Do the teachings translate?

This is a question I not only ask new YogAlign students but also long time practitioners do you understand what I am asking / does the information translate?

It can be intimidating to walk into your first yoga class with or without previous experience but then not to understand what the teacher is asking of you is not only confusing but also frustrating. It takes courage and confidence to let an instructor of any sort know that you do not understand or to ask why I am doing this posture? How is this benefiting me? So much so students will continue to try to do what is being asked of them even if it hurts or is very uncomfortable. I do not recommend continuing to move in a way that is hurting your body, mind or spirit so please stop and ask the question if not to the instructor to yourself:

  • does this posture allow my spine to maintain its natural curves (shock absorbers)?
  • in this posture do I have the ability to do deep, full, rib-cage breathing?
  • does this posture serve my human design and create functional movement positions?
  • is this posture causing me pain?

YogAlign translates to pain free yoga from your inner core it is a practice I am confident to teach a mixed class of beginners and longtime practitioners side by side. Aside from having severe health concerns and needing a one on one session the above mentioned seems to sync beautifully. I also find YogAlign is a yoga practice that is experiential. Meaning I like to keep the verbal cues limited and relatable as we move through the practice. Thus allowing the student the experience as well as building the trust and confidence of the practice. In a short time my words, the posture and feeling that comes with it will all connect like an aha moment.

Starting with breath is a for sure way to change your perspective from the outside world and transition into your yoga practice. I find most folks breathing habits have them breathing through their shoulders with the muscles around the neck and shoulders lifted and contracted. The easiest and most relatable way to shift the breath from the shoulders to the diaphragm is simply to let your shoulders relax away from your ears and let your shoulder blades relax down your back as you draw them slightly together. This allows the chest/ frontline to open up and draw the breath deeper from the diaphragm also known as our primary breathing muscle a muscle that also needs to be exercised.

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Then some self massage to not only allow you to relax into your practice but also allows a connection to the nooks and crannies of the body that do not get much thought or exploration. For example (have two yoga blocks or two small rolled up towels available to you) starting on your back, shoulder blades underneath you supporting your bodies natural curves. Start by bending your knees and placing a yoga block under your right foot and drawing your left ankle on top of your right knee. Next begin to press on each toe nail bed on the left foot for a few seconds and then gently roll down the toe joint (drawing circulation down into the toes and feet). Continue massaging the arch, heel and top of foot as well as below the ankle on the inside of the left foot. Work your way up the left leg between the ankle and knee, around the knee cap and into the large muscles of the upper left leg not forgetting the entire inner thigh. Interesting thoughts about the inner thigh I find many folks to contract and hold their inner thigh muscles much like the above mentioned neck and shoulder muscles (tight and short) which after long periods of time is exhausting to the muscle and to the body. Finally straighten the left leg, push the block from under the right foot out to the side, point the toes of the left leg to activate the left leg muscle (keeping the hip joint stable) and begin to do leg circles in towards the body. We do not want to hear or feel grinding (bone on bone) if so point toe more and make circles larger or smaller or stop altogether. Let your hips move as well as your right knee – your not glued to the floor. You will then hook that left leg over the right knee and roll onto your right side. Bottom right leg is straight (not locked out at the knee) the yoga block you pushed to the side earlier will now support your slightly bent left leg/knee and grab another yoga block to support your head as you are on your side. Important habit changer here do not bring the left bent knee in to close to your stomach and do not bring your chin to your chest. Why? Because this puts you in a fetal or C posture  and collapses the whole frontline, squishing your organs, inhibits the ability for full diaphragm breathing and does not support the bodies natural curves. From here the body is relaxed and then begin by massaging your behind (gluteal muscles), outside of leg (IT band), hip (iliac crest), up your side into the chest (pecs), arm pit (arm flexors), side of the neck (levator scapulae), the ear lobe and the side of the head. Massage all the way back down the sideline all the while thinking and feeling the body as a continuum not as separate pieces. As a student moves through this massage sequence I can name some of the muscles etc. while the students touches, connects to them and feels less intimated in the possibility of not knowing it all. Meanwhile the longtime practitioners are getting a little deeper with their massage and maybe covering more ground it’s a win win. Then we repeat massage sequence on the right side of the body, finish by laying on our backs with shoulder blades underneath us and prepare for three full body stretches.

