A chiropractic wellness patient presents to the clinic for his regularly scheduled maintenance adjustment.
Although the patient originally sought chiropractic treatment for back pain five years ago, he has not experienced any pain or discomfort while being under chiropractic care. Understanding the importance of properly maintaining the spine and nervous system, as taught to him by his chiropractor, the patient is more than happy to be checked for subluxations and adjusted as required. On one particular visit, the patient asks the doctor about an article he had recently read on “core exercises” helping to stabilize the spine. He asks the doctor to explain what “core” muscles are and if the doctor could show him some core exercises to do during his regular routine at the gym.
Would you be comfortable explaining what is meant by “core muscles” to your patients? Would you be able to teach basic, intermediate and advanced level core exercise to your patients in order to have them incorporate these into their regular exercise routine? In this edition of Technique Toolbox, I will address these questions and more, as we explore how to help stabilize the body’s core.
WHAT ARE ‘CORE’ MUSCLES?
That which experts refer to as the “core” actually consists of many different muscles that stabilize the spine and pelvis, and run the entire length of the torso. When these muscles contract, they stabilize the spine, pelvis and shoulder girdle and create a solid base of support. When this stability occurs, it enables us to generate powerful movements of the extremities.1 These muscles help control movements, transfer energy, shift body weight and move in any direction. A strong core distributes the stresses of weight-bearing and protects the spine.1
The following list includes the most common groups of core muscles: rectus abdominus; erector spinae; multifidus; internal and external obliques; transervse abdominus; hip flexors (illiacus, psoas, rectus femoris, pectinius, sartorius). 1
Therefore, in order to be effective, core conditioning exercise programs should incorporate exercises that target the engagement of many muscles. Specifically, muscle groups throughout the torso that cross several joints and work together to co-ordinate stability. We must be mindful that core muscles must contract at the same time and work as a unit in order to stabilize the spine.1
So, now that we understand a little more about the “core,” what exercises can you teach your patients to do in order to help stabilize the spine and support their adjustments? The following exercises that I am going to share with you start at a basic level that most people will be able to perform, and progressively get more difficult for the individual with each advancing level. Be sure to inform the patient to move on to the next exercise only once they can comfortably perform the previous ones.
| One: Modified pushup on plank.
|Two: Plank with diagonal arm raise.
| Three: Side bridge on plank.
|Four: Single-leg drops starting position.
| Five: Slowly lower one leg without touching the ground. Repeat both sides.
| Six: Spin wheel starting position
| Seven: Roll out to an extended position, then flex body back to the original position.
CORE EXERCISE #1: PLANK
(SEE PHOTO 1)1
- Begin in the modified push-up position with your forearms and toes on the floor.
- Keep your torso straight and rigid and your body in a straight line from ears to toes with no sagging or bending.
- Your head is relaxed and you should be looking at the floor.
- Hold this position for 10 seconds.
- Progressively increase time to 30-60 seconds.
CORE EXERCISE #2: PLANK WITH DIAGONAL ARM LIFT
(SEE PHOTO 2)2
- Assume a modified pushup position with your feet shoulder-width apart, forearms on the floor.
- Keeping your torso steady, raise your right arm forward and to the right, so that it points to two o’clock.
- Hold for two seconds, then lower and repeat with your left arm, raising it to 10 o’clock.
- Repeat for 10 repetitions. Slowly increase repetitions as you become more proficient.
CORE EXERCISE #3: SIDE BRIDGE
(SEE PHOTO 3)2
- Lie on your side with your forearm on the floor under your shoulder to prop you up, and your feet stacked.
- Contract your core and press your forearm against the floor to raise your hips until your body is straight from ankles to shoulders.
- Hold for 15 to 45 seconds; repeat on the other side.
- Contract your abs and butt muscles forcefully to keep your body straight.
CORE EXERCISE #4: SINGLE-LEG LOWERING
(SEE PHOTOS 4-5)2
- Lie on your back with your legs extended straight up.
- Keeping your legs straight, lower your left leg until your foot is two to three inches off the floor.
- Return to the starting position.
- Repeat with your right leg.
- Repeat for 10 reps. Slowly increase reps as you become more proficient.
CORE EXERCISE #5: SPIN WHEEL
(SEE PHOTOS 6-7)
- Begin the exercise in a flexed position, with your knees on the ground and your hands grasping either side of the spin wheel.
- Keeping your arms straight and knees on the ground, slowly use the spin wheel to roll out to an extended position.
- Once at the extended position, flex your torso to roll the spin wheel back to the original start position.
- Repeat 10 times. Slowly increase repetitions as you becomemore proficient.
Until next time . . . Adjust with Confidence!
Quinn, E. The Best Core Exercises.
Friedman, C. Stronger where it matters most. Men’s Health. March, 2007.