott Williams and Wilkins.

Credits

Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer	David A. Fleckenstein, MPT - Physical Therapy
Specialist Medical Reviewer	Kathie Hummel-Berry, PT, PhD - Physical Therapy
Last Updated	March 8, 2007