Positive Health Online

A whole industry and a myriad of professionals are living off the concept that bad backs are caused by muscle weakness. As a corollary, muscles have to be strengthened relentlessly. Not all muscles mind you. In recent years, a small group of muscles has been endowed with quasi-magical powers and achieved the status of panacea for back ache and general fitness. In this belief, the human spine is seen as an unstable structure that needs a constant co-contraction of trunk muscles. A select small group of muscles has acquired the title of 'core muscles' of which the darling is the transversus abdominis. The concept of 'core stability' was born. A craze followed, spurred by the 'core stability' credo. Leading the way towards a hard core is the fitness system known as Pilates, a multi-million pound industry thanks to intense marketing. In the desperate search of the now trendy, albeit elusive, toned core, thousands of people have been pulling their  tummies in and hollowing or bracing their abdomens till they are blue in the face.

Although the core stability mania is still going strong, some discordant voices are starting to be heard and the number of discontented people is growing – understandably so. In 2008 The Guardian published an article subtitled: Far from curing lower back pain, core stability exercise might be bad for you, some experts now believe... More recently, Professor Eyal Lederman wrote an excellent article called The Myth of Core Stability. Aside from the marketing work, the success of this fitness fad rests upon the age old belief, shared by most people, that toning up and straining our muscles is necessary for a healthy back and a flat tummy. A trend is easily adopted when people are coaxed into doing what they already think should be done Tucking in the abdomen is indeed an age-old practice. Core stability training might be fashionable, but it's certainly not new – it is just a re-hashed variant of an old system. I have before me a book called The Culture of the Abdomen by FA Hornibrook, first published in 1924. Photos in this book show us a gentleman on all fours practising abdomen retraction, a pet exercise of the core stability brigade. If only this gentleman had known that he was fashionable before his time and was practising core stability exercises!

The idea that the spine is lacking stability would be laughable if it didn't mean that thousands of people are wasting time and money on exercises which are at best, inefficient; at worst, harmful.  It is a commonly held belief that without strengthening exercises our bodies would collapse under the pull of gravity, that our vertebrae will pop out, that we will do our backs in or put our backs out, that we will slip a disk, or that our muscles will get flabby. The reality is the opposite of the picture described above. The human spine, far from being an unstable structure, suffers from rigidity and stiffness and proves to be a very unyielding structure. True, the human spine has a strong tendency to lose its normal shape and to become twisted and crooked into all kind of pathological shapes. In that way only, can the spine be said to be unstable.

The irony though, is that this unfortunate tendency is not caused by weakness in some imaginary core muscles, but rather by compressive forces created by the constant shortening of our posterior (dorsal) muscles. 97% of these muscles are poly-articular meaning that they overlap to form a long and uninterrupted chain. This particularity gives them an amazing power which is the sum of the strengths of all the muscles which constitute this muscular chain. Moreover, due to their innate strength, they are always the first ones to be recruited in any movement we make. It is this formidable force that uglifies and distorts us, that makes us stiff, that freezes our joints and that squashes our inter-vertebral disks. Of course, the remaining isolated muscles, the ones that do not overlap, do end up rather weak, inhibited as they are by the ever dominant overlapping ones. But to think that all there is to do is to strengthen the weak ones (the minority) in order to counteract the strong ones would be jumping to a foolish conclusion and to remain a victim of the strengthening delusion. Choosing this route would be like flogging an engine with the handbrake on. By doing so, you'll indeed strengthen your so-called core muscles to some extent, but you'll also inevitably strengthen even more the muscles forming muscular chains. The result will be a dangerous increase of compressive forces all over the body.

In The Myth of Core Stability, Professor  Lederman writes: "Maybe our patients should be encouraged to relax their trunk muscles rather than hold them rigid?" Indeed they should. They must be taught that, contrary to received wisdom, they suffer from an excess of muscle tone found in muscular chains. But to understand that they must first abandon the popular but erroneous notion of what constitutes tone. Then and only then will they be motivated to seek out therapists who have the  knowledge and skill to decrease the excessive muscle tone rather than increase it.

References