Latest / The Driven Athlete / Abs vs. Back: The Epic Battle Inside Your Spine | Ep 91

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Abs vs. Back: The Epic Battle Inside Your Spine | Ep 91 · The Driven Athlete

• 0:00
  Speaker 1: If you're a driven, active person who wants to reach and pursue a higher quality life with some ambition, then guess what this podcast is for you.
• 0:07
  Speaker 1: This is the Driven Athlete Podcast.
• 0:10
  Speaker 1: What's up, y'all?
• 0:13
  Speaker 1: Welcome back to the Driven Athlete Podcast.
• 0:14
  Speaker 1: It's your man, dr Kyle.
• 0:16
  Speaker 1: We're going to talk about core and the core stability, what the core is and how it contributes to lumbopelvic hip stability and trunk stability and rib and thoracic spine stability too.
• 0:31
  Speaker 1: So the best way I like to describe the core would be like imagine like a cup like this this is a little Yeti.
• 0:38
  Speaker 1: The core circumference around the perimeter would be like your abdominal muscles and your obliques and the front and lateral side, the back muscles.
• 0:50
  Speaker 1: In the back, the erector group would be contributing.
• 0:53
  Speaker 1: In the back, the roof of your core would be your diaphragm and then the floor of your diaphragm would be your pelvic floor.
• 1:00
  Speaker 1: All right, so imagine like a Coke can the front and lateral sides of your obliques and your abdominals.
• 1:05
  Speaker 1: The back is the erector groups, the top is the diaphragm and the bottom is the pelvic floor.
• 1:10
  Speaker 1: So all those are players with.
• 1:13
  Speaker 1: When we say like core stability, very often the low back muscles, the erector group, are already really strong and guarded and tense and sensitive and like hypervigilant and guarded and tense and sensitive and like hypervigilant.
• 1:27
  Speaker 1: So we got to get.
• 1:28
  Speaker 1: There's a muscle disparity of recruitment between the rector group muscles and then some of the other muscles which would be like your abdominals.
• 1:32
  Speaker 1: And a key thing that we like to ask people would be like have you ever, when people have spasms and we're involved with their back, where is the spasm located?
• 1:46
  Speaker 1: The spastic muscles are the ones that are overly active and overly protective because they're over-recruited and they're doing too much.
• 1:53
  Speaker 1: They're hanging on for dear life and they're doing too much is required of them to stabilize.
• 1:58
  Speaker 1: They're being recruited overly and too heavily where their companions aren't being recruited well enough.
• 2:06
  Speaker 1: So where the spasm happened, that tells you what the muscles are being overused are.
• 2:10
  Speaker 1: The ones that are being overused is the low back muscles.
• 2:13
  Speaker 1: It's the erector groups.
• 2:15
  Speaker 1: Right, there's several in there the iliocostalis longissimus multifidus spinalis those are some super common ones.
• 2:22
  Speaker 1: The quadratus lumborum, another one.
• 2:24
  Speaker 1: So those are the ones that are usually very they're hanging on for dear life, they're over-recruited and they're too.
• 2:31
  Speaker 1: They're just very recruitable and very active.
• 2:33
  Speaker 1: We've got to get those things to settle down.
• 2:35
  Speaker 1: Those are the spastic muscles, the ones that are just doing too much and too much are required of them.
• 2:40
  Speaker 1: Have you ever heard of an ab spasm?
• 2:42
  Speaker 1: Usually not.
• 2:43
  Speaker 1: Have you heard of like a hamstring strain?
• 2:47
  Speaker 1: For sure it's because hamstring dominance is super common, hamstring dominant.
• 2:52
  Speaker 1: You never heard like a glute strain right, like, oh there goes my glute again.
• 2:56
  Speaker 1: It's overly recruited, it's usually not the problem.
• 3:05
  Speaker 1: Hip flexor strain for sure, those are actually really common.
• 3:07
  Speaker 1: So running mechanics can be flawed.
• 3:08
  Speaker 1: But then also, like the psoas or the rectus femoris, those are the main hip flexors.
