How can I tell if I have core dysfunction?
Core dysfunction is so common that nearly every mother experiences it at some point. Many women improve on their own during postpartum recovery (before 8 weeks), but over half of women don't. Read on to learn more about the core system that is responsible for keeping you strong and protecting you against injury (as well as having a flat belly and a defined waistline) and what happens when this system has stopped working.
What is the core system?
The core "system" is made up of 4 parts that create a cylinder. The top is the diaphragm and proper breathing is part of a core-system that works. The tube in the center is made up of the transverse abdominis (TA) that has a fascia or connective tissue that connects at the linea alba in the front and wraps around the multifidus or muscles that run along the spine in the back. The bottom of the cylinder is the pelvic floor a hammock of muscles that support the pelvis (figure 1).
How does it work?
The core-system distributes loads (arm and leg movements or any object your lifting) and protects the spine through 2 methods. The first is through increasing pressure inside the cylinder (intra-abdominal pressure) as the TA draws in circumferentially like a corset and the pelvic floor raises. These movements increase the pressure inside the cylinder adding stiffness to the spine to evenly distribute the forces being lifted or moved (figure 2a).
The second method, the TA contracts and pulls on the fascia (muscle lining) that surrounds the multifidi muscles that run along the length of the spine. Because this happens in sequence, first the fascia is tightened, then the multifidus contracts - expanding the muscle in a smaller space - this creates a column of exponential force along either side stiffening the spine and distributes the load across the spine and pelvis (figure 2b).
What would you lift if you had exponentially greater strength? Probably your baby all day long, - wait you already do that. But what if it didn't make you so tired? That's what re-activating your core is all about!
What is core dysfunction?
Triggers such as back pain, injury, surgery, abdominal pain or excessive stretching of the abdominal or pelvic floor muscles during childbirth can cause the body to turn off the core-system, likely as a protective measure. However, sometimes the body doesn't turn the system back on (7). Why? During the recuperative or postpartum period an individual teaches the body to move and respond to loads in a different way while the core-system is deactivated. This learned compensatory response remains after the injury is healed.
Muscles that compensate for a deactivated core don't provide protection for the spine. Because the person lacks that exponential force created by an activated core-system, the more external muscles, though larger, tire due to their regular loads leading easily to muscle fatigue and strain. Excess forces are placed at single levels of the spine for example L4-L5 with forward bending can cause disc herniation or slipping. Diffuse disc degeneration, pelvic instability, recurring back pain are directly related to these forces (19). Some symptoms you might not have associated with core dysfunction include groin strains, leaking urine or gas, difficulty with bowel movements, shoulder pain, pelvic organ prolapse and more (13).
In my practice I commonly see that once the pain is gone, the person thinks that she is better. Sure the bulging belly and the intermittent back pain are bothersome but she assumes that with a diet, more consistent exercise or ongoing trips to the chiropractor they will remedy what she considers de-conditioning. Research supports what I've seen, that people can screen positive for a de-activated core even 10-15 years after the incident that triggered their compensatory response (7).
How do we re-activate the core?
The core can be re-activated just like someone who has lost the ability to walk can be re-taught. There is a sequence to this muscle activity and the brain needs to be re-connected to the correct sequence. The brain is re-taught the correct sequence by doing something you haven't done since you last learned something new. That is, using mindful movements - working through the correct process of activating the core system and practice turning on the muscles in the right sequence.
Once we have re-connected these muscles in the correct sequence, your brain starts using them automatically much like your calf muscles working to keep you standing. At this point you are able to continue with regular exercise programs to strengthen your core system and protect yourself from injury.
That's our goal with the Mommy Ready Postpartum Program . To help protect you from injury - and by restoring your core system, improve your symptoms of core dysfunction. It's easier than you think.......