SCANNING THE CORE MUSCLES – what is the point?

April 28, 2010

Please note that the comments in this blog come from many years of clinical experience and practice, combined with details and opinions taken from various sources, including open-source internet articles. Where relevant, links are provided.

Here at the Adur Osteopathic Clinic, the Osteopathic and Physiotherapy Practitioners are frequently asked to help with understanding and developing Core Stability exercises.

The term ‘core stability’ has gone in to popular culture and is widely used in fitness, training and health circles. However, I do believe that the very popularity of the term’s use often means that people are unclear exactly what ‘the core’ is. I ask many patients to tell me what their understanding is and it is clear that there is a huge range of interpretation and advice being given.

Now it should be said that there is no substantial danger in exercising and strengthening ‘the wrong muscles’, but I believe it is a matter of accuracy and you may not get the result that you want or expect . There may be some risk of aggravating lower back problems is the exerciser if overzealous.

Exercises range from gentle, subtle pelvic floor and lower abdominal contractions to highly taxing and often aerobic dynamic exercises such as Kettlebell and advanced Pilates routines. So, who needs what? That, of course depends on what your specific needs, physical condition and ambitions are. However, I generally like my patients to start off at the bottom, (sorry!), even if they are otherwise fit and able. This is because the technique is very important and running before walking is what leads to the confusion about what core strength and stability  really is.

For example, I have scanned some very fit professional footballers and they have wonderful external and internal oblique muscles – well defined, strong and capable. But, their Transverse abdominis muscle, (the really important one), is thin and poorly defined. Why? I think that it is partly training-specific and partly because they can see fantastic abs and six packs, (so therefore they are worth the effort), and partly culturally-driven within football – pelvic floor stuff, “is a bit girlie”. I do point out that ignoring this area is partly why they are on my treatment couch  in the first place and it my responsibility to educate them of the importance. Give people the right reasons to do something and they will usually do it, even if they do need a good push to get started! Let’s face it, the most valuable, basic structural exercises are also pretty dull – but see them as the base for the more glamorous stuff.

What then, can real-time dynamic ultrasound scanning offer, and why bother? It is all about feedback, a sort of visual carrot and stick – perform an exercise or muscle contraction and see the result there and then, able to visualize what is going on beneath the skin – a quick peek inside at how things work. Action and result before your eyes.

In times gone by I’d have been burnt at the stake for witchcraft, but today? Use the technology to prove a point to yourself and see if you really are doing what you think you are and what you have been taught.

This is an example of BIO-FEEDBACK, where, in this case, a physical action is reinforced by a visual memory. The benefit of real-time ultrasound scanning is that the patient is able to make a connection between what they are feeling when asked to perform a contraction and what they are seeing on the screen.

Two of the most important muscles that we can image are the Transverse abdominis muscle, (TrA), in the side of the abdomen and the Multifidus in the spine.  These, along with the pelvic floor, are among the most important muscles targeted by Pilates Instructors and are crucial for Core Stability.

It must be stressed that while the pelvic floor muscles are key components of core stability, WE DO NOT scan them specifically. The scan is performed over the patients side, just below the rib cage. Put plainly, no internal examination is required and no clothes need to be removed.

You do NOT need to be undergoing treatment to make use of this type of service and the scan and exercise advice will last approximately 15 minutes.

For those who are receiving osteopathic or physiotherapy treatment at this clinic, the technique can help in improving recovery from lower back injuries by reinforcing exercise advice.

So, is it worth doing? This is the age of information and being informed, I am constantly being told, is both a right and a necessity. My belief is that the more informed you are, the better able  you are to make the decisions that suit you and best help your personal circumstances.

Contact us at the Adur Osteopathic Clinic on 01273 455 775 if you would like to know more.

To see a short video screenshot

Adur Osteopathic Clinic

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‘Our patients visit us from Shoreham, Southwick & Lancing, (Adur), Brighton, Hove, Bramber, Steyning, Worthing & other towns in West Sussex & East Sussex’

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