Core Strength and Balance
When we think about exercising in the gym, we may not think of performing exercises that challenge or help improve our balance. We need to have good balance to complete everyday activities simply because it increases overall function. Having good muscle strength and being able to keep yourself steady throughout the day makes all the difference in improving functional mobility and quality of life.
Decreased postural control is one of the main causes of falls in older adults. Our posture is generated by musculoskeletal structures which are under the control of the central nervous system. Muscles are the sole source of energy for moving our body parts to proper positions during the control of balance. Having good balance almost always starts with a strong core!
The core has been described as a muscular corset! Our abdominals are in the front and our erector spinae and gluteal muscles are in the back. The diaphragm (main muscle for breathing) is the roof and the pelvic floor and hip girdle muscles are the floor/bottom. Our core muscles stabilize the spine and trunk during movements of the lower and upper extremities such as walking, running, and throwing. This leads to overall better balance and stability whether you are playing a sport or gardening!
Good core strength has been shown to:
Reduce and prevent lower extremity joint injuries
Improve performance, reducing the risk of injury in athletes
Increase physical fitness in healthy individuals
Decrease low back pain
Improve posture
But how does it affect our balance? There are multiple studies that have shown how core strength correlates to balance:
Previous studies revealed that trunk muscle fatigue led to decreased dynamic stability of the trunk and a resulting loss of balance control.
One study looked at badminton athletes who performed core strengthening exercises twice a week for a 6-week period. The core strengthening program included progressive challenges, focusing on strengthening the abdominal, low-back, and pelvic muscle. At the end of the 6 week study athletes demonstrated improvements in dynamic balance and core endurance.
Another study looking at individuals with Ankylosing Spondylitis showed that having good core strength and muscle endurance correlated to greater physical activity levels, less fatigue, and improved balance.
Another study looking at university students carried out a core strengthening program 3 days a week for 8 weeks. The study looked at postural pain, postural sway, and core endurance. Focusing on core strengthening led to a decrease in postural pain, postural sway, and improved core endurance.
Another study looked at chronic stroke patients, focusing on core strengthening with the use of PNF techniques. PNF is a technique used to facilitate the neuromuscular mechanism through application of stretch and resistance through movement patterns. Exercises were performed in 60 min sessions, 5 times per week for 4 weeks. The results indicated that core stabilization combined with pelvic PNF was effective for improving balance and gait of chronic stroke patients.
Another study assessed the actual thickness of core/lower limb muscles (hypertrophy) and found this to be an important determinant of balance in both older and young adults. These findings could provide a strong rationale for strengthening specific muscles (abdominals and quadriceps) to prevent falls and to improve posture/balance in the older population.
So how do you know if you need to strengthen your core?
Seeing a physical therapist that can assess your overall balance and determine areas of deficit is important. In addition, they can design a tailored exercise program for maximal benefits.
Training your core can be done without any specialized equipment or a gym membership!
Exercises that engage your abdominal and back muscles in a coordinated fashion help strengthen your core.
Check out some of the core exercises that were included in the studies above:
Supine bridge with pelvic floor contraction:
Setup
Begin lying on your back with your legs bent and feet resting on the ground.
Movement
Contract your pelvic floor muscles, then tighten your buttocks and lift your hips off the ground to a bridge position.
Tip
Make sure to continue breathing evenly and keep your pelvic floor muscles activated.
Quadruped with alternating upper extremity and lower extremity lift:
Setup
Begin on all fours with your arms under your shoulders and knees under your hips.
Movement
Extend your leg straight back so that it is parallel with the ground and your toes are pointing toward the floor. Hold briefly, then return to the starting position and repeat with the opposite leg.
Tip
Be sure to keep your back straight and maintain a gentle chin tuck during the exercise. Do not let your trunk rotate while moving your leg.
Setup
Begin on all fours with your arms under your shoulders and knees under your hips.
Movement
Raise one arm forward with your thumb pointing toward the ceiling. Hold briefly, then lower it back to the starting position and repeat with your opposite arm.
