Lymphedema Therapy

The Core

What is the “core”?

The core includes vast groups of muscles throughout areas in the entire torso. Some muscles included being the abdominals but on top of that we also have the pelvic floor muscles, the deep buttocks muscles, paraspinals, and larger back muscles. There is also some assistance from the lats, traps, and glute max. Therefore, much more than just the abdominals.

The core muscles function to:

-stabilize your spine
-control your center of gravity for maintaining balance
-extend and flex the vertebral column of the spine, lateral flex (side bend) at the spine
-flex at the hip
-stabilize the hip joint for walking and other activities
-provide control for urinary and bowel movements
– contain and protect the organs
-stabilize the top of the body over the bottom half
-controlling movement between the lumbar spine and pelvis (the pelvis can tip forward and backward to assist in motion)

Why would I need strength here?

If you find any of the above functions to be important then you will benefit from having strength and flexibility at your core. In the case that there is a muscle imbalance or weakness you will find difficulties with some activities.
This can include:

-inability to control bowel or urinary leakage
-inability to maintain balance
-inability to perform motion at the trunk such as side-bending without pain or loss of balance
-inability to sit up from laying on your back or side without difficulty
-pain at the back or hips
-poor posture or unable to maintain good posture
-unable or poor ability to balance on one leg

What exercises should I do?

It is important to start at an appropriate level, for example if you lead a largely sedentary lifestyle it is best to start at a beginner level. Of the listed exercises below, I would have you perform glute sets, single leg stance for 20 seconds and tandem stand for 20 seconds, pelvic tilts, clamshells, and possibly bridges if they are tolerable. There are more options and modification available but that would best be led in person by a therapist.

Practice your balance: Single leg balance–Standing at the kitchen sink stand on one foot while holding on with as much assistance you need from your hands (one hand, two hands, 2 fingers, etcetera) Try to maintain balance on one leg for 20-30 seconds and practice each side multiple times. Increase the seconds held as able. Try Tandem stance–stand with one foot directly in front of the other and try to maintain balance with as much assistance from hands as needed, hold 20-30 seconds and then switch to opposite foot in front. For more advanced people, try standing on one leg without holding on and reach your arms side to side at a counter top 10-20 times.

Glute exercises: clamshells—lay on your side and open and close at the knees while keeping the feet together (Do not let your pelvis tip backwards as you open at the knees) perform 3 sets of 10 on each side. Bridges—laying on your back with arms at your sides, bend your knees, squeeze your bottom and lift as high as you comfortably can. Perform 3 sets of 10. Glute sets—in sitting or lying down practice squeezing your bottom and hold the squeeze for 5 seconds, perform 3 sets of 10. Donkey kicks—on your hands and knees, kick one leg up and back while keeping the knee bent, perform 10-20 reps on each side. Squats—practice this with a chair behind you initially, use a mirror to check your form and ensure that your knees do not go past your toes. Bring your bottom back and come down almost like you are planning to sit and then stand back up (Push through your heels as you come upright from low position, make sure you are not arching your back, keep your knees at least shoulder width apart).

Core exercises: Pelvic tilt—lay on your back with your knees bent, imagine you have a tail and you are grabbing ahold and tucking it up between your legs, this will push the small of your back into the mat and tighten your tummy. Transverse abdominis contraction—lay on your back with your knees bent, try to pull your tummy in almost like you are trying to squeeze into a pair of high waisted pants. Hold this for 5 seconds and then relax, perform 3 sets of 10. Make sure you are not holding your breath! Sit-up—laying on your back with your knees bent, cross your arms over your chest and try to bring your elbows to your knees. Reverse sit ups—laying on your back with knees bent, pull your knees up toward your chest and then bring back to beginning position. Bird dogs—on your hands and knees alternate lifting the opposite arm and leg, alternate sides. May sure you keep your back stable (almost like you are trying to balance a cup of water on your back and not let the water spill out).

The above are just some examples of exercises you can try for strengthening the core but there are many more out there and the tolerance and ability of each person will be different. If you think decreased core strength is contributing to issues like the ones listed above, come see us at Preferred Physical Therapy. We can help you strengthen your core within your specific needs and fitness level and get you back to your best abilities! Our Therapists are happy to help and can establish a plan of care to help people from all walks of life.

Content provided by Lauren Cahn, CPTA