The Core


57448178.jpg

The innovative approach of linking the pelvic floor and restoring core strength is the foundation and basis of starting Core Restore Physiotherapy. This remarkable new direction was the brainchild of Emily Adams, who through the years of her practice recognized the missing link of the pelvic floor with respect to patient healing and restoration of core strength.

Whether you’re suffering from chronic back or hip pain, not succeeding in connecting to your core or, have never been the same since pregnancy, you can benefit from physiotherapy with a certified pelvic health physiotherapist, and restore your core.


What and where is your "core"?

The core refers to the space between your ribcage and your pelvis. It is the inner container between the bottom of your rib cage, where your diaphragm is, and the muscles at the bottom of your pelvis, the pelvic floor muscles.  There are four muscles that comprise the core, they are the:

  • Diaphragm

  • Pelvic floor

  • Transverse abdominus

  • Multifidus

We are familiar with our diaphragm, because it is also the breathing muscle and the diaphragm separates the chest and lungs, from the abdomen. The pelvic floor muscles are the muscles at the bottom of the pelvis. They span from the tailbone at the back of the pelvis to the pubic bone at the front.

The Transverse abdominus is the deepest abdominal muscle; it is the abdominal muscle deep to the rectus abdominus (sometimes known as the 6-pack ab muscle) and the oblique abdominal muscles. The multifidus is a deep back muscle that connects into the spinal vertebrae. These four muscles constitute the deep muscular core.


Why are the core muscles so important?

The deep core muscles are inherently crucial in our everyday activities and performance. The core muscles become active with anticipation of movement. When these muscles turn ‘on’ they help prepare our body for intended movement and load transfer, providing stability and control, to the joints in our back and also our pelvis.

 We know, based on research that recruitment and contraction of these muscles changes dramatically with injury to the back and pelvis, and also in the presence of back and pelvic pain.

 After a back or pelvis injury, or during pain these muscles fail to do their job, as they should. Your body will continue to use faulty muscle recruitment patterns unless you learn how to properly re-activate these muscles because you cannot strengthen a muscle your brain does not know how to activate.

Your physiotherapist at Core Restore Physiotherapy is specially trained to teach you how to re-connect with the deep core muscles. Once you’ve learned how to train your core, and strengthen with the guidance of your physiotherapist, you can integrate it into any exercise, or sport that you do.


Did you know?:

78% of chronic back pain is related to a pelvic floor dysfunction! (1)

50% of pregnant women develop Rectus Diastasis (separation of the abdominal muscles) and, 50% of those women, do not recover spontaneously.

Diastasis causes muscle weakness and imbalance throughout the core with
 increased risk for injuries in the back, and pelvis (2)(3)

 

References: 1. Eliasson K, Elfving B., Nordgren B., Mattsson E. Urinary incontinence in women with low back pain. Man. Ther.  2008.13(3):206-212. 2. Boxer et al 1997; Toranto 1990; Oneal et al 2011; Spitznagle et al 2007. 3. Spitznagle TM, Leong FC, Van Dillen LR. Prevalence of diastasis recti abdominis in urogynecological patient population. Uroggynecolo J Pelvic Floor Dysfunct. 2007; 18:321-8.


 

Diastasis

Diastasis Rectus Abdominus (DRA) is the condition where there has been separation of the abdominal muscles, specifically the rectus abdominus muscle (this is the muscle that gives the washboard abdomen or 6-pack look). The separation is between the left and right sides of the rectus muscle and is commonly associated with pregnancy, but diastasis can also occur for other reasons.

In pregnancy every women’s abdomen expands, and particularly in the third trimester. With the expansion of the abdomen the tissue between the rectus muscle, the linea alba, also expands. Most of the time, the stretched tissue recovers on it’s own, however in some cases the midline tissue stays stretched and are not able to stiffen and generate tension as they normally should. Research isn’t conclusive on why this happens to some women and not others, but the way the abdomen is supported in pregnancy does seem to have some role.

Before returning to exercise after pregnancy it is fundamental that the abdominal muscles are functioning properly and generating midline tension. At Core Restore Physiotherapy we stay current with the latest research, and have specialized training in diastasis, assessment and treatment skills. The exciting part is that it IS possible to restore proper tension to the abdominal tissues and get rid of “mummy tummy”.  Specialized physiotherapy for diastasis can help you get your abdominals working again!