Strengtheining the Core Through Coordination

When we talk about “the core” of the body, we are typically referencing the musculature around the abdomen and low back. These muscles consist of the abdominal muscles (rectus abdomini,  internal obliques, external obliques, and transversi) and the muscles of the back (lattisimus dorsi, serratus posterior inferior muscles, erector spinae, multifidi, interspinalis muscles, lateral intertransversi muscles, quadratus lumborum, and to some degree the iliopsoas).

Strengthening the core has become a fairly popular mantra these days. Many of us are walking around with poor posture and a fair amount of dysfunction as a result of poor core stability. A weak core leaves one susceptible to a host of joint and disc injuries as well as overly tight butt and leg and muscles. In contrast, a strong core can prevent a host of back injuries.

The word strength, however, needs some clarification in the context of strengthening the core. When most people think of strengthening muscles, they picture muscles moving against  significant resistance like lifting weights or power movement against gravity or some other force. These type of exercises can actually be detrimental to the core muscle and increase the risk of injury to the spine. Coordinating the movement of all of these muscle is what is most beneficial.

I mentioned in my last article that postural muscles are slow twitch, white fiber muscles designed for endurance. They need to be strong enough to hold you up all day. Strength in this case does not come from bigger muscle fibers but from having all of the muscle firing in a controlled and proper order. For example, if you lift a box, ideally your abdominal muscle and your spinal muscle would contract at the same time to stabilize the body so the shoulder and arms and hips and leg muscles can utilize their power to lift it. What often happens is that core muscle lay dormant until a significant strain forces is to respond. So, when you lift a box, you first engage your back muscles until you are upright then, if you go past vertical, the abdominal muscles will engage. Then, they will fire back and forth while they try to find a semblance of stability.

I bring this all to your attention to encourage you to strengthen your core appropriately. Exercises that promote coordinated movement like yoga, pilates, and modified exercises from yoga can make a huge difference. It can take time to build coordination  and it takes a consistent effort. In the following videos I demonstrate four very useful exercises for coordinating core muscles and therefore, strengthening it.

Cat/Cow

Bird Dog

A Safe Crunch

Side Bridge

Chiropractic and Physical Therapy

I was asked to write this article by one of my patients. She actually asked me write about chiropractic vs. physical therapy but I feel like there isn’t really a competition. They are different even if the end goal of improving one’s health is the same. There is some overlap but at the very least they are complementary. Nevertheless, here is the comparison.

Chiropractors focus on proper joint motion and nerve flow. Philosophically, we want to make sure that the innate intelligence that flows in each of us through the nervous system is not impeded. Subluxations or altered joint function can be a major cause of altered innate flow. When a chiropractor adjusts, the correct movement of a joint is restored and the nervous system flows as intended.

I don’t believe physical therapists have any such allusions to such a philosophy. Their focus is on mechanics, rehabilitation and improving activities of daily living. Physical therapists are rehabilitation specialists. After major injuries or surgeries, bodies need to be reeducated and strengthened. Exercises, joint mobilization, soft tissue work, and physiotherapy are their tools. They spend a lot more time teaching and pushing the patient.

Although most chiropractors are taught the same rehab techniques techniques as PT’s, the vast majority, including yours truly, have no interest in them. Our tool is the adjustment which can be compared to mobilization that PT’s do but the adjustment is much quicker and thorough. It is technically considered a Grade 5 Mobilization. I think most chiropractors would argue that it is much more than just a mobilization.

We can both teach exercises, do soft tissue work, and physiotherapy (e-stim, ultrasound, heat, ice, etc.). I personally will teach some basic exercises in a course of treatment and will do soft tissue work, if need be. However, physical therapy requires more time each visit. As a chiropractor I don’t spend very much time with each patient. An adjustment only takes a few minutes. Physical therapy appointments are typically at least a half hour.

Both treatments are effective for what they are. Getting joints adjusted is very important and may be all the body needs to heal. Sometimes the patient needs more. I refer to PT when it is more than I can feasibly handle. On the same token, some soft tissue injuries, especially muscle strains, need physical therapy and adjustments don’t really have an affect either way.

Like I said, Physical Therapy and Chiropractic are very complementary. With complicated cases, doing both can be extremely effective.  If a PT or a chiropractor tells you differently it is probably because they are insecure about their own skills.

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