All About Core Stability - September 11, 2012

All About Core Stability: Hard-CORE, CORE-ect, and not at all CORE-ny

Yes, we know the title is awesome.  But please, try to focus now. 

The phrase "core stability" is one that gets thrown around a lot by trainers, doctors, athletes and manual therapists.  The average person probably knows that they need good core stability, but may not exactly understand why.  Also, depending on who you ask, there are various opinions on the best way to achieve core stability.  The purpose of this post is to sort through the research and clinical results and give you the straight up facts regarding core stability. 

Um, what the heck is my "core"? 

We should probably start with the definition of what exactly makes up your core.  In the simplest definition, your core is what's left after you exclude your arms, legs and head.  Functionally, it's your spine, ribs and pelvis and all the muscles attached to them. However, many of the muscles are more important than others.  In regards to core stability, the most important muscles are the diaphragm, transversus abdominis, multifidus, internal and external obliques, and the muscles of the pelvic floor.  We talked about the importance of the diaphragm in a previous post HERE.  You might notice that rectus abdominis (the muscles that give you a 6-pack) and spinal erectors (big meaty muscles on your back) are absent from the list.  These muscles aren't stabilizers, they are made to move our bodies.

Why does it need to be stable? 

We know that without muscles, our spine would buckle and collapse with a force of just 90 N (which is about the force of 20 lbs applied on your spine)1.  However, many everyday movements apply over 2000 N to your spine!  Obviously, muscles play a gigantic role in core stability and your ability to function.  Research has also given us lots of information regarding core stability and low back pain.  We know that in people with low back pain, the activation of many core stabilizers is delayed.  Basically, your core stabilizing muscles don't "fire" when they should. This means the spine and other muscles get overloaded, causing injuries.  We also know that after back pain resolves, this delayed activation doesn't go away without proper rehab, which sets up potential future episodes of low back pain2.  If any of you have had an episode of low back pain before (which 70-85% of you have), you know how horrible it can be.  It's also horrible for the people around you, as they have to move your stuff and deal with a cranky person.  So core stability is critical in treatment and prevention of low back pain.  
Core stability is also important for athletic performance.  Anytime you move your arms or legs, your core stabilizers are actually the first muscles to fire.  Once your core is stabilized, it becomes a solid foundation for your arm and leg muscles. If you don't have good core stability, you now have a weak link.  You'll be less efficient and weaker in any arm or leg movements.  You are also asking for injuries, as your arm and leg muscles are now being strained more often. 

How do I make my core stable? 

Alright, so you want to supercharge your core.  You want to be able to throw couches across the room and laugh at the mere thought of getting low back pain.  We'll tell you how, but let's start with some things you shouldn't do.  First, stop doing sit-ups and back extension machines.  As we said above, your rectus abdominis and spinal erectors muscles are meant to MOVE you low back, not stabilize it.  These exercises place large amounts of stress on your spine and discs.  Basically, those exercises are a great way to ruin your low back and decrease core stability. We wrote about those and other exercises to never perform in another post HERE.  Secondly, it's important to realize that improving range of motion does not improve stability.  In fact, the more range of motion you have, the more likely you'll have low back pain3.  This is why low back pain is very prevalent in gymnasts.  Their core is like a runner band, which is pretty hard to stabilize. For this reason, trying to constantly stretch out your back muscles is a bad idea.  It's also the reason why certain Pilates and yoga poses may not be appropriate for people with low back pain. 

She's smiling as she doesn't have back pain yet 

So what should you do? First, focus on muscular endurance, not strength.  Surprisingly, having a stronger core does not correlate to less back pain. However, a higher core muscular endurance does equate to less back pain3.  Second, pick the right exercises.  Since we know a stronger core isn't necessarily better, we don't need to head to a gym to get a great core workout.  In fact, low-tech rehab exercises have been shown to be far superior to exercise machines in treating people with failed back surgery4. For starters, check out Stuart McGill's Big Three.  Stuart McGill is the world's leading researcher on low back pain and after testing and poking poor volunteers for years, he found three of the safest, most effective core stabilization exercises.  The "big three" are the bird dog, the side bridge, and the curl-up.  Finally, do these exercises CORRECTLY.  We met Stuart McGill a few years ago, and he himself stated that these exercises done correctly will BULLETPROOF your low back, but if done incorrectly, they will DESTROY your low back.  Form is key.  Quality over quantity.  
Finally, we highly recommend taking advantage of our free "Community Core" class. This is a weekly class that features core exercises (including the Big Three) to improve stability and endurance, functional stretching of commonly tight muscles, as well as hip and foot activation exercises to prevent lower extremity issues such as knee pain, plantar fasciitis, etc.  The class is every Thursday evening at 6pm, and takes place at Ultramax Sports in the Prairie Village Shopping Center (6911 Tomahawk. Prairie Village, KS 66208).  Just bring a yoga/exercise mat and some water and you'll be all set.  Seriously, it's free, so you don't have an excuse not to go!  We'll see you there! 

 1.  Panjabi MM. The stabilizing system of the spine. Part 1. Function, dysfunction, adaptation, and enhancement. J Spinal Disorders 1992; 5:383-389. 
2.  Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain: a motor control evaluation of transversus abdominis. Spine 1996; 35: 783-805. 
3.  Biering-Sorenson F. Physical measurements as risk indicators for low back trouble over a one year period.  Spine 1984; 9:106-119. 
4.  Timm KE. A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy.  J Orthop Sports Phys Ther 1994; 20:276-286. 

Drs. Jeff Remsburg and Thomas Cotter are chiropractors at Active Health Solutions: Chiropractic & Rehab located in Prairie Village, Kansas. Their clinic focuses on combining cutting edge chiropractic care with the latest in exercise and rehabilitation for pain treatment and performance enhancement.  You can find more information about their clinic by visiting their website at or by calling 913-341-1200.

  • Active Health Solutions uses the most current evidence-based protocols and techniques to functionally assess and treat patients with neuromusculoskeletal conditions (disorders of the nerves, joints, and muscles). With extensive hours in post-graduate education (over 1000 hours), the doctors at Active Health Solutions have a variety of treatment methods which allows them the ability to individually customize the treatment for each patient. This unique approach and extensive post-graduate work sets Active Health Solutions apart from other clinics. Please click on any of the services on the left for more detailed information.