Do you really know what the “core” is?

Many people think of the “core” as the abdominals….the six-pack muscles, or the obliques. Not true. The “core” is a series of 4 muscles; the transversus abdominis (TA), the multifidus, the diaphragm and the pelvic floor. The TA is a deep abdominal muscle that acts much like a girdle, wrapping around the abdomen. The multifidus muscles run up the spine and help stabilize the vertebrae. The top of the core is the diaphragm which is the breathing muscle. It pulls the lungs down and out allowing them to fill with air. The pelvic floor is the bottom of the core and helps to support the pelvic organs, maintain urinary/fecal continence and has a role is sexual function. Together these muscles work in a series of contractions and relaxations to hold the abdominals together, stabilize the body, protect the spine, hold up the organs, maintain continence, the list goes on…

Without a properly functioning core, problems can arise. There is a HUGE variation of issues that can develop, but some common ones include low back pain, sacro-iliac joint pain, chronic pelvic pain, sciatica, pelvic organ prolapse, urinary incontinence and genital pain syndromes. Really though, when your core muscles don’t work well, you tend to compensate in other areas, so places like the hips, pelvis, low back, thorax and knees can all be affected.

The core muscles anticipate movement, and therefore must contract a moment before limbs moves, or you land a jump or you kick a ball. I see lots of people who think they are doing “core” exercises; sit-ups, planks, V-ups, half wipers, pulse lifts, mountain climbers, you name it! And while these exercises can target core muscles, I find that people tend to use their abdominals, glutes, chest muscles, neck muscles and arms muscles well before they engage the entire core.

Remember – the core includes the TA, multifidus, diaphragm and pelvic floor. I often take people who swear by their core exercise program and test their actual core strength only to have them dismayed when a simple diaphragmatic (belly) breathing exercise leaves them dizzy. Or a kegel combined with a TA activation and a leg lift is a challenge. There is no point in doing “core” exercises if you are using other muscles and not your core at all.

There are basic core exercises that most physiotherapists can teach you.  I always encourage my patients to master the basics before moving on to advanced core exercises.  If you struggle to activate your pelvic floor, are confused about how you should kegel, or have symptoms like urinary leakage, pelvic floor heaviness or pelvic/genital pain conditions, then maybe a pelvic floor physiotherapist is the right practitioner to teach you core activation. Whomever you choose to help you strengthen your core muscles, take good care of them! They play a large role in day to day activities and should be an integral part of your fitness routine.

Katie Kelly,


BSc., MSc. PT