Written By: Lori Duncan, DPT, MTC, CPT

Core stability is one of the most important concepts to teach a patient for healthy movement. It is a low-load, continual activation of specific muscles that allow our body to feel organized, safe and prepared for any movement. In order for the human body to feel and use its optimal strength, it must master stability first.

There are many misconceptions about core stability and here are few:

1. It requires a ton of effort to engage the abdominals
2. A C-section makes deep core work impossible
3. A posterior pelvic tilt and flat back are core stability
4. Belly breathing is a great way to train the core
5. Core stability is limited to the abdominal muscles

Our core system is vast and every muscle associated attaches to the thoracolumbar fascia. These include:

• Deep abdominals: transverse abdominis and internal abdominal oblique
• Scapular complex: latissimus dorsi, serratus anterior, rhomboids, lower trapezius
• Gluteals: gluteus maximus, gluteus medius, gluteus minimus
• Diaphragm
• Multifidus

Mastering core stability requires our patients to be able to breathe from the diaphragm, rotate the trunk from the internal abdominal oblique, hold good posture and know where in the world their glutes are. That is A LOT to teach each patient but luckily stability begets stability. So, working on a few elements of the core system can be a big game changer for our patients.

On of the most important concepts to teach patients at first is the ability to control a neutral pelvis. We are in a world of “tuckers” (think posterior pelvic tilt) and yet that is not how we function.

Click the video below for further explanation:

Progressions in the video to demonstrate neutral pelvis:

1. Supine core stability + hand on belly (finding exercise)
2. Core + march (stability)
3. Core + roll-up (stability + strength)
4. Roll-up + march (stability + strength + stability)

Although this blog is only addressing ONE element of the core system it continues to be one of the most dysfunctional neuromuscular patterns I see in patients. Hopefully neutral core will be the wave of the future!