January 23, 2024
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Bridges are among the numerous exercises that can be done to help strengthen the core muscles that provide stability to the rest of the body.
Maintaining a strong, stable core is among the most common fitness recommendations given to everyone from athletes to people with chronic pain. Terms like "core exercise" and "core activation" get a lot of buzz in fitness circles, but what they mean practically for people hoping to develop good habits is sometimes difficult to pinpoint.
"There's not a great definition of what 'core' is," said Justin Shaginaw, a physical therapist at Penn Therapy & Fitness. "I think for most people in the medicine and physical therapy world, we look at the core as not just your abdominals but also your low back, your hips and even your hamstrings and glutes — pretty much anything that attaches to your pelvis."
Many of the complaints physical therapists hear from their patients, from low back pain to muscle flare-ups, can be traced to improper or inadequate use of the core.
"It's sort of the foundation of all of our movement," Shaginaw said. "If we don't have good strength and stability in our core, then that can affect us from both our upper extremities — like throwing things and pushing things – as well as our lower extremities like jumping and running."
Shaginaw used an analogy to explain how a lack of routine engagement of the core can affect overall strength.
"It's like trying to shoot a cannon out of a canoe," he said. "It's going to push the canoe as much as it shoots the cannon ball out if we don't have a strong core."
One of the challenges of identifying a weak core is that there aren't reliable measures that can be used to test its strength, Shaginaw said. Although people often associate the core with visible features like six-pack abs, core stability also is impacted by the diaphragm — how we breathe — and our day-to-day posture. Poor functioning of core muscles tends to be more about not using them than obvious signs of weakness.
"For most people, what we see is an inability to use it," Shaginaw said. "As we age and we're sedentary and don't work out, that becomes more pronounced. But even in professional athletes, they don't always use their cores correctly. If you look at athletes, they often have an arched back. They rely on their vertebrae — the bony structures — to give stability to the core versus their abdominal muscles."
There are some characteristics that tend to contribute to a weaker core. Being overweight or obese centers body weight forward, stretching out the abdominal muscles and creating a disadvantage for posture. Sedentary lifestyles, especially as people age, also compromises use of core muscles. Many people don't realize they are not functioning optimally because they aren't active enough to notice problems.
"There are plenty of people who have weak cores and function just fine," Shaginaw said. "The more active you are and the higher level of activity you do, the more likely any sort of weak link is going to become symptomatic. When you're 22, you can do whatever you want and not pay for it. When you get into your 30s and 40s, that's when the weak links catch up to you."
Gaining greater core stability can be achieved by making some simple exercises part of a weekly routine. In many ways, the key to developing strength is helping core muscles support a healthier spine.
"It's really about retraining the core and finding what we call 'neutral spine,'" Shaginaw said. "That way, we get out of that excessive arch."
There are different types of exercises recommended for core strength. Some involve being in static positions, while others are more geared toward movement.
"We start with it being stable and then we progress to it being moving," Shaginaw said. "That's because our core functions both ways. As we're running or throwing, we need to be stable. If you're going to hit a tennis ball or baseball, your core needs to produce motion, power and velocity."
Bridges are among the best exercises for core stability. There are many variations on bridges, but the goal is always to keep the stomach tight, engage the abdominal muscles and keep the back flat.
While lying on your back with knees bent, tighten your lower abdominals, squeeze your buttocks and then raise your buttocks off the ground to create a "bridge" with your body. Hold the pose for 5 seconds and then lower yourself. This can be repeated in sets of 8-20 repetitions three times a week.
Another great exercise for core strength is the bird dog. While in a crawling position, brace your abdominal muscles. Slowly lift one leg and the opposite arm, extending them outward to put the hip in an extended position. Maintain a level and stable pelvis the entire time. This can be done twice a day, performing the exercise with both sets of limbs, with two or three sets of 5-20 repetitions.
Supine pelvic tilts also help activate and train core muscles. Lie on your back with your knees bent and feet flat on the floor. Start by taking a deep breath. As you breathe out, flatten your back into the ground by tightening your abdominal muscles. The movement is somewhat subtle, but it helps acclimate the body to using muscles that often are neglected. These can be done two or three times a day in 2-3 sets of 10-20 repetitions.
Supine marching is another useful core exercise. While lying on your back with your knees bent, push your back flat into the ground by tightening your abdominal muscles. Slowly raise up one foot a few inches and then set it back down. Alternate legs. This can be done in two or three sets twice a day in 5-20 repetitions.
Resistance bands also are useful for a number of exercises.
Paloff presses are one of the best exercises for core strength, Shaginaw said. These require a stable, fixed surface to attach a resistance band. The other side of the band should be wrapped in both hands in a firm grip. Stand with your knees slightly bent and your feet shoulder-width apart. Keeping your hands close to your chest to start, press the band out in front of you and resist the pull of the band. It's important to brace your abdominal muscles for this exercise to maintain tension in the midsection. Once your arms are fully extended, slowly return your hands to the starting position. Pay attention to your spine to maintain a neutral spine throughout the motion.
Other advanced core exercises focus more on flexion — like crunches — and side-bending or rotation, Shaginaw said. Exercises like planks can be good for the core, but Shaginaw said that maintaining a plank position for long periods often leads to people disengaging their abdominal muscles and relying on the spine for stability.
Beyond exercising, Shaginaw stressed that people should try to move around as much as they reasonably can to keep the body limber.
"I think a big misconception is that you need to have perfect posture," Shaginaw said. "Even if you sit with perfect posture, if you do it for two or three hours without getting up, it's probably worse than sitting for half an hour with bad posture. The body doesn't like to be in one position for too long. The best thing is to vary posture every 30-60 minutes."
People with pain and other notable symptoms are advised to visit a doctor to help figure out what's causing problems. Signs to watch for are numbness, tingling down the leg, weakness in the leg, and bowel or bladder retention or incontinence. These can be indications of an acute disc herniation in the spine that's pushing on nerves.
For most people, problems that stem from an inactive core tend to be a natural part of aging that requires more vigilance with exercise and other daily routines.
"A lot of what we get is the aging process — a little grey hair on the inside that's more likely to be symptomatic," Shaginaw said.
