‘The core’ is an umbrella term used to describe the relationship between the abdominal muscles and the pelvic floor.
The abdominal muscles are essentially made up of 3 layers. The 2 most superficial layers are known as the internal and external obliques, and the deepest layer is known as the transverse abdominis (TrA). The TrA is a muscle that reflects the action of a corset – two sheets of muscle, with each sheet beginning at either side of the lumbar spine (low back) and wrapping around the abdomen to connect at the front. When the TrA is activated, the two sheets tighten around the abdomen, thereby creating stability through the low back. In most cases, people with low back pain are unable to activate the TrA meaning they have instability in their low back. Clinical pilates is used to teach people exactly how to activate their TrA and train them in switching on the corset when doing any sort of activity.
The pelvic floor is a collection of muscles which lines the base of the pelvis. These muscles are used to support the contents of the pelvis including the reproductive organs, bladder and intestines. Like any other muscle in the body, the muscles making up the pelvic floor can too, become weak and when this happens people can suffer from incontinence, prolapses and pain. Clinical Pilates is used to help people in activating their pelvic floor (and correctly!) and training them to engage it during movements when it is most susceptible to injury.
The relationship between the pelvic floor and the TrA is an important one as they reciprocally work in order to provide stability through the low back and pelvis, thereby preventing injury. Ideally when the pelvic floor is activated, the TrA will switch on and the ‘corset’ tightens. In people suffering with low back or pelvic girdle pain, the relationship between the pelvic floor and TrA will often be compromised, in addition to a lack of awareness as to how to activate one or both of these 2 areas. Clinical pilates is used to practice activating both of these areas in isolation and then, incorporating this activation into functional movement which will replicate day to day activities allowing you to move through life with minimal risk of injury.