A Patient Guide to Core Strengthening
Frank Gilroy- Consultant Physiotherapist
Stephen Reid- Student Physiotherpist
Antatomy of the core
The Core is made up of a group of muscles; Transverse Abdominis, Rectus Abdominis, External Abdominal Oblique and Internal Abdominal Oblique – which can be seen in the diagram below.
These core muscles are vital in helping to keep the body balanced and stable and to minimise the load put through other joints.
Remember that your Glutes and Back muscles also help to stabilize your body too!
Common reasons for core weakness
Poor Posture
-Lower cross syndrome
-Upper cross syndrome
Surgeries
-All hip and knee surgeries
-All surgeries around the core area
Trauma
-Abdominal strain/ tear after childbirth
-Injuries to your back
Inactivity
Physiotherapy and Prevention
It is important that the core muscles stay strong in order to:
- Carry out everyday tasks
- Prevent injuries
- Allow good movement
- Stay balanced
Before you begin to strengthen your core muscles, they first must be able to move freely. A couple of simple stretching exercises have been included in this handout which are to be done before completing the strengthening exercises.
WEAKNESS > RANGE OF MOVEMENT > STRENGTHEN > FULL POWER
Simple Stretches
Stretches are important before exercising, helping to prevent injury and tightness.
Each stretch should be held for around 30 secs and repeated 3 times. Complete the following stretches before each set of exercises.
1. Front stretch
While standing clasp your hands and lift them over your head
Once you feel a stretch hold that position
2. Side stretch
While standing lift one arm over your head towards the opposite shoulder
Once you feel a stretch hold that position
Phase 1
Make sure you are supervised by your therapist when completing your exercises for the first time. Complete each exercise until your muscles feel tired 2 times per day 5 days a week
Once you can hold each exercise comfortably for more than a minute move onto the next phase
1. Bridge
Lie on your back with your knees bent
Flatten the small of your back into the ground and lift your hips up by pushing through your heels
Focus on keeping a straight alignment
2. Plank
Start on your knees and forearms
Straighten out your legs to take the weight through forearms and feet
Focus on tightening your core muscles to keep your back straight
3. Side Plank
Start side lying with legs straight
Place your elbow directly under your shoulder to prop up your torso
Focus on keeping your body in a straight alignment
Phase 2
Complete each exercise until your muscles feel tired 2 times per day 5 days a week. Once you can hold each exercise comfortably for more than a minute move onto the next phase
1. One-legged Plank
Begin a normal plank
Lift one leg straight in a controlled movement and hold it
Focus on keeping your hips level with each other
2. One-legged Side Plank
Begin a normal side plank
Lift your top leg up in a controlled movement and hold it
3. One-legged Bridge
While keeping one leg straight perform a bridge
Focus on keeping your hips level with each other
Phase 3
Complete each exercise until your muscles feel tired 2 times per day 5 days a week. Once you can hold each exercise comfortably for more than a minute move onto the next phase
1. One-legged Plank with Band
Attach a theraband to something stable and wrap it around your thighs. Perform a single leg plank
2. One-legged Side Plank with Band
Wrap a theraband around your ankles. Perform a single leg side plank
3. One-legged Bridge with Band
Attach a theraband to something stable and wrap it around your thigh which is planted. Perform a single leg bridge
FITT Principles and Evidence Base
F.I.T.T principles play a vital role when constructing a strengthening program in order to target the treatment goals for the patient. They consist of:
Frequency – How often the exercise is completed
Intensity – How hard the patient is working
Time – How long the session lasts
Type – What exercise is being completed
(Waehner, 2014).
Through the use of literature research, strength training has been proven to be beneficial for adults exercising 3-5 times per week. The study concluded that 3 sessions of strength training per week were more beneficial compared to once per week. However, these findings were only found in the short time, which may suggest that in the adult population there is a threshold of strength training. (Murlasits, 2012).
Cinar et al (2015), found that postural stability scores increased with core stability exercises included in rehab programs for patients with ACL reconstructions.
Wen-dien Chang et al (2015, concluded that core strength training is also effective in alleviating low back pain in chronic patients.
Willardson (2007), found that stability of the core is crucial to provide a foundation for movement of the upper and lower extremities, to support loads and to protect the spinal cord and roots.