• 3:10
  Speaker 1: Those are going to be overly recruited and too much required upon them to make the action happen.
• 3:16
  Speaker 1: So when it comes to core stability, usually the abdominals and the obliques and the transverse abdominis, those are less recruited and the diaphragm also less recruited and that allows that then continues to feed back loop, the low back erector group muscles to always be super dominant and strong and first thing, recruited.
• 3:40
  Speaker 1: The other question we usually have would be like to prove this point if somebody does a plank and it's hurting, what usually hurts when they do a plank, like, oh there it is, I feel it in pain?
• 3:52
  Speaker 1: Their low back.
• 3:54
  Speaker 1: It's because their low back muscles are the first things to kick in and those are the ones that are the first ones to cause pain and spasm.
• 4:00
  Speaker 1: It's because they're the first ones to recruit.
• 4:02
  Speaker 1: So if we're doing something that's aggressive and hard from an exercise standpoint, the first muscles to kick in are the dominant ones.
• 4:11
  Speaker 1: We have to change that recruitment pattern and get the core, the abdominals, the obliques and the transverse abdominis, the rectus abdominis, to be more involved and contributory and maybe even be more dominant than the low back, because right now the back is strong enough.
• 4:26
  Speaker 1: Definitely don't need to do any hinging right now.
• 4:29
  Speaker 1: Prone hyperextensions, prone leg lifts Like bro.
• 4:33
  Speaker 1: We don't need to do that right now.
• 4:34
  Speaker 1: They're strong, your back is strong enough.
• 4:35
  Speaker 1: It's doing too much.
• 4:36
  Speaker 1: We need to settle that thing down, all right.
• 4:39
  Speaker 1: So from court, from just a anatomy standpoint or like a visual, the core would be like a Coke can, all right.
• 4:45
  Speaker 1: But anyway, the diaphragm is a huge key player with this too and it plays a role with the core.
• 4:53
  Speaker 1: And there's a huge, strong correlation in the research between a lack of diaphragmatic breathing and diaphragmatic activation, recruitment and low back pain and trunk pain.
• 5:03
  Speaker 1: So it's super common Right and rib dysfunction, all right.
• 5:07
  Speaker 1: That also plays with trunk, a lack of trunk stability, trunk strength, core strength is really what it is.
• 5:17
  Speaker 1: So can we leverage all groups of the core simultaneously equally?
• 5:19
  Speaker 1: Because right now, when somebody comes in to see us and they have back pain and their back is super tight, that's not equal.
• 5:23
  Speaker 1: Right now, the muscle and balance of recruitment is not as equal as it could be.
• 5:28
  Speaker 1: They're just way over-recruited.
• 5:30
  Speaker 1: We need to get the abdominals to kick in more.
• 5:31
  Speaker 1: So that's what we're going to be working on in some of the corrective exercises.
• 5:35
  Speaker 1: All right, so here's the recipe for core stability.
• 5:40
  Speaker 1: All right, there's a difference between core stability and core strength.
• 5:45
  Speaker 1: Core strength would be like how many sit-ups can you do?
• 5:50
  Speaker 1: How many V-ups, how many leg raises?
• 5:52
  Speaker 1: All right, that's core strength.
• 5:53
  Speaker 1: Core stability is how well can you resist against forces outside of your body?
• 5:57
  Speaker 1: How well can your spine and your trunk resist outside forces to keep things in place?
• 6:03
  Speaker 1: Keep things stable.
• 6:04
  Speaker 1: Resist outside forces to keep things in place.
• 6:06
  Speaker 1: Keep things stable.
• 6:06
  Speaker 1: What I mean in place?
• 6:07
  Speaker 1: What I mean is like um, keep your trunk in a posture that it's maintaining.
• 6:09
  Speaker 1: Can it maintain a posture during athletic movements?
• 6:12
  Speaker 1: Um, cause, you have limbs extending off of your trunk and your trunk has to stabilize against those outside forces tugging in different directions.
• 6:22
  Speaker 1: That would be resisting against outside forces.
• 6:25
  Speaker 1: That would be core stability.
