How much do we actually need to "strengthen our core"?

As a therapist, Pilates instructor & previously a fitness instructor the phrase I have heard the most without doubt is "I need to strengthen my core".

This can be for a number of reasons back pain, posture, flat stomachs, toned abdominals etc. 

But the questions is will we achieve the results we want to by simply just strengthening our core?

So let's take back pain for example, as this is probably the biggest reason I see for people wanting to improve their core strength. Often we can believe that back pain is down to weak abdominals or a weakness in the back. I'm not saying that working on our "core" will not help, however I do believe there's a few other factors to take into consideration:

Is an alignment issue causing the back pain?
More often than not when people come to me for biomehcanics coaching or for a massage with back pain, there is usually some sort of pelvis mis-alignment. For example say someone is having the symptoms of what is commonly referred to as "sciatica" and on testing I can see that their pelvis is misaligned in a position which could increase the likelihood of sciatic. Would they really need to "strengthen their core"? By "strengthening the core" in this situation, could we not be further increasing the chances of the "sciatica" symptoms? I have found in this instance it is far more beneficial to correct the pelvis mis-alignment first and then possibly work on some stability exercises after, when the pelvis is functioning better. 

Do we even know how to activate "our core"?
Sometimes we can believe by simply doing some sit up's, plank's or by attending a Pilates class at our local gym our core will strength and our issues will disappear. Again it is not always as simple as this. Let me refer to some of John Gibbons book about Sacroiliac joint stability. Here he talks about the "inner core unit". The inner core unit consist of Pelvic floor, Transverse Abdominals, Diaphragm & Multifidus. Now let's be honest how many of us have considered using any of these during "core" exercises? Do we know how to activate our pelvic floor (No its not stopping halfway when your in the bathroom!) or transverse abdominals or even our diaphragm?

That's why in all my Pilates classes from Beginners to advance levels we learn how breath correctly (to activate the diaphragm) and how to activate pelvic floor & transverse abdominals correctly. I have found results achieved here are lots more effective against just doing "core exercises" which usually ends with compensation which usually leads to pain (usually in the back) somewhere down the line. This quote from John Gibbons makes it easy to understand "failure of the inner unit to work in the presence of outer unit demand often results in muscle imbalance, joint injury, and poor performance". 

Whilst these are just a couple of things to consider, these are the ones I find a most common in my line of work. There would be other things to consider such lack of mobility in other areas (mid back I find a lot of the time), muscle spasms (these would need releasing rather than stretching) and tight nerves. 

If you would like any more information on the above, please feel free to get in touch. 

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Thanks for reading.

Reference
Gibbons, J. 2016. Functional anatomy of the Pelvis and the Sacroiliac joint p48

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