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Full body stretch may sound like we are pulling the body apart however, it is the exact opposite. Everything about YogAlign is to empower the body, allow it to feel whole and put together versus in pieces. We begin lying on our backs, shoulder blades underneath us and down towards the floor now see if you can place your hand in the small of your back and feel the space between your body and the floor these are your natural curves or springs/ shock absorbers as we like to call them in YogAlign. Next reach your arms overhead, hip distance apart (shoulders relaxed do not squeeze your head), fingers spread and palms facing each other. Point your toes away from you inhale through the diaphragm (SIP breath if you have learned it) now tighten the entire body like you are laughing so hard you cannot breath. Fist your hands and pull down like you are pulling ropes towards you this will engage your core and them exhale or lion breath with tongue out (ssshale if you learned it) and completely relax the body. (2 more) Why do we do this full body stretch? To reset the tension in the body, make tighter what is already tight in the body and then let it all go – resetting the resting length of the muscles. We can now come up to standing (slowly do not get a head rush), have a drink of water and begin our standing YogAlign practice with hopefully some confidence and better understanding of our body and the practice.

Starting something new with a negative outcome due to not knowing or continuing with something that may hurt or you do not understand is a dis-service we have all made to ourselves at one time or another. Your personal yoga practice or self study is that time to ask questions, know why you are doing what you are doing to better yourself and most of all feel good before, during and after your class. After all looking forward to your yoga class and  feeling better when you walk out of class then before you arrived is the whole point of the practice isn’t it? To this I say YES!

See you on the mat.

What is the importance of breathing? Maybe your quality of life.

By Renee’ Fulkerson

What is the importance of breathing?

Every system of the body relies on oxygen. From cognitive to digestion, effective breathing cannot only provide you with a great sense of mental clarity, it can also help you sleep better, digest food more efficiently, improve your body’s immune response, and reduce stress levels.

Let us sink a bit deeper into what is the importance of breathing and I would like to share with you the moments that provided the evidence that made the above statement true for me.

In the year 2010 I received a phone call from my uncle that my dad had been hospitalized, he was unconscious, and unstable. At the time of admitting my dad the doctors had no idea what was going on with him. Later that same day when I arrived to see him he was still in what they now were calling a coma and a machine was breathing for him.

Flash forward to days which turned into weeks of endless testing and near death moments the diagnosis was my dad had the West Nile Virus. About 1 in 5 people who are infected develop a fever and other symptoms. About 1 in 150 people who are infected develop a severe illness affecting the central nervous system such as encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes that surround the brain and spinal cord) unfortunately my dad ended up being 1 of those 150 people. His symptoms included:

  • high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis and being over 60 years of age put him at a greater risk for complications and death.

After several months of laying in a hospital bed, paralyzed and unable to talk or breath on his own he was stable enough to be moved to a rehabilitation facility. This marked the beginning of what the rest of his quality of life would look like. To the naked eye the scene appeared bleak when a machine was breathing for him.

A reminder – what is the importance of breathing? Every system of the body relies on oxygen. From cognitive to digestion, effective breathing cannot only provide you with a great sense of mental clarity, it can also help you sleep better, digest food more efficiently, improve your body’s immune response, and reduce stress levels and my dad struggled daily with all of this.

Fast forward – after many months of rehabilitation my dad was finally able to breath on his own. It felt like from the first breath he took on his own it jump started his body. With the tube out of his throat and vigorous breath he was eating and digesting food which in turn gave him sustenance and strength. The ability for him to breath on his own relieved a great deal of stress for him and allowed him to get the healing rest/ sleep the body needs for recovery of any sort of trauma. Every time I came to visit him his mental clarity was sharper and his ability to talk, communicate and laugh yes laugh was amazing.

