Getting it all to work together

Getting it all to work together

Welcome back!

From the previous 2 blogs:

  1. We now know about the actual core and how it works.

  2. It’s a fancy pressure system that synchronises with the breathing and kicks in before you move and with as much strength needed to do the task. But in an unbalance or un-coordinated system, the timing can be off, the muscles can weaken, and the body will use whatever coping strategies it can (overusing the other abdominals, breath holding) and putting increased stress on other tissues (joints/ligaments).

So how do we re-train it?

We start with something your body does all the time, on its own, but you also have control over……….

Breathing

As breathing activates all the muscles together, learning to breathe optimally is the easiest place to start. But different postures can limit the movement of the rib cage. So you’ve guessed it, posture plays a big part in this too.

Muscles work best at their mid-point (try to squeeze your bicep with your arm straight and with your elbow bent – easiest with elbow bent right?).  The midpoint for all the core muscles is when the trunk is in its neutral position or ‘good posture position”. Research even backs this up. Another reason to work on your posture!

“Good posture” is not one position, but a range. Your neutral posture will look different to mine but, you can tell if you in a good posture if, you are breathing efficiently. I usually start all this in side lying or on the back, as it’s just easier to check you are set up well.

Next we need to re-train the brain.

All core training (actually all exercise and fitness training) needs to involve the brain. What we call the neuromuscular connection, is the brain talking to the muscles/tissues/structures through the nerve signals. How can you expect a muscle to work if you have no idea where it is or how to contract it?

You cannot contract a muscle you brain cannot activate. So we need to learn to contract the core muscles first. Once the breathing has improved, next you need to check if the pelvic floor and Trans Abs are working together with the breathing.

Reproduced with kind permission from Burrell Education

Reproduced with kind permission from Burrell Education

I like when research makes life a bit easier for me as a physio. Instead of training two muscles, learning to engage the pelvic floor correctly will produce a co-contraction of the transverse abdominis. Remember this photo?

During inhalation, the pelvic floor lowers and Trans abs moves outwards. In the good posture position with proper breathing, you should be able to feel a downward movement of the pelvic floor from outside the body, and exhalation should cause a lift of the pelvic floor and a gentle drawing in of the abdomen.

(Just a quick note here….for any pelvic floor dysfunction, post-natal or woman’s health patient, I will usually always assess the pelvic floor with an internal examination, to check it is working efficiently and is strong enough to feel a contraction from outside the body. There is often other muscles that will try to contract along with the pelvic floor, and this may need to be addressed first)


Now the posture is set up well, the breathing is optimal and the pelvic floor is working, it’s time to start training the pelvic floor contraction. This is when I teach “lifting your kidney beans” to achieve an isolated pelvic floor contraction that’s timed with the exhalation. Practice, practice, practice and the brain learns to switch on the core when the breathing is optimal. And with lots of repetitions the core contraction and breathing becomes an automatic function where you don’t have to always be thinking about it for it to happen.

And that’s it…the core is now active with relaxed breathing, and the pelvic floor and core can contract stronger when needed. But you are still lying on your back. We need to apply this core training to:

  • Sitting,

  • Standing,

  • Walking,

  • Bending,

  • Lifting,

  • Running,

  • Moving,

  • Sport.

All aspects of your life, but especially ones that cause any symptoms. When you are doing a movement or task that requires more core control you “lift the beans” more and use the breathing to help do the movement. The core gets more efficient, co-ordinated and stronger at completing the task, until you don’t have to “lift the beans” quite as much.

This is the basis of my physiotherapy core rehab. I use core strategies with most of my patients at some stage of their rehab and implement this with all my Pilates and fitness classes. For Woman’s Health patients, this is the foundation of ,y pelvic floor rehab – it’s not just doing you Kegels and holding for as long as you can! Each women’s plan is individualised, even if most start out the same way - learning to breathe and lift the beans.

Core training has to be individualised, even in a group class. I think you should know the basics, be able to apply it to your own body, and the exercise you are doing, with my guidance. For each new Pilates term, I spent 30 minutes going through these points with new beginners, and checking every single person has no pelvic floor dysfunction (using a screening tool and offering advice if they do), correct posture set up, diaphragmatic breathing, feeling for pelvic floor contraction through clothing (if comfortable to do). Keeping a close eye on any doming or bulging of the abdominals, or over working of the wrong muscles. Post-natal fitness MUST include this or the body will simply not be ready of exercise.


I really hope this has given you some insight into what the core actually is and, how it works. It’s a wonderfully dynamic system that can be re-trained, even after years of dysfunction. Knowing how your own body works means you can take back some control over your injuries and conditions, and learn how to “fix” or manage them.

Thanks so much for taking the time to read these blogs. If you have any questions or want to get in touch about classes, or appointments, please visit the contact page. I’d love to hear from you!