Cómo fortalecer tu centro: consejos del fisioterapeuta

Key takeaways:

1. Engaging your core involves activating the muscles in your midsection, including the rectus abdominis, obliques, and transverse abdominis.

2. A strong core is essential for maintaining healthy posture, reducing back pain, and improving overall health.

3. Various exercises engage your core, including planks, bridge, and dead bugs (see videos below).

Hinge Health offers virtual physical therapy and more to help you incorporate core exercises into your routine. Learn more.

Have you ever been told your back pain is due to a weak core? Or that doing sit-ups every day is the best way to strengthen your core? The truth is that there are a lot of myths and misconceptions out there when it comes to core strength and what it means to “engage your core.” 

Many people think of the core as being synonymous with abs, but your core is actually more than just your stomach muscles. It includes all the muscles that stabilize your trunk, which refers to the spinal muscles, diaphragm, pelvic floor, and abdominal muscles. If all those groups are not ready to work together and take on the activities you do, you may be set up for joint and muscle pain.

The good news? You don’t need an expensive gym membership, fancy exercise equipment, or a top-notch personal trainer to keep your core strong. There are many ways you can keep your core at its best and help prevent joint and muscle pain.

What are your core muscles?

The core is the center of your body. It’s also more than just your abs. While you may often hear about six packs when it comes to your core, it’s actually more like a single can of soda, says Kristin Vinci, PT, DPT, a physical therapist at Hinge Health. Think of it this way: 

• The lid of the can is your diaphragm

• The front wall of the can is your abdomen

• The back wall of the can is your spine

• The bottom of the can is your pelvic floor

“All these muscles contract and relax as we do activities,” explains Dr. Vinci. “They play an important role in stabilizing the entire center of your body.” This in turn impacts how you do everyday activities. Everything from reaching overhead to grab dishes in a kitchen cabinet or squatting down to pick up a laundry basket — even shifting your weight from one foot to the other — activates your core to support your spine and entire body through that motion. 

What does it mean to engage your core?

When you hear the words “engage your core,” you may visualize a series of crunches or squeezing the muscles of your trunk. The truth is, there are a lot of different ways you can utilize your core muscles, and most people don’t actually need to learn a specific way to engage their core. Just like you do not need to learn how to engage your quad (thigh) muscles when you squat or your diaphragm when you breathe, your body will know what to do with your core muscles when you lift something or when you get into a plank position. The core muscles really have no choice but to engage when they’re held in certain positions or do certain movements. 

Knowing this, you may still want to understand what it feels like to engage your core when you’re not in the middle of everyday activities. This may help you become more aware of what your body is naturally doing when your core muscles engage on their own. 

There are countless different ways to engage your core muscles and no way is better than another, but the following is a simple exercise that can help you practice what it feels like to engage your core: 

• Start by sitting (or standing) in a comfortable position. 

• Place one hand on your upper chest and the other below your rib cage so you can feel your diaphragm move as you breathe.

• Breathe in slowly through your nose so that your stomach moves out.

• As you exhale through your mouth, tighten your stomach muscles so that your stomach moves in. This activates not just your abdominal muscles, but all the muscles that support your trunk.

PTs also like to use verbal cues like “tuck your tail” or “pull your belly button toward your spine.” So if you roll your hips underneath, you flex your pelvis, and this flexes your low back and engages your core. Another way to visualize this is to think about lying on your back and setting an ice cube on your stomach. That cold reflex helps people think about engaging their stomach muscles. 

You can also effectively engage your core through a form of deep breathing known as diaphragmatic breathing. When you do this, you not only relax your entire body and reduce stress and tension, but you also activate your core muscles, including your diaphragm muscles, notes Dr. Vinci. 

Although these are all different ways to practice engaging your core, just remember that your body does this naturally when you move or lift something. Practicing engaging your core in whatever way works for you may just help you understand which muscles are being activated next time you lift a heavy box or balance on one leg. 

