Core Stability | Maintain Weight Balance

Core stability is important for our bodies to maintain balance in relation to our weight (load) around the spine, the pelvis and the kinetic chain. The spine and abdominal viscera are surrounded by a cluster of muscles known as the core muscles. They all work together to ensure that the trunk of the body is stable. Core stability and motor control are crucial to athletes for movement as well as to prevent injury.

Strengthening the Core

Physiotherapists can help you with a program and techniques to strengthen your core muscles and also prevent and treat injury. You have to start with moderate activities in order to warm up at the beginning of your program. An example is Cat and camel. Then you should learn to stimulate the abdominal wall muscles. This is challenging if you are in pain. You can use the brace; or the “big three”, i.e. the Bird Dog, the side plank and the Curl up. You should lie supinely (on your back) or be on all fours when you do these exercises. Remember to always focus on the curve on your lower back, which is the position of strength and low burden on your spine. As you get stronger you can move on to different positions like sitting and standing. You can also modify the activities with the aim to increase the simultaneous work of your muscles. You should ensure that the spine is not loaded, while you maximise on the activities of your muscles. You can continue to move on to more activities and postures that will have more effect, especially for sporting purposes. The aim is to improve strength, power and, more so, endurance.

Here are the Things to Avoid:

You should at all times try to avoid overloading the spine as this increases the risk of injury. A few “traditional” exercises are guilty of this maximising of load on the spine:

  • Heavy resistance exercises of the back extensors
  • Old style sit-ups
  • Roman chair exercises
  • Full flexion rotational exercises
  • Exercising as soon as you wake up

Who benefits most from core strengthening exercises? Research has shown that some groups benefit more from core exercises than others, and also that some factors have a bearing on the effectiveness of exercises. Consider the following factors:

  • Younger age (40 years and younger)
  • Positive active straight leg raise tests
  • Greater elasticity (hamstring length greater than 90)
  • Positive pain provocation tests
  • Positive prone (horizontal) stability test
  • Presence of abnormal movement (catching)
  • Positive posterior pelvic pain tests
  • Positive Trendelenburg test

What are the benefits of core strengthening exercise?

People with chronic lower back pain and sacroiliac joint pain can benefit from core strengthening, as they show signs of weakness as well as poor muscle recruitment. Individuals with lower back pain also show signs of lethargy, decreased cross section and intrusion of fat in their paraspinal muscles. Athletes, and more so female athletes, can also have core weakness. If core weakness is present, athletes can risk getting anterior cruciate ligament injury. Core exercises can help to lessen the risks.

In Conclusion

Core strengthening exercises are helpful to treat and prevent spinal disorders, but some studies have found that there may be other superior regimes that can be as effective, or can be used at the same time. Other therapeutic exercise regimes can be as effective as core strengthening exercises in restoring muscles that have degenerated through pain or injury.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

Buy now 3D Gait
Payment Success
Request TelehealthRequest Telehealth Request in office visit Book now