The biggest gift he received after literally getting his breath back was his immune system. When the machine was breathing for him he constantly had pneumonia and was always coughing and fighting for breath it was like he was in a never ending loop of despair. However, once his own breath kicked on the immune system his cough ended and he never again got pneumonia in the rehabilitation facility.

With his own breath flowing freely through his body the next step was getting him out of bed and walking on his own again and over time this too happened. Standing in front of my dad cheering him on when he took his first steps I thought my heart would burst with pride and joy for him. With the sweat on his brow and the racing beat of his heart I knew the ability for him to breathe on his own was his turning point to a quality life. The moment that happened all systems were ago and he had everything he needed on his side to succeed with his OWN breath.

After a year in the rehabilitation facility my dad was ready to go home to a quality of life he could be happy with. He started out in a wheel chair, could not feed himself as his whole right arm was still paralyzed and needed help with bed and bath. Over time with breath and movement he fully walks on his own, has learned to do most everything with his left arm/ hand and gets out as much as he can. Although his left arm does remain paralyzed to this day, he is unable to drive and does get frustrated and down sometimes he is a beautiful alive human being with a heart of gold. Getting his own breath his life force back gave him the ability to beat the odds.

See you on the mat

The quality of your health is a direct reflection of your level of independence.

By Renee’ Fulkerson

in·de·pend·ent
/ˌindəˈpendənt/
adjective – not depending on another for livelihood or subsistence.
“I wanted to remain independent in old age”
synonyms – self-sufficientself-supportingself-sustainable.
My experience with this above mentioned topic has happened within this last year and as always got me looking around at folks moving through their daily lives.
I grew up in Southern California and spent every summer (which then was June, July and August) in Baja California at my grandparents house on the beach until I was well out of high school.
In both geographical locations the weather was mostly sunny and warm which I am a huge fan of and I spent most of my days wearing cut off Levi shorts, tank tops and flip flops. In other words closed toes shoes, socks, pants and jackets were far and few in my everyday life.
I do everything in my flip flops (called slippers here on the Hawaiian islands) probably not the best option for most of my outdoor projects. While thinking back to my 16 years living in a mountain community (including snow) I still spent a great deal of time in my flip flops. I had a large yard/ garden in the mountains as well as here on the island consequently digging, raking, weeding etc. yes in my slippers. I have also done many hikes, walks and dancing in my flip flops as a side not ipanema slippers are my favorite.
Inner Breath Yoga YogAlign Kauai Hawaii (1)
This last June as my family and myself were preparing for our annual summer mainland mountain road trip my flip flop existence took a turn for the worst. As I was outside in the garden digging with a shovel pushing down on the metal piece with the the arch of my foot I felt a stretch and pull of discomfort and my heart dropped as I knew I had injured my foot.
I hobbled into the house and began icing three to four times a day with a frozen bottle of water, lightly massaged the surrounding areas (directly massaging soft tissue injury may make it worse) and slept with my foot wrapped in an Ace bandage.
Once on the mainland I continued feeling the discomfort and the lack of stability in my foot however road tripping and camping left me little time to continue my therapy routine. As the road trip progressed I wore shoes and socks much of the time as well as my slippers I was frustrated to say the least. I was not as agile, comfortable or confident in my daily ventures and had to opt out of hiking back to camp for a boat ride back to camp – Boo Hiss Growl
Upon arriving back on Kauai and to this very day September 09/2019 I continue to feel some pain in my foot. I have continued my normal daily activities at home (although I wear shoes and socks now while gardening). YogAlign, snorkeling and continuing icing and wrapping has kept me comfortably active. In my humble opinion being sedentary after and injury is the wrong way to go – the body wants to heal and circulation is key. I have purchased a new style of flip flops during healing process OOFOS Recovery Footwear.
Inner Breath Yoga YogALign Kauai Hawaii
As I began looking around me one day while I was out running errands in my OOFOs feeling comfortable, confident a mostly pain-free when I noticed how many folks were not stable on their feet. Young and old, small and large, black or white it did not matter their health or lack of was hindering their independence. Canes, wheel chairs having to be pickup or dropped off from the car and needing a partners arm for assistance was what I was seeing. Again these were not just mature folks (which by the way can also stay very independent).
That is when it hit me The quality of your health is a direct reflection of your level of independence or lack thereof. I think most of us would agree it is hard enough to ask for help much less be reliant on somebody to get you around physically. I could not imagine my life without my physical independence.
What have I learned:
Directly – flip flops / slippers have a time and place. lol
Staying physically active is a key component to independence but not only that being in proper posture and alignment while preforming that action keeps you less likely to get an injury. What I mean by that is when I am teaching a YogAlign class and we are doing the YogAlign SIP ups (properly aligned sit ups) with SIP breath (structurally Informed Posture- informs our body of how to be in good posture by aligning from the inside out)  before students begin movement we prepare are body for optimal results and less negative impacts to the body.
Students begin by lying on their backs, knees bent toward the ceiling/ with a yoga block placed between the meaty part of the inner thighs, shoulder blades under them to create and support the natural curves in the spine (no belly button toward the back body flattening out our natural spinal curves aka springs) hand over hand palm facing up supporting the Occipital Bone on the back of the head, drawing elbows up enough to see from their Peripheral vision thus turning on the arms and with a lion’s exhale let out all their breath. Next we look up at the ceiling take in a full diaphragm SIP breath, squeeze the block between out knees, engaging the core an lifting from the core (maintaining an open front line – no chin to chest) and coming down with the S-hale like a snake. If during that practice I see a student pulling from the neck with their hands or rounding the spine by pulling the chin to the chest I request they come out of the posture immediately as they are doing more harm then good to their body. We do not want to rob Peter to pay Paul. Again it is more important to practice a yoga posture correctly to receive the optimum benefits than doing more harm then good.
I wish us all to be proactive in maintaining our personal independence – you don’t know what you have until it is gone.
See you on the mat.

