Stabilizing the Core Starts with the Pelvic Floor

by Leslie Howard

Today I’d like us all to explore a place we have all heard of, “the core.”

If you practice yoga, Pilates, or Bar Method, you have probably heard the instruction to work from your core. Classes are often spiked with catch phrases like “core power” or “core strength.” This wouldn’t be bad if everyone understood what core means. However, if asked to describe the core, most people will wave their hand over their belly area and guess, “My front abdominals?”

Like the Loch Ness monster or Bigfoot, the core is legendary and elusive. How can we engage the core properly, if we don’t know exactly what muscles are meant to work? This lack of knowledge means we may run the risk of harming ourselves by not working our core correctly. In fact, some of the practices that are billed as “strengthening the core” may do the exact opposite.

We need core muscles for power, strength, and stability. We need to use them when we lift something heavy in order to avoid straining other, more vulnerable parts of the body, like the lower back. We need them to work as shock absorbers, like when we drive too fast over a big bump. We need them to keep our spine and organs safe when we are jumping, dancing, and playing sports. Core muscles are crucial for our stability and safety.

The core musculature consists of:

• The diaphragm, which attaches at the xiphoid process (bottom of the breastbone) along the 7th to 12th ribs, and to lumbar vertebrae L1, L2, and L3.
• The pelvic floor muscles, which run from the pubic ramus to the ischial spine, ischial tuberosity (sitting bones), and coccyx with attachments along the crus of the clitoris, if you have one, and perineal body and encircling the anus, urethra, and vagina or base of the penis.
• The abdominal muscles, of which we have four layers. The most superficial layer is the rectus abdominis (the famous “six pack”), which runs vertically from ribcage to pelvis. On the sides of the torso are the external and internal obliques, which run diagonally from lower ribcage to pelvis. The deepest abdominal muscle, the transverse abdominus (TrA), runs horizontally beneath the other layers. Because the TrA is the deepest abdominal muscle and runs in a lateral (side-to-side) rather than a vertical (up-and-down) manner, it is often considered the true core by many in the anatomy world. When the TrA is properly recruited, it works like the cinching in of a corset.
• The postural spinal muscles (multifidus spinae), which extend from C1 (top of the cervical spine) to the sacrum. The short and deep muscles attach between the spinous and transverse processes as well as the vertebral bodies. They are like super-supportive struts.

There are many reasons we fail to engage the full range of core muscles. One of the most common is “perma-tuck” of our bellies—we hold in our bellies because we want to look thin. Perma-tucking has become such a habit that people don’t even notice it anymore. Many women have told me their mothers encouraged them from a very young age to keep their belly pulled in to look thinner.

By the way, the social pressure to look thin is a relatively new phenomenon. When we look at sculptures from ancient Greece or paintings by Rubens or Renoir, we see women with nice soft round bellies. The Gibson Girls were full-figured gals in the early 1900s, and even as late as the 1950s, we still admired the voluptuous body of Marilyn Monroe (I am pretty sure that if Marilyn were a star today, the tabloids would call her fat). Rather than real corsets, we wear mental corsets. I have worked with students who trained themselves to hold their bellies in so strongly that they were unable to take a full abdominal breath. This puts constant strain on the lumbar discs and the pelvic organs.

The perma-tuck is often exacerbated by the instruction to “work your core,” which people commonly interpret as “pull your belly in as intensely as you can.”

And that brings me to another pet peeve, the “navel to spine” cue. It’s true that when we strongly pull our navel toward the spine, a lot of muscles are activated. The problem is that this action also makes our rectus abdominus and erector spinae muscles dominant. The rectus muscle is our most superficial abdominal muscle, but it is not necessarily considered a stabilizer because it also flexes (forward bends) the spine. When we pull the navel to the spine, the pelvis tucks even more and the spine becomes less stable. That action destabilizes our poses and increases the chance for injury, which is the exact opposite of what we want.

If the cue “draw the navel to the spine” is inadvisable, what are some alternative actions for activating the core?

I prefer phrases like “draw the sides of the navel toward the back of the body” or “draw the frontal hip points toward one another,” in order to keep the spine in a neutral position. Overworking the rectus can result in too much spinal flexion (forward bending), which can make us vulnerable to lower back pain or even nerve impingement. Pelvic health specialist Isa Herrera, M.S.P.T., of Renew Physical Therapy in New York City, asks us to “draw our navel to our heart.” Experiment with these cues in your own body and see which one gives you the most stability. Just avoid the “navel to spine” action.

It takes time to learn how to properly stabilize the core. Here is an exercise that seems relatively easy. However, you will need to be careful, as the body creates all kinds of ways to cheat.

Leg Lifts

1. Lie on the ground. Place a folded blanket under your head. Bend the knees and place the soles of the feet on the floor.
2. Place your fingers on the lower belly, below the navel and above the pubic bone.
3. Lift your feet a few inches off the floor (if you have back pain, lift only one at a time). Observe what happens to the area under your fingers and to your lower back.

Most likely you will feel that your belly muscles firm and lift toward the ceiling. You may also notice that your low back lifts off the floor and begins to overarch. Some people say that their lower back actually flattens. If this is the case for you, put more support under your head.

Now try a variation of this exercise:

1. Follow instructions for 1 and 2 above.

2. As you exhale, lift your perineum toward the crown of the head.

3. Slowly lift your feet off the ground.

Did you notice a difference in your belly and your back? Most people experience that the belly no longer lifts toward the ceiling and the lower back remains stable; there’s no overarching.

For more information on the pelvic floor and yoga poses that can help, see my book Pelvic Liberation at www.lesliehowardyoga.com or Amazon.com.

Leslie Howard is an Oakland-based yoga teacher, specializing in all things pelvic. She leads workshops and trainings nationally and has written a book about caring for the female pelvis, Pelvic Liberation. She is a regular presenter for the Yoga Journal conferences and a regular contributor to Yoga Journal magazine.  Her own struggles with healing her hips and pelvis led her to intense study of the anatomy, physiology, cultural messaging, history, and energetics of this rich area of the body. Her teaching is informed by over 3500 hours of yoga study with senior Iyengar yoga teachers.  She considers Ramanand Patel her most important influence and mentor. She has designed two very successful studies for UCSF on how to use yoga to alleviate incontinence and pelvic pain.

 

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