Are core exercises as important as we once thought? Several reviews have recently challenged the idea of improving core stability for the prevention and treatment of low back pain. There is strong evidence suggesting that stabilization exercises are no more effective than other forms of active exercise in the long term. That is not to say that core exercises have no utility, as I prescribe core exercises on a daily basis within the clinic. This article demonstrates a few advanced core exercises that you can perform to take your core muscle function to the next level!

 

First – What is the Core?

As the core is quite complex, there is an absence of a universally accepted definition of core stability. The “Core” is often referred to as the lumbopelvic-hip complex which consists of muscular boundaries that are shown in the image above. Think of the core as the kinetic link transferring forces between the upper and lower extremities, this transfer of force is a component of many daily movements and athletic activities. Most of the exercises in this article consist of an isometric core contraction while moving the extremities. It is important to note that the exercises within this article are high-level exercises not appropriate for everyone. What is essential when starting any type of exercise programming is to know your baseline, and what is most appropriate for YOU specifically! If you want to learn more about this, read our blog on training age!

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An Introduction

Now that you have an understanding of what the core is and what it entails, you now can follow along to visualize demonstrations as well as written explanations of advanced core exercises. What is important to understand is that many of these exercises are much tougher than they may appear! Be honest with yourself if you are going to attempt these exercises. It is totally OK if you have to take breaks, modify the way you are performing an exercise, or perform fewer repetitions/hold times to ensure you are not compensating! If you’re looking for easier core exercises to improve your low back health, check out our Low Back [P]rehab Program!

High Plank With Arm and Leg Raise

Sample Core [P]rehab Program Exercise

• HOW: Begin in a high plank position while maintaining a neutral spine. Try driving your hands and your toes together to keep tension in your core. Then elevate one arm and the opposite leg up parallel to the floor.

 

• FEEL: You will feel the core and shoulders working with this exercise.

 

• COMPENSATION: Avoid allowing the low back to arch or the torso from rotating as you perform this exercise.

 

3 Levels To Bulletproof Your Core!

 

 Dead Bug With Swiss Ball

Sample Core [P]rehab Program Exercise

For this exercise begin by laying on your back for this exercise, knees over hips and hands over shoulders- with a swiss ball in between both. Then bring your hands and knees together by squeezing the swiss ball. Slowly drop one leg and the opposite arm to the floor.

Core stability is highly debated when it comes to low back health. Take a listen to our [P]Rehab Audio Experience where you can hear physical therapists talk all about the low back!

LISTEN: HOW TO IMPROVE LOW BACK PAIN

 

Anti-Rotation

The exercises shown here are 4 great ways in which you can improve your rotational core strength:

1. Anti-Rotational Plate Push-Away
2. Standing Pallof Press
3. Dead Bug Pallof Press
4. TRX Anti-Rotation

Make sure to move in a slow and controlled fashion with all of these exercises. You have an option to hold at the end position for a certain amount of time. Parameters we recommend include beginning with a 30-second hold or 15 repetitions for 3 sets. Maintain an absolutely stable and still pelvis/spine…only your arms should be moving in this exercise. The further you bring your arms out in front of you = the longer moment arm = greater demand.

 

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Dead Bug + Progressions

The Dead Bug is a great exercise to build a strong core, endurance, and functional capacity. The problem is, often times people are compensating by overarching their back and don’t even realize this. Here is a progression of Dead bugs from easiest to hardest. Start at the most regressed version, and slowly progress! Too often individuals don’t control this movement properly and compensate with low back extension, demonstrated with your ribs coming up. The pelvis and low back should stay braced throughout the leg movements. Stay strong proximally as you are moving distally.

Here are a few Dead Bug Progressions:

1. Supine Hooklying Marching Feet Supported
2. Supine Hooklying Marching Feet Supported
3. Supine Single Leg Kickouts
4. Supine Double Leg Kickouts

 

Level Up Your Plank

Here are a couple of ways to regress and progress the traditional planks:

Level 1: Modified Plank – on your knees

Level 2: Plank – keeping your ankle, knee, hips, and shoulders all in alignment

Level 3A: Plank + Arm Raise – try to keep your pelvis level here, AVOID any pelvic rotation

Level 3B: Plank + Leg Raise

Level 4: Bird-Dog Plank

Alternative: Plank + Military Press = An ultimate Core/Shoulder combination exercise.