• 6:26
  Speaker 1: All right, that's core stability.
• 6:30
  Speaker 1: So here's the steps we do for helping improve core stability.
• 6:33
  Speaker 1: The first step is just awareness, as in like what do you feel when you're doing this exercise?
• 6:36
  Speaker 1: Can you do a plank or a bird dog or a TRX plank or something like that, or a pushup position hold and not have your back hurt?
• 6:46
  Speaker 1: And people come in?
• 6:48
  Speaker 1: That's the point.
• 6:49
  Speaker 1: Of course it hurts, right?
• 6:50
  Speaker 1: That's what they're seeing us, right.
• 6:51
  Speaker 1: Like, as soon as I get in that plank position, it just guards.
• 6:54
  Speaker 1: I feel my back.
• 6:55
  Speaker 1: That's just represents that's the first thing that kicks in.
• 6:58
  Speaker 1: The low back muscles are the first ones to contribute and kick in and hold what needs to be held.
• 7:03
  Speaker 1: We need to reverse that, all right.
• 7:05
  Speaker 1: So we work on awareness, which is how well can you recruit the other muscles, which would be your, like your abdominals, during this plank or during a bird dog or something like that?
• 7:17
  Speaker 1: How well can those muscles be focused on and a little bit of mental effort placed on keeping those guys to be active and override the low back muscles?
• 7:29
  Speaker 1: Because right now the low back muscles are kicking in too much, you feel them too much.
• 7:31
  Speaker 1: So the question would be like where do you feel this?
• 7:34
  Speaker 1: Do you feel this in your back, like your back's kicking in, or do you feel this in your abdominals?
• 7:38
  Speaker 1: So super common people are like, well, I feel mostly my back, but I feel some of my abs.
• 7:43
  Speaker 1: I'm like, all right, what percent?
• 7:44
  Speaker 1: What percent of this plank hold right now?
• 7:46
  Speaker 1: Or this bird dog position, do you feel like your back is kicking in versus your abdominals?
• 7:52
  Speaker 1: Oh, my back is like 80% kicking in and my abdominals is like 20% kicking in, so it's like 80-20.
• 7:59
  Speaker 1: My low back muscles are active and I can feel them.
• 8:03
  Speaker 1: They're tight and it's kind of hurting, whereas my stomach is like 20%.
• 8:11
  Speaker 1: All right, that's a disparity in recruitment.
• 8:12
  Speaker 1: All right, at minimum we want it 50%.
• 8:13
  Speaker 1: So by the end of the session, my goal is let's reverse that and make it 20% in your low back and 80% in your abdominals, with this plank hold position as an example.
• 8:21
  Speaker 1: All right, it's easy to visualize.
• 8:23
  Speaker 1: Even better, what if we made it like 90 -10?
• 8:26
  Speaker 1: 90% abdominals, 10% low back muscles, so like feeling both right.
• 8:32
  Speaker 1: So putting them in a better position and a better posture sets it up for success.
• 8:37
  Speaker 1: And then they have to concentrate.
• 8:38
  Speaker 1: Because I asked them this if awareness is the goal for step one, like, where do you feel this?
• 8:43
  Speaker 1: Can you reverse what things are being recruited and overly recruited and under recruited?
• 8:47
  Speaker 1: Can you focus?
• 8:48
  Speaker 1: What controls your muscles?
• 8:51
  Speaker 1: The question I ask is what controls your muscle activation?
• 8:54
  Speaker 1: The nerves do.
• 8:55
  Speaker 1: What controls your nerves?
• 8:56
  Speaker 1: Your brain?
• 8:57
  Speaker 1: You control, voluntarily at will.
• 9:01
  Speaker 1: You can and you can work on this.
• 9:03
  Speaker 1: You can control and focus on what muscles to use.
• 9:06
  Speaker 1: All right, so you just have to concentrate.
• 9:07
  Speaker 1: It can be done.
• 9:08
  Speaker 1: I promise I've done this hundreds of times day one with people where it's like I can't even be done.
