Strengthening your core

Susan Locke says building your core strength can benefit overall health and wellness . . .

Susan Locke

Building “core strength” has been an essential component of most fitness programs. Core strength refers to the muscles of your abdomen and back. They are essential for supporting your spine and keeping your body stable and balanced.

The major muscles of the “core” are:

• Transverse abdominis: This is the deepest of the abdominal muscles that lie under the obliques. It wraps around your spine for stability and protection.
• External obliques: These are the muscles on the side and front of the abdomen around the waist.
• Internal obliques: These muscles lie under the external obliques and run in the opposite direction.
• Rectus abdominis: This is a long muscle that extends along the front of the abdomen. It is the muscle that gives the appearance of “six-pack abs” when it is well toned and there is reduced body fat.
• Erector spinae: This is a collection of three muscles along your neck extending to your lower spine.

There are many benefits of improving core strength. A strong core improves balance and stability which can reduce falls and prevent injuries during sports and other activities. A strong and flexible core can help in almost everything you do.

Activities of daily living require the use of core muscles. The simple acts of putting on your shoes, looking behind you, sitting in a chair, standing upright are just a few of the many movements that engage your core. Jobs that involve twisting, lifting and standing all depend on core muscles. But sedentary jobs tax your back muscles also.

Most sports activities are powered by a strong core and require flexibility. Housework, home repair and gardening requires twisting, bending, lifting, carrying, reaching — these are all core activities. Strengthening core muscles not only improves your appearance, but also decreases the wear and tear on your spine.

Back pain can be caused by a number of different conditions, but a weak or imbalanced core contributes to the pain. Nonsurgical treatment of back pain includes physical therapy and core strengthening exercises.

For more information on back pain, we went to a world-renowned back surgeon and Healthnetwork Service Excellence Award recipient Ali Bydon, MD, from Johns Hopkins Hospital in Baltimore, Md.

What types of back issues are most responsive to nonsurgical treatment?

Back pain is divided into acute vs. chronic. Acute back pain, the most common type, is a severe acute onset back pain that lasts up to six weeks. It typically resolves on its own and is amenable to physical therapy and possibly injections. Chronic low back pain is any back pain that lingers beyond three months.

The back issues that are most responsive to nonsurgical treatment are the acute low back pain. When buttock and leg pain are involved as well, the likely etiology is nerve root compression. This is amenable to selective nerve root injections or surgery as a last resort.

If my doctor sees “structural issues” (herniated discs, etc.) on my MRI, is surgery in my future?

Structural issues on MRI are quite common and may be mildly symptomatic or asymptomatic. If symptomatic, then surgery may be an option. You should discuss all treatment options with your physician.

How do you differentiate muscle pain from spinal nerve pain?

Muscle pain is distinguished from spinal nerve pain by the location of the pain: buttock and leg denotes nerve compression vs. back pain, which denotes muscular pain.

SUSAN LOCKE, MD, is the Healthnetwork Foundation’s medical director.

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