Is your yoga practice sustainable? If we are moving through a yoga practice that is harming or damaging our human body what would be the point?

By Renee’ Fulkerson

SUSTAINABLE | definition in the Cambridge English Dictionary
https://dictionary.cambridge.org › dictionary › english › sustainable
sustainable meaning: 1. able to continue over a period of time: 2. causing little or no damage to the environment and therefore able to continue for a long time.
We could exchange the word environment for human body.  By the above definition the question could be re-worded to – Is your yoga practice causing little to no damage to your human body? Will you be able to continue this yoga practice for along time?
The answer for me is yes at this current time as my yoga practice is The Yoga Align Method – pain-free yoga from your inner core focuses on proper body alignment and real life movement.
I have found whether young or mature of age we all want to feel good and be happy in our mind, body and spirit.
In my teaching and personal experience most of use can connect to the physical body easily we can touch it, see it and feel it. Where as the mind takes time to connect with with in regard to meditation and stillness. The spirit for some is altogether unattainable in the tangible sense and they cannot find the connection. So doing some physical movement seems like a rational place to find some joy and happiness.
For some yoga practice means only physical movement (asana) for others it is only meditation they seek and actually in this day and age yoga can come in many forms. For this blog lets stick with yoga practice in the physical sense.
When you are in your next yoga practice/ class ask your self some important questions:
  • Am I able to take a full deep breath in this posture?
  • Does my spine and sacrum maintain their curves and integrity?
  • Does this posture simulate functional movement, am I comfortable and stable?

We have been exploring in my public YogAlign practice that some folks do not and have not ever felt comfortable and stable in a forward lunge. A lunge is a lower-body exercise that works several muscle groups at once. The targeted muscles include the glutes in your hips and butt along with the hamstrings and quadriceps in your thighs. The calf muscles in your lower legs, your abdominal muscles and your back muscles act as stabilizers during this exercise.