• 9:12
  Speaker 1: I promise I've done this hundreds of times day one with people where it's like I can't even feel my abs with this, I just feel my back and by the end of the session they're like, oh, I'm 80% abs and I'm 20% back and actually right now I'm 90-10.
• 9:20
  Speaker 1: The goal is 99-1,.
• 9:22
  Speaker 1: Right, because the back is strong enough.
• 9:27
  Speaker 1: Now we need to get the core to be purposely more active right now and then that will normalize the disparity of muscle recruitment.
• 9:35
  Speaker 1: So where do you feel this?
• 9:37
  Speaker 1: What controls your muscles?
• 9:38
  Speaker 1: Your brain does you can focus on what muscles to concentrate and recruit.
• 9:43
  Speaker 1: You just got to concentrate and think about it.
• 9:45
  Speaker 1: The posture sets it up for success.
• 9:46
  Speaker 1: The positioning, which we get super detailed on that and nitpicky.
• 9:50
  Speaker 1: And then we focus on recruiting the right things tactile cues I'll poke the right thing, I'll turn everything up, we'll have conversations, we'll change it up, I'll change my vocabulary that clicks with them.
• 10:01
  Speaker 1: That's a key one.
• 10:02
  Speaker 1: And by the end of that step one, they're like yeah, my back doesn't really hurt right now, I only feel my abdominals.
• 10:07
  Speaker 1: That was a huge change and it took 10 minutes.
• 10:10
  Speaker 1: Man, that's amazing.
• 10:11
  Speaker 1: Imagine, feel in my abdominals.
• 10:12
  Speaker 1: That was a huge change and it took 10 minutes.
• 10:13
  Speaker 1: Man, that's amazing.
• 10:14
  Speaker 1: Imagine what the next 45 minutes will look like.
• 10:15
  Speaker 1: Or the next eight sessions that we work together doing this.
• 10:17
  Speaker 1: What's that going to look like seven sessions from now?
• 10:19
  Speaker 1: Probably a lot better, right?
• 10:21
  Speaker 1: And if nothing changes, if we don't work on this, what does that look like?
• 10:24
  Speaker 1: If nothing changes, nothing changes.
• 10:25
  Speaker 1: So if you don't work on that, what does the next five years look like?
• 10:29
  Speaker 1: Because your back's been hurting for eight months now.
• 10:31
  Speaker 1: It's been two years at this point.
• 10:32
  Speaker 1: What's it look like five years from now if we don't fix it?
• 10:35
  Speaker 1: Probably not good, right?
• 10:36
  Speaker 1: So very encouraging, amazing, right now, after this little session that we're talking about, their back feels a lot better and they're able to recruit their abdominals more than their low back, where 15 minutes ago ago was the opposite Cool.
• 10:52
  Speaker 1: So step one is awareness.
• 10:53
  Speaker 1: Step two can you translate that recruitment, awareness and mental effort with functional stuff like a plank or lunges, running power, cleans, squats, jumping agility ladder Like?
• 11:13
  Speaker 1: Can this type of core awareness and stability and bracing?
• 11:17
  Speaker 1: Can you apply that while doing functional movements and exercise and athletic things that might not be thought of as like core activator exercises, like lunges?
• 11:27
  Speaker 1: What about overhead shoulder press?
• 11:29
  Speaker 1: Can your core be engaged while doing overhead shoulder press?
• 11:32
  Speaker 1: Because it's never been involved before?
• 11:34
  Speaker 1: That's why you have back pain and what's going on right now.
• 11:36
  Speaker 1: That's step two.
• 11:38
  Speaker 1: It's translating that to functional activity and then trickling that into sports, and the question I would ask at that point would be like for pro athletes that don't have back pain tennis players, golfers, football players, nba basketball players, whatever Do you think they have weak cores?
• 11:56
  Speaker 1: Probably not because they do so much activity.
• 11:59
  Speaker 1: If they were lacking core stability, they probably would have some kind of back pain, and then when they do get a bout of back pain, they get in the lab and they fix it with guys like us and girls like us.
• 12:10
  Speaker 1: So the question would be like but during their sport, do you think they're thinking about?