Why core strength matters 

Although your body may engage your core muscles naturally during many movements, there are still benefits to strengthening your core muscles, such as: 

• It helps prevent injuries. Research shows that increased core strength can help improve back pain, so we can assume that lack of core strength can play a role in musculoskeletal aches and pains, especially in the lower back. Just remember that pain is complex. While we can say that core weakness is a factor in back pain, we can’t say that it’s the sole cause of it. Even athletes with great core strength can have back pain. That being said, we might see core weakness as a contributor to back pain if you’re trying to move more load than your body can handle. In cases like this, there’s good evidence that combining core strengthening exercises with total body and endurance exercises can help reduce back pain. 

• It makes it easier to do everyday activities. What do bending over to tie your shoes, turning to look behind you, or getting dressed all have in common? They all use your core muscles. This also includes things like sitting at your desk and typing on your computer.

• It boosts balance. Since your core stabilizes your body, it allows you to move in any direction or stand on uneven terrain without losing your balance.

• It improves workout performance. Whether it’s a round of golf, a long bike ride over the weekend, or your weekday run, a strong core can make all these activities easier and boost your performance.

The best way to develop a strong core is to exercise it, just like you would any other part of your body. The exercises above are recommended by Hinge Health physical therapists because they not only engage the deep abdominal muscles, but other muscles that support your trunk, like your back and glute muscles.

This is important: A weak core does not cause low back pain. Some core exercises, however, may help decrease pain and improve physical function among some people with low back pain, according to a 2017 review in the Journal of Athletic Training. Another thing worth noting: Some people with back pain have a tendency to overtense their core muscles. So while it is good to keep the trunk muscles strong, it is also helpful to relax them when they aren’t needed.

The exercises above, recommended by Hinge Health physical therapists, can help you strengthen your core and possibly help reduce back pain. Some people may need additional training or exercises to relax their core muscles. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Nelson, N. & Beach, P. V. (2012). Diaphragmatic Breathing: The Foundation of Core Stability. Strength and Conditioning Journal 34(5), 34-40. 

2. Diaphragmatic Breathing. (2022, March 30). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing

3. Cho, H., Kim, E., & Kim, J. (2014). Effects of the CORE Exercise Program on Pain and Active Range of Motion in Patients with Chronic Low Back Pain. Journal of Physical Therapy Science. doi: 10.1589/jpts.26.1237

4. Koumantakis, G. A., Watson, P. J., & Oldham, J. A. (2005). Supplementation of general endurance exercise with stabilisation training versus general exercise only: physiological and functional outcomes of a randomised controlled trial of patients with recurrent low back pain. Clinical biomechanics, 20(5). 474-482. doi: 10.1016/j.clinbiomech.2004.12.006

5. O’Sullivan P. B., Caneiro, J., O’Sullivan, K., Lin, I., Bunzli, J., Wernli, K., & O'Keeffe, M. (2019). Back to basics: 10 facts every person should know about back pain. British Journal of Sports Medicine, 54(12). doi: 10.1136/bjsports-2019-101611

6. Coulombe, B. J., Games, K. E., Neil, E. R., & Eberman, L. E. (2017). Core Stability Exercise Versus General Exercise for Chronic Low Back Pain. Journal of Athletic Training, 52(1), 71–72. doi:10.4085/1062-6050-51.11.16

7. Geisser, M. E., Haig, A. J., Wallbom, A. S., & Wiggert, E. A. (2004). Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain. The Clinical Journal of Pain, 20(2), 61–69. doi:10.1097/00002508-200403000-00001

8. Core Anatomy: Muscles of the Core. (2013, October 11). American Council on Exercise. https://www.acefitness.org/fitness-certifications/ace-answers/exam-preparation-blog/3562/core-anatomy-muscles-of-the-core/

9. Bowman, E. A Review of Core Stability Training in Rehab: Facts, Fallacies and Future Directions. Physio Network. https://www.physio-network.com/blog/a-review-of-core-stability-training-in-rehab-facts-fallacies-and-future-directions/