 

Fun Fact: The world record for a front plank on elbows was set by a Chinese policeman Mao Weidong, who held a plank for 8 hours, 1 minute and 1 second on May 2017!

 

Side Plank Roll To Plank

The side plank is one of Stewart McGill’s Big 3 exercises, along with the modified curl up and the bird dog. The side plank roll to plank to opposite side plank is one of the McGill’s most advanced progressions of the side plank, and MAN IS IT HARD. I can barely do the exercise PROPERLY with a completely neutral spine throughout, and I am fatigued after just 3-4 rolls.

The goal of the roll is the maintain a COMPLETELY STABLE AND NEUTRAL SPINE THROUGHOUT. The rolling motion should occur STRICTLY FROM THE HIPS AND SHOULDERS, and there should be absolutely NO SPINAL TWISTING. Mind you, this is extremely hard to do! In a study by McGill and Karpowicz in 2009, they looked at this exercise performed under the guidance of a normal clinician, and then an expert clinician (my guess it’s McGill himself lol). They wanted to see if muscle activation patterns could be improved by fine-tuning exercise techniques as a result of verbal and manual cueing.

With this particular exercise, they found that clinician correction significantly increased activity in both obliques and the latissimus dorsi (18% to 35% MVIC in lats). Even more importantly, torso twisting was reduced from 11 degrees to 4 degrees with corrected instruction. The main verbal cue they used was to emphasize “locking the ribcage to the pelvis” to eliminate spinal twist. The decrease in a spinal twist is HUGE because oftentimes it is those little MICROMOVEMENTS that make the difference between doing an exercise PAIN-FREE vs HAVING PAIN. This goes to show that a MOVEMENT EXPERT can facilitate not only greater muscle activity, but potentially ELIMINATE pain during exercises.

 

Stir The Pot

Sample Core [P]Rehab Program Exercise

Begin in a plank position on a swiss ball. Once you find your balance then perform circles. Begin with small circles and work your way into moving through larger circles. Ensure to keep your core engaged as well as your glutes and quadricep muscles to ensure you are not allowing your low back to arch down with this exercise, but rather keep your hips elevated the entire time. When you need a break, take a rest, then return to the starting position and repeat.

 

Reverse Salamander

Perform this exercise with your foot supported on the ground for a regressed version of the exercise, this will decrease the demand placed on the core. I progress this exercise by elevating my entire leg to allow myself to ONLY make contact to the floor with my hips!  You should feel the core muscles working here.

 

Closing Thoughts

Remember, there is strong evidence suggesting that stabilization exercises are no more effective than other forms of active exercise in the long term. This means if you are experiencing low back pain, find any way to stay moving as well as build a strong core! This article demonstrated ways to stay active through advanced core exercises, however, there are numerous methods to stay active. The key is to find the routine that motivates you most! In addition, do not be discouraged if you ever have to regress exercises, meaning make them easier to perform. Staying humble and honest with what your body is capable of doing will help you avoid compensation and potential injury.

 

Take Control of Your Core Health

The outcome of a great core program is NOT a 6-pack but it if does happen we are sure you wouldn’t be upset! The core should be thought of as both a dynamic suitcase and an energy transfer center. The goal is to build a rock-solid suitcase for each aspect of the core and to improve its ability to transfer energy to and from the legs and arms.

 

About The Author

Arash Maghsoodi, PT, DPT, CSCS

[P]rehab Co-Founder & Chief Marketing Officer

Arash Maghsoodi received his Doctorate in Physical Therapy from the University of Southern California. For his undergraduate studies, he attended San Diego State University and studied Kinesiology. After sustaining a career-ending ankle sprain while playing collegiate soccer, he realized how disabling and life-altering injuries can be. Arash currently resides in beautiful Santa Monica, California. His clinical experience is primarily in the orthopedic and sports setting. He has treated a wide variety of conditions ranging from the post-operative individual to the professional athlete. Arash is keeping the family legacy of becoming a physical therapist, as his mother is a practicing clinician of 30 years in the Orange County area.

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.