Are you teaching your clients how to correctly contract their core? Kendall Scales, women’s health lead physiotherapist at Ten Health & Fitness, shares why you should and how to do it.
When health and fitness professionals use the word ‘core’, they’re talking about a range of muscle groups.
But (at least in my experience), when I ask my clients what they think their core is, they’ll say “my abs” or “the six-pack muscles”. Though they’re not wrong, it’s the superficial and obvious answer. Ask them about their pelvic floor muscles (PFM) and transversus abdominis (TA) and most will say they’ve heard of them but that’s about it.
When a client comes in wanting to train in any capacity, but particularly wanting to strengthen the core, it’s paramount that they know what these muscles are and how to correctly contract and relax them. This is because the PFM and the TA provide lumbo-pelvic stability meaning that, if it’s weak and overloaded or loaded incorrectly with exercise, injuries can occur.
The PFM and TA work together to support the abdominal viscera (keep your organs in place), as well as supporting the spine. They provide resistance to increases in intra-abdominal pressure (jumping, coughing, lifting). They promote continence, while also allowing for voiding, defecation, sexual activity and childbirth.
Well, they do when they’re working correctly. But a weak PFM/TA complex and increased loading – think repetitive heavy lifting (weights) or HIIT exercises with excessive jumping, for example – may lead to spinal injuries, hernias and urine leakage during a workout.
Although correct contraction is important in everybody, for women it’s of prime importance. A weak PFM and TA puts women at increased risk of issues like incontinence and pelvic organ prolapse. And, despite the accepted wisdom, that’s not exclusive to women of a ‘certain age’. These issues can be a barrier for any woman to exercise with a trainer or in a gym, due to the risk of leakage.
A quick PFM/TA assessment is maybe not something you want to spend your first session with a new client doing.
However, educating your new client as to why you want to look at this before doing anything like the weights or HIIT exercises they were probably expecting, will show them that you’re thinking of their best interest in avoiding injury during their sessions and, therefore, keeping them on track to meet their goals.
And that in turn will tell them (a) that you know your stuff, (b) that you’re a cut above the average PT and (c) that they’ve spent their money wisely.
Especially after you’ve explained that, if they can learn to isolate and engage these muscles correctly, they will find they are more efficient in their workouts, as secondary muscles like the superior abdominals and gluteals aren’t wasting energy co-contracting to help the core. Basically, by strengthening the PFM and TA, your peripheral muscles then have a solid base to work from. (Hint: Pilates instructors don’t call your core a ‘powerhouse’ for nothing.)
So, how do you contract the PFM/TA? In a crook-lying position (lying on the back, knees bent and feet on the floor) with their hands wrapped around the hips for feedback (index and middle finger sitting just on the inside of the pelvic bone). Encourage the client to gently close their back passage like they’re trying to stop wind escaping. From there, the contraction will feel different in men and women. For women, it should then feel like the contraction is moving forward and up in the pelvis like an escalator towards their pubic bone. For men, it will feel like they are drawing their genitals back up into their pelvis. With these gentle contractions, a drawing in of the TA and therefore a swelling under the fingertips is automatically felt. When they finish the contraction, the swelling under the fingers should subside.
Encourage your clients to practise this at home; this will help to strengthen these muscles. Long (10-second) holds, breathing normally, 10 times with 10 one-second holds will help to strengthen both the fast- and slow-twitch fibres. For anyone lifting weights, or particularly for any clients who have incontinence or prolapse issues, teaching them ‘the knack’ to avoid leakage and injury will be revolutionary for them. ‘The knack’ is a contraction of the PFM/TA right before they do the activity.
Helping them to understand the cues of what to look for in a correct and incorrect contraction will allow them to self-monitor during exercise. From there, you can then use the plethora of exercise you know and love to further build on your clients’ core strength, knowing their foundations and their confidence in you as a trainer are solid.
What to look for in a pelvic floor and transversus abdominis contraction
– Drawing in of the lower abdominals
– Neutral spine maintained
– Relaxed upper abdominals
– Normal breathing
– Surrounding muscles (glutes, inner thigh) remain relaxed
– Contraction is gentle
– Lower abdominal doming
– Excessive spine and pelvic movement
– Bearing down of the upper abdominals
– Breath holding
– Co-contraction of the glutes (buttock squeeze) or inner thigh (legs drop in)
– Contraction is excessive
Lead Physiotherapist, Ten Health & Fitness.
Graduating from the University of Notre Dame in Australia, Kendall spent several years working in private clinics across Perth and with some the city’s top sports clubs before moving to London.
Kendall takes a hands-on approach to treatment, using a combination of manual therapy, dry needling, Pilates and exercise rehabilitation. Her interests have continued to develop, particularly around Women’s Health, where she focusses on the safe introduction or continuation of exercise along with advice and treatment throughout and after pregnancy, and into perimenopause and the menopause years. She is trained to examine, assess and treat many of pelvic floor and bladder issues that affect women of all ages and from all walks of life.
Want to learn more from Ten Health & Fitness? Check out their Dynamic Bodyweight Pilates online course.