Not feeling stable in the forward lunge restricts deep breath, alignment and there for is not comfortable or stable. The solution is simple we have placed a yoga block under the back foot which has a double duty purpose. One it allows the student to get alignment from the foot to the hip, raises the heel to a comfortable level and creates the stability the student was lacking and once they are in a stable lunge everything else falls into place.

Inner Breath Yoga Yogalign kauai hawaii

I have also had students lunge with the assist of the wall. Placing their right foot forward big toe close to the wall be not touching, left foot back on a block or heel lifted once they feel stable (foot in alignment with hip) I have them check to see if the back of the head the Occipital bone and the sacrum are in alignment creating even more stability and bonus proper alignment. Next when alignment and stability are solid we sink into the front knee and place the pads of our fingers (fingers open to turn on the arm muscles) against the wall upper chest height and start our SIP breath (structurally Informed Posture- informs our body of how to be in good posture by aligning from the inside out). Allowing this core breath to stabilize the body along with drawing the shoulder blades together creating even more stability.

When properly aligned in a posture with effective breathing and feeling stable and comfortable then and only then will we reap all the benefits the posture has to offer. I would say the above described YogAlign Power Lunge is sustainable for the human body as it ticks all our boxes.

If we are moving through a yoga practice that is harming or damaging our human body what would be the point? Although sometimes this may happen and we do not even realize it is happening. Be careful when an instructor cues a posture is supposed to be painful and to breath through the pain. That may be somewhat true for a person who has had a debilitating accident and is in recovery (physical therapy) and even then I would question the motive and benefits.

We can create a happy healthy mind, body and spirit well into a mature age by putting our body in breathable, aligned, functional, comfortable and stable yoga postures.

Now go out and use your sustainable body for good!

See you on the mat.

How does to much time sitting in chairs damages our ocean’s reefs? 

By Renee’ Fulkerson

You might be thinking what does sitting in a chair haft to do with an ocean’s reefs? I would be thinking the same thing if I had not made the connection personally on my last adventure out snorkeling.

A little back story:

Last year in the middle of April 2018 Kauai received 50 inches of rain in 24 hours that devastated the island. The north shore communities of Wainiha and Haena were cut off from the rest of the island due to countless mudslides that covered the only two lane road in or out of these communities. It took over a year to repair the road to a safety standard that would allow all non Wainiha and Haena residents to re-enter the area.

YogAlign Inner Breath Yoga Kauai (18)

During this one year period the only folks allowed in and out of the above mentioned communities while massive road repair was taking place were the full time residents. As a full time resident living in Haena I saw with my own eyes the land transform.

Myself and many of the locals had an opportunity of a lifetime to spend time on the secluded and empty beaches. We began to see the fish returning, turtles nesting that had not been there since folks could remember and the reefs were coming alive again.

DCIM100GOPRO  DCIM100GOPRO

This is when I began my regular snorkeling adventures!

During this time I continued teaching and practicing YogAlign – pain-free yoga from your inner core. I began realizing much of my movements in the water reflected my movements in YogAlign. Not to mention breathing through the snorkel replicated the SIP breath in my practice. Like snorkeling a full body activity we too in YogAlign engage the entire body in practice and view the body as a whole.

The primary muscle groups engaged while snorkeling include:

Hip flexors, ham strings, upper and lower abdominal’s, quads and gluteul muscles

A fair amount of flexibility in the ankle region as well as the ability to point the toes like a dancer is necessary (if you prefer to avoid leg and foot cramps).

A  strong core (abdominal, Oblique and back muscles) help to create a stable platform for legs to kick as well as a balance in your front and back leg strength.

Here is were the sitting in a chair comes in as none of the above mentioned muscle groups are engaged during sitting – it is quite the opposite. (the average American spends 7.7 hours a day sitting)

Having said that you take an average person who sits 7.7 hours a day in a chair and he or she decides one day to go snorkeling chances are the ocean reefs (fragile underwater ecosystem) and themselves are going to suffer.

