Once upon a time, we walked on rocky, uneven ground, sat on wobbly wooden stumps, climbed trees and ran from dinosaurs. Now, we walk on perfectly level floors, sit on solid chairs, catch an elevator and drive to the supermarket.

Our environment used to frequently challenge our balance. As a result, our bodies developed the strength and stability to meet these demands. Today, these natural challenges to our balance are far less prevalent. If our weight creeps up, our trunk can end up looking more ‘apple’ than ‘core’! As a result of these environmental changes, our bodies are weaker and less stable, which can lead to injury.

Strength and stability are required in all areas of our body but are more important around our pelvis and lower back area. This is the centre point and base of our body, commonly referred to as our core. If our core is not working effectively, our spine and limbs are at risk. To improve stability, we have to practice operating in an environment of instability. Fortunately, we can reproduce this without having to be chased by T-Rex!

Anatomy made easy

There are two main types of muscles around our trunk.

First, there are the outer unit muscles. These are the most superficial muscles and are closest to the skin’s surface. There are designed to work forcefully for short bursts of time. They switch on to move our trunk around then stop and have a rest. The outer unit are like sprinters––they work hard for short periods of time. An example is the rectus abdominis or six pack muscle, which we exercise with sit-ups.

The second group of muscles around our trunk are the inner unit muscles. They are located deeper down and are closer to our spine and organs. The inner unit muscles are designed to activate gently for long periods of time.
They constantly activate to provide stability and support to all of the small moving parts of our spine. The inner unit muscles are like marathon runners––they work sub-maximally for long periods of time. An example is the transversus abdominis muscle, which wraps around our trunk like a back brace and controls intervertebral movement.

When people refer to core strength or core stability they are generally referring to the strength of this inner unit muscle group.In normal movement, the inner unit muscles control and support our precious spinal structures, while the outer unit generates the gross action. Before every movement we make with our bodies, the inner unit switches on a split second earlier to ensure that everything in our spine is supported before body movement takes place.

What goes wrong?

Unfortunately, the inner unit muscles can become inhibited and weakened by a number of things, such as:

  • Being overweight or obese
  • Inactivity
  • Abdominal surgery
  • Pregnancy
  • Previous back pain or injury

Research has shown us that once these inner unit muscles weaken, they do not automatically bounce back to efficient working. The person is, therefore, left with a deficit in inner unit strength, and this predisposes him or her to spinal (and other) injury.

However, strength in the inner unit muscles can be restored through a progression of exercises that specifically engage the inner unit muscles. First, it important to find these muscles and work out how to switch them on. Then, because their role is to stabilise, we must safely create an unstable environment in order to exercise them. Base level exercises are included below, but these should be then progressed by a physiotherapist or trained fitness instructor. Balance boards, fitballs and reformers are often used.

Take action before you break

You can take some simple steps to introduce more instability into your life.

Injury Proof Toolkit

1. Change your environment

  • Walk on different surfaces regularly, like grass, gravel and soft sand.
  • Alternate you desk chair with a fitball for 10 minutes every hour

2. Change your habits

  • When you talk on the phone, or brush your teeth, practice standing on one leg
  • Take the stairs instead of a lift

3. Do a core stability exercise program, such as Pilates

  • Talk to your PSM Physiotherapist about Pilates.