• 12:16
  Speaker 1: Like, while they're driving the lane in basketball or running through a football play or hitting a tennis shot, are they like, oh, but hey, I'm trying to figure out where it's shot to hit and I need to.
• 12:28
  Speaker 1: I need to hit this ball on this particular direction as a tennis player, but don't forget, use your core.
• 12:32
  Speaker 1: So they can't think about that.
• 12:34
  Speaker 1: Then you focus on, like, hitting the ball.
• 12:36
  Speaker 1: So they, how do they normalize that recruitment?
• 12:39
  Speaker 1: They do it all the pre-work, it's all the pre-work and all the workout stuff they do prior.
• 12:43
  Speaker 1: They do a lot of activation exercises and concentration stuff.
• 12:46
  Speaker 1: They apply that with their strength training and agility training and so by the time they get to the sport and the game, they don't have to think about it.
• 12:55
  Speaker 1: It's just a normal recruitment pattern at this point where, for this patient that came to see us, their normal recruitment pattern a couple of weeks ago was their low back just dominating and kicking in all the time.
• 13:05
  Speaker 1: Their low back is super guarded and stiff, right and spastic and hanging on for dear life.
• 13:09
  Speaker 1: That was their previous recruitment pattern, but you can train it to be the opposite, where the abdominals is the main key player now with producing force and producing rotational force and producing effort, ultimately to stabilize your spine.
• 13:24
  Speaker 1: That's the rationale, all right, and prevent shearing in your low back and your lumbar vertebrae.
• 13:30
  Speaker 1: The third thing, third step, with core stability is leveraging your diaphragm is involving diaphragmatic breathing with core stability at the same time.
• 13:40
  Speaker 1: All right, that's the trifecta to be a core stability ninja and have a solid core and ultimately stabilize your vertebrae and your spine with hard exercise and activities like lunges, split squats, split squat jumps, box jumps, running, agility, football, lacrosse, tennis, golf all that stuff producing the force to hit a golf ball.
• 14:03
  Speaker 1: Right, like, where's that force coming from?
• 14:05
  Speaker 1: Well, there's a lot of studies on that.
• 14:08
  Speaker 1: Very often, with people with pain, they're not involving their core enough and they're not involving their glutes enough.
• 14:13
  Speaker 1: Those two things combined is what stabilizes the lumbopelvic region in the spine.
• 14:18
  Speaker 1: Where a lack thereof, they're going to recruit something else, which is usually their low back muscles, their psoas or if they're quad dominant with exercise and squats and stuff like that, and their glutes aren't being helped enough.
• 14:30
  Speaker 1: That's a classic.
• 14:32
  Speaker 1: So leveraging the diaphragm is the final trifecta step, that after multiple sessions, we'll start involving that too.
• 14:39
  Speaker 1: And they're feeling better at this point.
• 14:40
  Speaker 1: They're feeling more stable, their back doesn't hurt, they're able to kick in their core and find quote, find their core with this exercise pretty quickly.
• 14:49
  Speaker 1: It's like perfect, now let's involve the diaphragm.
• 14:51
  Speaker 1: All right, so diaphragmatic breathing the diaphragm is a breathing muscle and it's located under your rib cage, just below your sternum, and it's a muscle and that muscle can be worked and focused on and strengthened and more normalized and ready to be recruitable with functional activity.
• 15:07
  Speaker 1: So the thought would be like imagine if your core is a Coke can, that's even better.
• 15:12
  Speaker 1: Let's say a cinder block okay, an open cinder block, and imagine the inner walls of that cinder block would be like your core.
• 15:20
  Speaker 1: The front and lateral sides would be your abdominals.
• 15:22
  Speaker 1: Imagine blowing up a balloon inside that cinder block would be like your core.
• 15:26
  Speaker 1: The front and lateral sides would be your abdominals.
• 15:28
  Speaker 1: Imagine blowing up a balloon inside the cinder block.
• 15:29
  Speaker 1: It has nowhere to go and it's going to compress the outer walls of the balloon into the inner walls of the cinder block and it's going to compress and create a lot of pressure and tension in there.
