Who needs core strength?

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We all do! People always talk about core strength, but why is it so important? Core strength relates to the region of the body bounded by the abdominal wall, the pelvis, the lower back and the diaphragm, and its ability to stabilize the body during movement. The main muscles involved include the transversus abdominis , rectus abdominis, the internal and external obliques, the multifidi, pelvic floor, and the diaphragm. Our deep core acts as a natural corset to support our spine, which provides a strong foundation to perform functional and higher level activities. A strong core makes our everyday activities more efficient, improves balance, and can prevent injuries such as hip and low back pain. A weak core can create decreased support, which can cause stress and injury to other body parts. A program that addresses core strength can improve posture, reduce/prevent pain, and remind important muscle groups to do their job. Core strengthening isn’t just about targeting the front side of your body to achieve a six-pack, but involves your gluteal muscles and the muscles that make up your back as well.

Below are some basic examples of how to strengthen your core. It’s important to note that every individual is different and some may need to modify exercises based on their level of comfort. Always consult with your physician or physical therapist before starting a new form of exercise.

1) Transversus abdominus (TA) contraction: This is the deep abdominal muscle that acts as our body’s natural corset. It is a deep muscle that provides stability to our spine. The concept of this exercise is necessary for the exercises that follow.

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Lie on your back with your knees bent. Pull your belly button in and up towards your spine, while breathing out. At the same time, activate your pelvic floor by performing a Kegel exercise. You can use your index and middle finger to feel for the contraction. Hold for about 5 seconds. Repeat 10 times.

2) Plank on forearms: Great for shoulder stability/strength, core, and lower body strength

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Lie face down on the floor resting on your forearms. Place your elbows directly under your shoulders and forearms with your hands grasped together. Push off the floor raising up on your toes and resting on your elbows. Push through your elbows to keep your shoulder blades from winging (protruding from your back). Draw your belly button in toward your spine (TA contraction), tighten your buttock muscles, and draw your heels back. Keep your back flat in a straight line from head to heels and try not to let your back sag or your buttocks come up in the air. Beginners should hold this position for 15 seconds, more advanced exercisers can hold for 30 seconds and work their way up to 60 seconds. Lower your body and rest, repeat 3-5 times.

3) Quadruped alternating arm and leg: This exercise works on your transverse abdominis and your low back stabilizers.

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Starting on your hands and knees, perform a TA contraction. While holding the contraction, lift your opposite arm and leg. Do not let your back move and keep your hips square. Hold this position for 5 seconds. Return to the starting position and alternate sides. Repeat 10 times on each side.

Erin Corbo is a doctor of physical therapy and a board-certified Orthopedic Clinical Specialist at the Hospital for Special Surgery Integrative Care Center.







Jocelyn-Mastropolo-200-240Jocelyn Mastropolo is a doctor of physical therapy at the Hospital for Special Surgery Integrative Care Center.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.


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  1. Hi Erin,

    I know a weak core can lead to back pain as well as poor back support. I was encountering back pain and had some pretty poor posture. I ended up getting really into Waist-Training and I found that it helped both of my issues. My question is, do you think this is an adequate solution? or do you think I could potentially be doing some damage that I’ll end up paying for later in life?

    1. Hi Megan, thank you for reaching out. Here’s an answer from the HSS Rehabilitation Department: “It’s great that you’re being so proactive about your health and fitness! Our suggestion would be to schedule an evaluation with a physical therapist who can assess your posture and guide you in establishing a fitness program that is both safe and effective.” If you wish to receive care at HSS, please contact our Rehabilitation Department at 212-606-1005 for further assistance.

  2. I have had 3 back surgeries with two of them being fusions. I also have sjogren’s and R/A. I was fused between S1 and t-10. It didn’t take in the middle of the thoracic back. My doctor says it’s because of the r/A and R/A meds it didn’t fuse. I can’t stand perfectly straight. There is a hump in my back that can only be taken out by having another fusion. The whole fusion won’t have to come out they would do it from T1-T5. Is this necessary to correct the problem? Will the recuperation be as tedious as the last one? Is there anything else that can go wrong? What are pros and cons of this surgery? Since it will be fused all the way to T10 will it affect mobility in the neck area or give me less mobility in the thoracic area. I am looking for an honest opinion on this. Thank you.

    1. Hi Sharon, thank you for reaching out. Dr. Matthew Cunningham, Orthopedic Surgeon, says: “It does not sound like you have pain, or at least you didn’t mention it. With that in mind, you don’t like the way your back looks, and there is a spot that didn’t heal, but does not hurt. It would be uncommon for it to get any better without surgery, but if you are willing to live with it the way it is, then surgery can definitely be avoided/delayed. Don’t feel rushed into getting back into an operating room. It is a similar surgery, and would be expected to have a similar recovery. There are the same risks associated with the revision surgery as were present in the first one. The pros of the surgery is that it presents a chance to get better, with the cons being that you either get a complication, the surgery goes perfectly, but does not work, or leaves you with a back that hurts all the time post-operatively. Since it will be fused all the way to T10, there will be less mobility in the thoracic area. That is the purpose of the surgery you described: fusing the spine from T1-T10 (resulting in a fusion T1-S1) would make nothing be able to move from where your neck meets your chest down to your hips. If the fusion works, it will make all of the thoracic motion go away. In the neck, I’d warn you to expect to be stiffer, but the surgery you describe does not involve the neck, and shouldn’t change the neck motion much.” It is best for you to consult with your treating physician who is familiar with your medical history and treatment plan. If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

  3. Hi Erin and Jocelyn, I had Lower Lumbar spinal fusion (1/11 @ HSS by Dr. Patrick O’Leary) and I was wondering, if “planking and the other exercises shown would be ok to do ? I guess I’m worried that it might affect the area where my surgery was done. L3,4,5
    Thank you,

    1. Hi Madeline, thank you for reaching out. Erin Corbo and Jocelyn Mastropolo, Physical Therapist, say: “Exercise is an important part of your post-operative plan. The best thing to do is discuss your activity and any restrictions you may have with your surgeon to make sure you make the best choices for your body to help you get back in the game safely. If you?re working with a physical therapist, they too should be able to help guide you through an appropriate exercise progression.” If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.