How because he or she would be expecting their bodies to preform in a way it is incapable of preforming. The primary muscle groups that need to be engaged while snorkeling have amnesia from sitting. Flexibility in the ankles and pointing of the toes  would be limited – due to the shortening and tightening of the front line while sitting. Their core would be void creating an unstable platform for their legs to kick not to mention the unbalance between the back and front leg muscles.

How does all of this effect the oceans reefs?

On my last snorkeling adventure I realized I had gained greater endurance, strength and stamina (all supported by my regular YogAlign practice). However when I looked all around me as far as my eye could see people were STANDING ON THE REEFS! Why? Because they were tired and or had leg/ foot cramps and difficulty breathing (and yes I asked).

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I swam up and said do you realize you are standing on a fragile underwater ecosystem that has had a years gift to repair itself from the endless years of damage it has received? Usually the response was I was so tired I could not get back to shore or I was having trouble breathing and got a leg cramp. lol

I encourage everyone to get out and get moving including snorkeling however, not at the sake of our ocean reefs (fragile underwater ecosystems) or their safety. #getupstandupforyourlife

See you on the mat!

Top 10 benefits of Snorkeling 

Golf injuries: Play it safe with these tips

Golf injuries are common but avoidable. Learn how to protect yourself.

By Mayo Clinic Staff

Although golf is a low-impact sport, it’s associated with a significant number of injuries. Many golfing-related injuries are a result of poor mechanics or overuse. The most commonly injured area is the lower back, followed by the elbow, wrist and hand, and shoulder.

Follow these tips to stay in shape on the course.

Adjust your swing

The entire body is used to execute a golf swing in a complex and coordinated movement. When this movement is repeated frequently, significant stress is placed on the same muscles, tendons and joints. Over time, this can result in injury.

Understanding the mechanics behind your golf swing can help you prevent golf injuries. Try to:

  • Use proper posture. Stand with your feet shoulder-width apart and rotated slightly outward, and with your knees slightly bent. Hold your spine relatively straight; your trunk should be tilted forward, but most of that movement should come from your hips. Avoid hunching over the ball, which may contribute to neck and back strain.
  • Stay smooth. The power of a golf swing comes from force transferred smoothly through all the muscle groups, from your ankles to your wrists. If you depend on one part of your body for your hitting power, you may be more prone to injuries. For example, overemphasizing your wrists during your swing can lead to golfer’s elbow — a strain of the muscles on the inside of the forearm.
  • Don’t overswing. If you swing the club too hard or too fast, you may stress your joints. Relax and take a nice, easy swing at the ball. The best golfers have consistent — not necessarily fast — swing tempos.

If you want to reduce the risk of golf injuries, consider taking lessons. What you learn about your golf swing may even help you shave strokes from your score.

Other tips to keep you on the course

There’s more to golf than your golf swing. Consider other ways to lower your risk of golf injuries:

  • Warm up. Before you practice your swing or play a round of golf, warm up for at least 10 minutes with a brisk walk or a set of jumping jacks. Stretch your hands, wrists, forearms, elbows, shoulders, spine and pelvis. Swing your golf club a few times, gradually increasing your range of motion.
  • Start slowly. You might start out by practicing your swing for hours, believing it’s helping your game. But if your body isn’t conditioned for the strain, repetitively practicing your golf swing may do more harm than good. Work up to your desired level of activity instead.
  • Strengthen your muscles. You don’t need bulging muscles to hit a long drive — but the stronger your muscles, the greater your club speed. Stronger muscles are also less prone to injury. For best results, do strength training exercises year-round.
  • Focus on flexibility. Regular stretching can improve your range of motion and lead to a more fluid golf swing.
  • Build up your endurance. Regular aerobic activity can give you staying power on the course. Try walking, jogging, bicycling or swimming.
  • Lift and carry clubs carefully. Golfers who carry their own bags have higher rates of shoulder and back injuries than do other golfers. If you jerk heavy clubs out of the trunk of your car, you could injure yourself before you reach the first tee. Use proper lifting technique: Keep your back straight and use the strength of your legs to lift.
  • Try to avoid hitting objects other than the ball. Elbow and wrist injuries are often the result of hitting the ground or the rough.
  • Choose proper footwear. Dress for comfort and protection from the elements. Wear golf shoes with short cleats. Long cleats dig into the sod and hold your feet planted as you swing, which may strain your knees or ankles.

