Why Core Matters for Pelvic Health and Fitness Training?

Many people and trainers talk about strengthening the core muscles, but few are certain about their location, purpose, and the correct way to train them. The core muscles are primarily deep muscles located in the abdomen, pelvis, and lower back, as opposed to superficial muscles located closer to the skin’s surface.

The core muscles resemble an apple’s core, with the pelvic floor muscles located at the bottom and the diaphragm at the top, connected by a corset-like binder made up of various muscles that wrap around the body.
It’s important to focus on the muscles that make up the deep core not the six packs muscle.

The main core muscles are a group of muscles that work together to provide stability, and support to the spine and pelvis. The main core muscles include:

  1. Diaphragm is an important part of the core muscle group and plays a crucial role in creating and managing pressure within the abdomen, which can have a significant impact on pelvic health. In addition to its role in breathing, the diaphragm plays an important role in creating and managing pressure within the abdomen, which can have a significant impact on pelvic health, helping to maintain proper pelvic alignment and providing support to the pelvic organs.
  2. Transverse Abdominis: The deepest abdominal muscle that wraps around the abdomen like a corset, providing stability and support to the spine and pelvis.
  3. Multifidus: A series of small muscles that run along the spine and are responsible for stabilizing the spine and maintaining proper posture.
  4. Erector Spinae: A group of muscles that run along the spine and are responsible for extending and rotating the trunk.
  5. Pelvic Floor Muscles: Muscles that stretch like a hammock from the tailbone to the pubic bone, providing support for the bladder, uterus, and rectum, and helping to control urinary and bowel functions.

The diaphragm and pelvic floor muscles move together effectively, they can help to reduce the risk of pelvic floor dysfunction, however if there is dysfunction in one or both of these muscles, it can lead to increased pressure and tension on the pelvic organs, potentially leading to pelvic floor disorders, such as pain, bladder leaking or pelvic organs descend/prolapse. When working effectively with the pelvic floor muscles, the diaphragm can help to maintain proper pelvic alignment and support the pelvic organs, reducing the risk of pelvic floor dysfunctions.

Accessory core muscles are muscles that work in conjunction with the primary core muscles to help support and stabilize the trunk during movement. These muscles are typically located superficial in the hip, lower back, abdomen or shoulder regions, and include muscles such as the hip flexors, gluteal muscles, rectus abdominal ( the six packs) obliques muscle and shoulder stabilizers. While the primary core muscles, are responsible for providing the primary support and stability to the spine and pelvis, the accessory core muscles help to reinforce this support and provide additional stability during movement.

Incorporating exercises that target both the primary and accessory core muscles into your fitness routine can help to improve overall core strength and stability, reduce the risk of injury and enhance performance during physical activities.

Crunches, planks or other exercises done incorrectly can potentially cause harm, especially if they are performed with poor form, too much repetition, or without proper activation of the deep core muscles.

Crunches primarily work the rectus abdominis muscle, which is responsible for flexing the spine. If performed incorrectly, they can put excessive strain on the neck, spine, and hip flexors, leading to pain, discomfort, and potential injury, additionally there is a risk of excessive pressure on the pelvic floor, which can lead to pelvic floor dysfunction, such as incontinence or prolapse.

To reduce the risk of injury and ensure that you are properly activating the deep core muscles during crunches, it’s important to maintain proper form, including keeping the spine in a neutral position, engaging the pelvic floor muscles, and perform proper breathing . It’s also important to avoid overdoing it with too many repetitions or performing the exercise too frequently.

If you are unsure about how to properly perform crunches or have concerns about your pelvic health, it’s recommended to consult with a qualified pelvic health physical therapist first before working with a certified fitness professional.

Fitness trainers who are certified by reputable organizations such as the American Council on Exercise (ACE), National Academy of Sports Medicine (NASM), or the International Sports Sciences Association (ISSA), among others, should have a good understanding of correct core exercises and how to teach them to clients.

However, it’s important to note that not all fitness trainers are created equal, and some may have more expertise and experience than others when it comes to core training. Additionally, it’s always a good idea to seek a pelvic floor physical therapist, they have the knowledge and expertise to develop a safe and effective exercise program.

DR. Daniela Moise, DPT, MDNC


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