Core Stabilization

Core Stabilization

Low back pain can be described as pain in the lumbar region. Low back pain is very common in the adult population and can occur for a variety of reasons such as muscle strain, overuse of the muscles, ligaments and discs that support the spine.

A muscle injury that has not been treated or managed correctly may lead to an overall imbalance in the spine. This imbalance can lead to making the back more prone to injury or re-injury. If you experience low back pain for more than two weeks, call Injury Care Center and allow our professional staff of physicians diagnose and explain what is causing your back pain. They can also prescribe physical therapy as an option to treat your low back pain.

Our knowledgeable physical therapy will use their expertise in providing an individual program to treat and manage low back pain. We offer rehabilitation programs that focus on the combination of strengthening the lumbar musculature with core stabilizing exercises.

What is the “Core?”

The word “core” refers to the body’s area between the diaphragm and pelvic floor. It is important to understand the way certain muscles work, in this case we are talking about the core muscles, and how to feel and perform the exercises correctly.

The “core” is comprised of a group of muscles including the transverse abdominus (the deepest abdominal muscle), multifidus (deepest back extensor muscles), diaphragm and the pelvic floor muscles. These muscles work in conjunction with each other to stabilize the abdominals and lumbar area. These muscles also coordinate movements of the upper and lower extremities.


The Core Muscles:
Transverse Abdominus- (TVA) The TVA is one of the most important of all the sore muscles and also one of the deepest muscles in the abdominal area. It works to compress abdominal contents and adds stability to the lower back and pelvis.
The TVA should normally be in a state of continued contraction, whether sitting or standing, because it facilitates good posture. This muscle can be retrained to maintain a contracted state to improve upon good posture.

Lumbar Multifidus:
The lumbar multifidus is the most important stabilizer of the spinal extensor group. This muscle not only helps with maintaining good posture, it also aids in spinal stability during all movements of the body. People with chronic low back pain have significant atrophy (wasting away) of the multifidus.

Pelvic Floor Muscles:
People with low back pain do not have the ability to perform pelvic tilting due to limited or blocked extension. The pelvic floor works with the TVA and multifidus to stabilize the pelvis.

The diaphragm is the main respiratory muscle. The muscle helps to stabilize the spine because of its attachment to the ribs and the spine. The diaphragm also forms the roof of the abdominal cavity, which also aids in abdominal cavity stabilization.

Internal Obliques:
The deeper of the oblique muscles, the internal obliques are responsible in stabilizing the core.

Indications for Exercise:
You can enhance your core stability through specific exercise. Research has shown that combining abdominal stabilization exercise with a routine exercise program aids in the reduction of pain levels in the lumbar spine, while increasing muscle endurance and functional activity.

Performing core strengthening exercise gives you strong, flexible trunk muscles that support well aligned bones. These exercises target the spine, abdominals and pelvic area. Core strength can be described as the muscular control required around the lumbar spine to maintain functional stability.

Core Coach:
At Injury Care Center, our professional physical therapy staff utilizes a device called the “Core Coach”. The Core Coach is a pressurized, biofeedback pillow. This device enables a patient, who suffers from low back pain or weakness in the abdominal, to actively focus on the TVA to ensure a stable core, relieve pain and discomfort in the lumbar spine.

Our PT staff teaches patients to activate their TVA utilizing the Core Coach. Activating and stabilizing the TVA can correct issues such as back spasms, misalignment and other serious issues. It also helps decrease pressure in the spine caused by these issues. Decreasing pressure in the spine can help relieve disc degeneration (commonly known as spondylosis) and related issues.

How Does the Core Coach Work?

The Core Coach consists of an inflatable pillow connected to a pressure gauge. The pillow is placed under the lumbar spine. The gauge will detect movement in the lumbar and abdominal area.

We teach the patient how to engage their TVA, which is the deep abdominal muscle. This is performed by getting the patient to perform a posterior pelvic tilt and then to maintain a neutral spine. The gauge needle should rise if TVA is engaged and contracted. The patient is instructed to hold the contraction for 10 seconds, then to relax for 15 seconds, working their way up for a total time of five minutes. If the needle doesn’t move, while the TVA is activated and contracted, this will indicate a stable core. Should the needle move around while trying to maintain the contraction, this will indicate the core is weak and there is room for improvement. Once the patient perfects neutral spine position, they can then move on to more intermediate and advanced positions utilizing the Core Coach and building strength and stability in the abdominals and lumbar spine.


Donna Fedena, PTA
901 West Ashland Ave.
Glenolden, Pa. 19036

Injury Care Center
901 W. Ashland Avenue
Glenolden, PA 19036

Injury Care Center
1502 Upland Street
Chester, PA 19013

Injury Care Center
3300 Grant Ave.
Philadelphia, PA 19114