Watch out for hazards on the course

Be careful to limit your sun exposure while golfing. Remember to:

  • Use sunscreen.
  • Wear sunglasses to filter out UVA and UVB rays.
  • Wear a hat with a visor to shade your eyes and face.

Watch for signs and symptoms of dehydration, heat exhaustion and heatstroke. Drink plenty of water, whether you feel thirsty or not, and cut your game short if necessary. Red flags for heat-related injury might include:

  • Headache
  • Weakness
  • Dizziness
  • Nausea
  • Muscle cramps
  • Rapid heartbeat
  • Confusion

When riding in a golf cart, keep your feet inside the cart. Golfers have suffered broken ankles when their feet have been caught in the moving parts of golf carts.

Keep an eye out for storms. Call it quits at the first sign of threatening skies or lightning.

Play smart

Whether golf is a new interest or a lifelong passion, make the most of your time on the course by protecting yourself from golf injuries. Consider it all part of the game.

“Hey Doc. I’ve lost my core”. Spinal Stability explained.

Article written by Healthfocus Physiotherapist Dr Mandy Hobbs PhD.

Have you ever been told that you need to work on your “core” by a health professional or fitness instructor? Does your “core” just disappear because you didn’t know it was there in the first place or did you just misplace it one day?

So what does the term core stability mean? Like so many terms related to health, it has various meanings to different health professionals.  Some clients with back pain will roll their eyes when I suggest using an exercise approach to low back pain.” I’ve done it all before and it doesn’t work” they lament.  What can be difficult, is determining what they have been shown as exercise  previously and how this relates to their particular back problem. Whilst no one approach to back pain works for all people, understanding the concepts used to treat low back pain is useful.

The concept of spinal stability has evolved  through the 20th century.  Joseph Pilates devised his “Pilates” system of exercise , that emphasised control of movement, in the first half of last century. The idea  of spinal pain resulting from  poor control of spinal stability, developed in the 1970s. This suggested that repetitive microtrauma damages spinal tissue because the spine looses stability. In the 1990s Manohar Panjabi, a researcher in the US described a system of spinal stability that further enhanced this knowledge .

If the spine is considered an unstable stack of bones that buckles without muscle control, Panjabi’s spinal stability theory relies on 3 subsystems that all work together .

The first known as the  passive system is the bony and soft tissue structures including the ligaments and discs, and joints of the spine that keep the spine together particularly at the extremes of movement.

The muscles that act on the spine, know as the active system, is  the second. Muscles can generate forces that control how the spine moves. This however is only as good as the computer that drives it. Relying on the third system known as the control system, muscles can only work when receiving correct messages from the brain.

Confused? You’re not alone. But essentially, a break down in any one of these three systems can lead to poor spinal control and potential damage and pain. So what can we do to improve this when things go wrong and can exercise help?

One approach is to identify which muscles are not working  well and then retrain them so that they return to doing  their job of controlling the spine. Because in the “normal” healthy  spine  these work on automatic pilot without us thinking about them, learning to turn them on during activity is not necessarily easy. It is not a case of just bracing everything and hoping for the best. Too much force and pain can actually increase, and mobility can be lost.

Thorough assessment by a physiotherapist can identify those muscle that have stopped working , and those that may be overworking because the brain has identified an error in the system and has started to recruit the incorrect  muscles. Technology such as  real time ultrasound can be utilized to accurately  visualise  how the deep muscles are working. This can  assist in prescribing the correct exercise program for each individual.

So for those of you that are lucky enough to not have back pain, breathe a sigh of relief that this wonderful, complex system of motor control continues to work and protect your spine without having to think about it too much.