Holy Name Medical Center Blog

Physical Therapy Core Training and Progressions

Posted by Christopher J. Cordero, PT, DPT, OCS
Physical Therapist
Board-certified Clinical Specialist, Orthopedic Physical Therapy
HNH Fitness, Center for Physical Rehabilitation on July 2, 2020
Christopher J. Cordero, PT, DPT, OCS - Physical Therapist

Our core can be viewed as the foundation of our body. There is no better time like the present to train one of the most important structures in the human body.

What is the Core?

When you ask the general population what the core is, one of the most common answers is “the abs.” Although this answer is partially correct, the abdominal muscles are only a small component of an entire network of core musculature.

Most literature defines the core as a framework of deep structures surrounding our mid-to lower spine, including the transversus abdominis, the lumbar multifidus, the quadratus lumborum, the pelvic floor, and the diaphragm. In physical therapy school, we are taught that the core is actually any muscle having a direct attachment to our axial skeleton, or any muscle originating from the cranium to the sacrum. This would also include the abdominal wall, latissimus dorsi, quadratus lumborum, and back extensors. When all of these structures are properly engaged at the same time and intensity, they create a cage of protection surrounding our entire spine.

Why is the Core so Important?

Many of the injuries we see at HNH Fitness, whether a low back injury or an ankle injury, are found to originate from a lack of stability and motor control surrounding the spine. If an individual is not able to properly generate stiffness throughout his/her spine, then he/she is more likely to experience degenerative changes over time. Although an injury may occur during a single, heavy-lifting incident, most injuries are caused by an accumulation of poor lifting and bending mechanics throughout the lifespan.

Therefore, having a strong core not only helps us move, lift, jump, and run more efficiently, but it also helps us prevent unforeseen injuries.

Evidence-Based Core Training

There has been a lot of excellent research in recent history examining the link between core training and spine health. Five key components to take away from the research are the following:

  1. The core functions to maintain stiffness and stability in spinal neutral positions.
  2. The core is designed to both accept and transfer loads at various speeds, intensities, and durations in a multitude of positions.
  3. Having a properly activated core allows our extremities (arms and legs) to have improved quality of motion and perform at optimal levels.
  4. Degenerative changes to the spine are often attributed to abnormal movement patterns (i.e., lack of core stability, improper lifting and bending techniques) causing excessive compressive forces and shear stresses to the vertebral column over time.
  5. Traditional abdominal exercises requiring large flexion- and rotational-based movements such as sit-ups, hanging leg raises, and weighted torso machines have been shown to dramatically increase shear and compressive forces to our spine, potentially accelerating degenerative changes.

By understanding this information, we can begin to formulate an effective, yet spine-friendly core training program. The key is to incorporate progressive-resistance exercises beginning with foundational movements in spinal neutral positions, gradually transitioning toward advanced loading of the spinal musculature.

Core Progressions and Exercises

Follow this series of exercises to maximize your potential and create a core that can protect you during the most challenging times.

Christopher J. Cordero, PT, DPT, OCS, is a physical therapist and board-certified specialist in orthopedic physical therapy by the American Board of Physical Therapy Specialties (ABPTS) of the American Physical Therapy Association (APTA). Dr. Cordero practices at HNH Fitness and also runs the Sports Performance Academy, training athletes of all ages with a focus on implementing evidence-based injury prevention techniques and developing proper body mechanics. Dr. Cordero finds passion in the clinical and educational aspects of physical therapy, using manual orthopedic techniques and exercise to help patients regain function in their lives.

Dr. Cordero can be reached by email at ccordero@holyname.org.

Call to schedule an appointment at 201-265-1076 or email physicalrehab@holyname.org.

HNH Fitness | 514 Kinderkamack Road | Oradell, NJ | 07649