by Kelly Otis, PMA Certified Physical Therapist /Polestar Pilates Certified
As a physical therapist working with people in chronic pain, I work to teach strategies and exercises that will reduce pressure and unnecessary movement in vulnerable or painful joints. The concept of moving from the “core” is at the forefront of this work.
There are generally two types of muscles in the body that contribute to movement: large, superficial muscles that move bones (e.g., biceps, quadriceps, hamstrings, hip flexors, buttocks, etc.) and those usually smaller muscles that lie deep in the body (e.g., pelvic floor, diaphragm and tranversus abdomnus, and multifidi) acting to stabilize bones with functional movement. Functional movement may include shifting from sitting to standing, squatting, lifting, pushing, or pulling for instance. As a group, those stabilizing muscles are defined as “core” muscles in the body.
Quite often, chronic pain of the low back, neck, knees, or shoulders is a result of poor movement patterns. The way out of chronic pain resulting from poor movement is to increase awareness of and begin to use the core muscles, consciously engaging in activities that will strengthen them.
We are a society of sitters and slouchers. We sit more than we stand or lie down. Long-term sitting puts the core to sleep. Eventually, the core gets weaker and we begin to slouch in sitting and round in standing. As time goes on, we gradually function less from the stabilizing core and depend more on the larger, superficial muscles to take over. These poor movement strategies can be the beginning of a chronic cycle of joint pain and dysfunction.
What can we do then, to help ourselves get out of pain? Getting back to using core muscles will be a good way to interrupt the cycle. There are many options, but you can start at home with some easy exercises. Simply standing or sitting tall will activate the core immediately. Remember the adage about “Balance a book on your head when you walk, for good posture”? Try that and then, with that same book balancing on your head, try to sit and then stand back up without the book falling. As a further challenge, try to get down onto your knees and then back up to standing without losing the book. You will find your core immediately. The feeling of having to tighten your belly and activate your pelvic muscles to do the work is an excellent way to feel the core muscles I am referring to.
An even more challenging movement to activate the core is to hold a plank position for 10 to 30 seconds: balance on your hands (or elbows) and toes. The key here is to line up your ear, shoulder, hip, knee, and ankle without sagging in the low back or letting your head drop below your shoulders. As you work to keep still in that position, you will find you need to use those deeper core muscles.
I am a big believer in simplicity. These are simple, everyday activities to get connected to your long-lost core and help yourself back into a healthier body awareness.