• 15:35
  Speaker 1: Perfect, that's creating more intra-abdominal pressure.
• 15:39
  Speaker 1: While not holding a breath, we're breathing with our diaphragm and that creates more spinal stability and prevents a lot of shearing from happening, which is ultimately what causes back pain and accelerates degenerative changes that you would see like arthritic changes and bone spurs and herniated discs and ligament and plavam inflammation and facet arthropathy all that stuff.
• 15:57
  Speaker 1: It usually comes from micro shearing of the lumbar spine, from hypermobilities, which that hypermobility podcast we did a little while ago was about that.
• 16:08
  Speaker 1: So core stability prevents extraneous, excessive micro-shearing movements of the vertebrae in your spine and your pelvis and your sacrum and your facet joints of your spine.
• 16:20
  Speaker 1: That would cause pain and joint irritation.
• 16:23
  Speaker 1: That then causes the muscles that connect to those joints to hang on for dear life and be overly recruitable to protect and stabilize too much.
• 16:32
  Speaker 1: And then it also involves the nerves, the nerves that pass through that area and that can cause preferred pain.
• 16:36
  Speaker 1: So that's a breakdown of core stability and the core and what it is, where it's located, what it involved, what's the three-step process to be a core stability, trifecta, ninja, and then some of the insights on how we do that and the Coke can analogy.
• 16:54
  Speaker 1: So all that combined that's a breakdown on core stability and the core.
• 16:58
  Speaker 1: So this is a really common thing.
• 17:01
  Speaker 1: We work on this all the time with patients.
• 17:02
  Speaker 1: So if you have any issues or you know anybody that has issues, please don't hesitate to reach out and have them reach out to us.
• 17:07
  Speaker 1: We can at least talk on the phone, because we've done this a bunch of times.
• 17:09
  Speaker 1: All those five-star reviews on Google we have, like those high five moments, come from after a plan of care, people see improvements and the proof, ultimately, is in the pudding.
• 17:16
  Speaker 1: And that's what we want to provide for people and get it quickly right, get some clear answers and get them on a good trajectory and pathway.
• 17:24
  Speaker 1: Because if it hurts right now, what does five years from now look like?
• 17:27
  Speaker 1: If you're 38 right now, what does 48 look like 10 years from now?
• 17:31
  Speaker 1: Right, probably not good.
• 17:33
  Speaker 1: We got to change something and we got to fix it right and that's what this recipe.
• 17:37
  Speaker 1: We have to involve this.
• 17:38
  Speaker 1: Otherwise, not doing this usually leads to meandering around, lingering pain.
• 17:44
  Speaker 1: It's not getting better.
• 17:45
  Speaker 1: I'm waiting for another image, I'm waiting for another test.
• 17:47
  Speaker 1: I'm going to get more pain meds, more injections, another surgery.
• 17:51
  Speaker 1: I don't hate surgery and injections and meds when it's necessary, but it's not always necessary we can prevent that.
• 17:57
  Speaker 1: I mean, it's a big reason why people call us.
• 18:01
  Speaker 1: But anyway, we'd love to help you.
• 18:02
  Speaker 1: So please don't hesitate to give us a call 561-899-8725.
• 18:08
  Speaker 1: We're located in downtown West Palm, right off Palm Beach Lakes Boulevard, next to the Tanger Outlet Mall, just east of 95.
• 18:13
  Speaker 1: So we're central located.
• 18:15
  Speaker 1: But please don't hesitate to reach out.
• 18:16
  Speaker 1: We'd love to help you.
• 18:17
  Speaker 1: We can at least send you in that direction.
• 18:18
  Speaker 1: If not with us, we'll send you somewhere else.
• 18:20
  Speaker 1: Totally understandable.
• 18:21
  Speaker 1: At least give some insights on what to do next.
• 18:22
  Speaker 1: So we'd love to hear from you and if you have any comments, questions, concerns or conflicting opinions or ideas for a different podcast, please let us know and we'll catch you on next time.