The Core- Beyond The Spine


The Core consists of structures that make up Lumbo-Pelvic-Hip Complex (LPHC). It includes the lumbar spine, pelvic girdle, abdomen, diaphragm and hips. It is where body’s center of gravity is located and where all movement originates.

A strong and efficient core is necessary for maintaining proper muscle balance throughout the entire Human Movement System (Kinetic Chain).

Optimal length-tension relationships in muscles, joint kinematics and recruitment patterns of the core muscles, enable the Kinetic Chain to function with optimal neuromuscular efficiency. This is a prerequisite for efficient movement acceleration, deceleration, and stabilization in all planes of motion and is essential for prevention of injuries.

The core can be subdivided into three distinct but interrelated systems:

  1. Local
  2. Global
  3. Movement

Local Stabilization System

Local stabilizers are muscles that attach directly to vertebrae. They consist primarily of slow twitch type I fibers and function to limit excessive compressive, shear, and rotational forces between spinal segments.

The primary muscles that make up local stabilization system include transverse abdominis, internal obliques, multifidus, pelvic floor musculature, and diaphragm.

Global Stabilization System

Muscles of global stabilization system attach from pelvis to the spine. These muscles transfer loads between upper extremity and lower extremity, provide stability between pelvis and spine, and provide stabilization and eccentric control of the core during functional movements. The primary muscles that make up global stabilization system include quadratus lumborum, psoas major, external obliques, portions of the internal oblique, rectus abdominis, gluteus medius, and adductor complex.

Movement System

The movement system includes muscles that attach the spine and/or pelvis to the extremities. These muscles are primarily responsible for concentric force production and eccentric deceleration during dynamic activities. Muscles that make up movement system include latissimus dorsi, hip flexors, hamstring complex, and quadriceps.

Collectively all muscles within each system provide dynamic stabilization and neuromuscular control of entire core. They produce force concentrically, reduce force eccentricity, and provide dynamic stabilization isometrically  in all planes of movement during functional activities.


Core Integration

In isolation, the core muscles do not effectively achieve stabilization; rather stability is achieved through their synergistic interdependent functioning that enhances segmental and global neuromuscular control.

This concept is essential when designing a core strengthening program, which should combine flexibility, Intramuscular Activation and  multi-planar, compound functional movements.

Flexibility (Self-myofascial release and stretching)

Activation exercises (e.g. scaption, bridging, etc.)

Functional multi joint exercises (e.g. squat to row, Single leg touchdown with a rotational component, etc)

Many people consider strengthening their core for back pain, but research shows that core strength (or lack thereof) is implicated in both upper and lower extremity injuries.


Lower Extremity Injuries


There is a clear relationship between trunk muscle activity and lower extremity movement.


Decreased core stability has been suggested to contribute to the etiology of lower extremity injuries, particularly in females.


Patients with patellofemoral pain syndrome (PFPS) have hip and core muscle weakness leading to dynamic malalignment of the lower extremity. Hip strengthening is a common PFPS treatment approach.


Chronic ankle sprains have been associated with weaker hip abduction strength and less plantar-flexion range of motion on the involved sides. Therapists should consider exercises to increase hip abduction strength when developing rehabilitation programs for patients with ankle sprains.


Upper Extremity Injuries


Dysfunction or weakness of the scapular stabilizers often results in altered bio-mechanics of the shoulder girdle, which can result in:

(1) Abnormal stresses to the anterior capsular structures

(2) Increased possibility of rotator cuff compression

(3) Decreased performance.


Managing shoulder and elbow injuries and injury prevention, should focus on optimizing mechanics, core strength, scapular control, and joint range of motion.


Key Take Home Points


  • Core strengthening and stability exercises have become key components of training programs for athletes of all levels.
  • The core muscles act as a bridge between upper and lower limbs
  • Force is transferred from the core (the powerhouse) to the upper and lower extremities
  • Some studies have demonstrated a relationship between lack of core stability and increased incidence of injury.


Are you addressing the Core of your injuries or pain?


Additional References

Clark, M., & Lucett, S. (Eds.). (2010). NASM essentials of corrective exercise training. Lippincott Williams & Wilkins.




  • Do you experience chronic muscle and joint pain?
  • Do you have tight knots and tender spots throughout your body?


These knots are known as Myofascial trigger points. Trigger points can result in either local or referred pain and can affect your range of motion, flexibility and strength.


Studies show that trigger points can be a primary cause of pain in up to 90 percent of musculoskeletal conditions.


While most of us don’t have the luxury getting a massage or acupuncture every day to work out these knots, we can experience similar benefits with the use of a foam roller or tennis ball.


Come learn how.


When:   April 30th

Where: Yoga Bliss (Mercer Island)

Time:    1:30-3:30

Sign Up Here:

(Space is limited)

About the Author

Dr. Geoff LecovinNaturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/View all posts by Dr. Geoff Lecovin