Tip
Be sure to keep your back straight and maintain a gentle chin tuck during the exercise. Do not let your trunk rotate while moving your arm.
Dead bug:
Setup
Begin lying on your back with your legs bent.
Movement
Lift your legs and arms off the ground, keeping your knees bent. Lower one arm to the ground and lower your opposite leg at the same time. Repeat with your opposite arm and leg, then continue this movement.
Tip
Be sure to keep your abdominals stiff as you lower your arm and leg, and do not let your low back arch off the ground.
Superman:
Setup
Begin lying on your tummy with your arms reaching overhead and legs straight.
Movement
Imagine you are flying through the air as you lift your arms, head, chest, and legs off the ground. Hold this position for as long as possible.
Tip
Be sure to keep your back and tummy muscles strong to help you hold this position.
Side Plank:
Setup
Begin on your side with your feet stacked, resting on your elbow.
Movement
Lift your hips off the floor so your body is in a straight line and your hips and shoulders are facing forward. Hold this position.
Tip
Be sure to keep your head in line with your trunk, do not let your hips drop toward the floor, and do not roll forward or backward during the exercise
Medicine ball Russian twist:
Setup
Begin sitting on the ground with your knees bent, holding a medicine ball. Lean back and lift your heels off the ground.
Movement
Move the ball to one side of your body, rotating your trunk, then bring it to the other side and repeat.
Tip
Make sure to keep your abdominals tight during the exercise and do not let your feet touch the ground.
Takeaway: Strengthening our core is an important factor in having good static and dynamic balance as we move throughout our environments each day. Check out our balance class series for a great workout addressing core strength to improve overall balance! As always if you have any questions, don’t hesitate to reach out to us at info@neurolab360.com
References:
1) Granacher U, Gollhofer A, Hortobágyi T, Kressig RW, Muehlbauer T. The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports Med. 2013 Jul;43(7):627-41. doi: 10.1007/s40279-013-0041-1. PMID: 23568373.
2) Ozmen T, Aydogmus M, Yana M, Simsek A. Effect of core strength training on balance, vertical jump height and throwing velocity in adolescent male handball players. J Sports Med Phys Fitness. 2020 May;60(5):693-699. doi: 10.23736/S0022-4707.20.10382-7. Epub 2020 Mar 11. PMID: 32162502.
3) Sarac DC, Bayram S, Tore NG, Sari F, Guler AA, Tufan A, Oskay D. Association of Core Muscle Endurance Times With Balance, Fatigue, Physical Activity Level, and Kyphosis Angle in Patients With Ankylosing Spondylitis. J Clin Rheumatol. 2020 Nov 24. doi: 10.1097/RHU.0000000000001641. Epub ahead of print. PMID: 33252392.
4) Toprak Çelenay Ş, Özer Kaya D. An 8-week thoracic spine stabilization exercise program improves postural back pain, spine alignment, postural sway, and core endurance in university students:a randomized controlled study. Turk J Med Sci. 2017 Apr 18;47(2):504-513. doi: 10.3906/sag-1511-155. PMID: 28425239.
5) Sharma V, Kaur J. Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke. J Exerc Rehabil. 2017;13(2):200-205. Published 2017 Apr 30. doi:10.12965/jer.1734892.446
6) Liu H, Li J, Du L, Yang M, Yang D, Li J, Gao F, Ma K. Short-term effects of core stability training on the balance and ambulation function of individuals with chronic spinal cord injury: a pilot randomized controlled trial. Minerva Med. 2019 Jun;110(3):216-223. doi: 10.23736/S0026-4806.19.05952-4. Epub 2019 Feb 22. PMID: 30809995.
7) Özkal Ö, Kara M, Topuz S, Kaymak B, Bakı A, Özçakar L. Assessment of core and lower limb muscles for static/dynamic balance in the older people: An ultrasonographic study. Age Ageing. 2019 Nov 1;48(6):881-887. doi: 10.1093/ageing/afz079. PMID: 31268513.