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The Breath-Core-Pelvic Floor Connection

When I say Core, you say abs...And yes - our abs is a part of our core muscles - but there is a lot more to it than the six-pack we are lead to believe we all need to chase. A strong core also gives you better stability and balance, which becomes increasingly important as we age. Stability and balance are important foundations for doing exercises safely and correctly, which in turn helps strengthen your trunk. The core muscles allows us to bent forward and backward, bend sideways and rotate - all of which are movements we use in everyday life, all of which are movements we want to carry on doing without pain. Doing crunches alone simply won't cut it, as it doesn't address all these movement patterns, and focusing purely on the aesthetic of our midline isn't the right approach either. For the record, most people with a defined six-pack have an extremely low body fat percentage, which is not only unattainable, but also unhealthy and unsustainable, for many of us. Let's just be clear on this: Having a strong core does NOT equal a defined six-pack you can use as a cheese grater. So, moving on.


A good posture

The most obvious benefit to a strong core is a good posture. And when you have a good posture you breathe better, feel better and you avoid back pain and digestion issues. Having a good posture is essential in countless sports and everyday activities, both physically and mentally - a good posture actually makes you feel and look more confident. In a society where many of us spend a lot of time seated, it becomes even more important to sit upright rather than slouch to avoid back issues. If you are sitting a lot, make a conscious decision to stand up and move around regularly to 'switch on' your stabilising muscles in the trunk. Your back and core will serve you better in the long run if you do.


Core anatomy

So we know that the 'six-pack' is part of the core, more specifically the Rectus Abdominis. These are the muscles that naturally separate during pregnancy to make room for a growing baby. Underneath the abs you find the left and right (plus inner and outer) obliques, which wraps around your waist on either side and attaches to the lower back ribs. The deepest abdominal wall muscle is the transversus abdominis. This is a corset-like structure that creates intra abdominal pressure for breathing, support emptying processes and keep internal organs in place. We also consider the diaphragm and pelvic floor muscles as integral parts of the core system, alongside of the main back muscles including the lats, QL, spinal erector muscles and glutes. In other words, we need to think of and work the entire trunk to promote a strong core.

Anatomy of core musculature

...and breathe!

The aforementioned diaphragm is our breathing muscle, which works in direct correlation with our core and pelvic floor muscles. When you take a deep breath in, the diaphragm contracts and moves down, at the same time as the abdominal muscles expands and pelvic floor muscles lengthen and relax. When you exhale, the diaphragm and pelvic floor moves up and contracts alongside of the abdominal muscles, pushing air out of your lungs. This takes a little bit of conscious effort to master, as many of us have adopted a shallow breathing pattern that doesn't fully engage these muscles. There are many benefits to 'belly breathing' or diaphragmatic breathing: You take in more oxygen, improve your core stability and strengthen all muscles involved. You promote relaxation and slow your heart rate, which is useful for stress relief. So before you do anything else for your core, get your diaphragmatic breathing right. Below is an excellent illustration of from Burrell Education, whom I did my pre/postnatal and peri/postmenopause training with.

Burrell Education Core and Diaphragm model
Thanks to Burrell Education

Top 5 core exercises for beginners

Forget about sit-ups. They are not particularly effective, but they can also put unnecessary strain on your spine and neck. Instead, opt for exercises that recruit multiple muscles in your trunk and think quality over quantity. Small modifications can make all the difference, so make sure you nail your technique AND your breathing before you move on to more advanced exercises. The below exercises are safe to do for postnatal women and women who experience low back pain or have diastasis recti (wide separation for the abdominal muscles). As with any exercise, do get the all-clear from your GP before starting a core exercise programme. Do not perform these exercises without professional supervision if you have severe diastasis recti or severe low back pain.


Before you start these exercises, take a moment to master your breathing technique, 'belly breathing'. Lie on your back with knees bent. Put one hand on your chest and one hand on your tummy. Take a deep breath in through your nose and into your tummy, feeling your ribs expand in all directions. Your tummy should rise more than your chest if you are breathing into your tummy correctly - watching your hands rise is a good indication of whether you 'belly breathe' or 'chest breathe'. Breathe out through your mouth, emptying all the air out, at which point you should feel your core muscles contract and lower back sink into the floor. As you breathe out, actively contract the pelvic floor by 'pulling up' on your full out-breath. Relax the pelvic floor and core muscles as you breathe in. Do 5 deep breaths and carry on with this breathing pattern throughout all exercises.


1. Pelvic tilts

Carry on with the breathing pattern above and add a pelvic tilt. Think of your pelvis as a bowl of water, where you alternate tipping the water out at the front and back. As you breathe in and allow the tummy and ribs to expand, you tilt the pelvis forward, arching your lower back off the floor. This is when you can imagine tipping water out of the bowl at the front. As you breathe out, you tilt the pelvis forward, your lower back gets glued to the mat and you pull the pelvic floor up - all at the same time on out-breath. This is when you can imagine tipping water out of the bowl at the back. Do 8-10 repetitions, allowing your deep breaths in and big breaths out to guide your tempo.


2. Toe taps

Carry on with the breathing pattern above. Move your legs into a tabletop position, knees stacked above hips and in a 90° angle. Place arms out to the side for support. Breathe in to prepare. As you breathe out, you lower one leg towards the floor, ensuring that the lower back is firmly glued to the floor throughout. Breathe in to return to tabletop. You won't get a medal for reaching the floor with your foot when you are starting out. You may come halfway down when you feel your lower back starting to lift off the floor, and that's ok. Stop at this point, return to tabletop and repeat with the other leg. Imagine making a big dent in the mat with your lower back as you breathe out and lower the leg - this modification makes this exercise a lot more effective, as you recruit more of your TVA (transversus abdominis); which is what we are targeting here. Do 8-10 repetitions, allowing your slow and deep breathing to guide your tempo.



3. Dead bug

When you feel confident doing the toe taps, with good breathing technique and controlled movements; you can move on to the dead bug. Dead bugs are not only excellent for stabilising and strengthening the core, spine and back muscles, they also help improve coordination and balance. Lie on your back, with both legs and arms straight up. Breathe in to prepare, breathe out as you lower one leg and the opposite arms towards the floor. Come back to centre and repeat on the other side. As with the toe taps, you need to ensure your core is fully engaged and your lower back glued to the floor to make the most out of the exercise and avoid lower back pain. Done correctly, the dead bug helps alleviate low back pain by strengthening the relevant muscles. Do 10-12 repetitions, taking your time with each rep.



4. Bird dog

Another great exercise for strengthening and stabilising both the core, spine and back muscles - and a go-to for both preventing and rehabilitating back pain. Starting in all fours with hands placed under shoulders, knees under hips, lift and lengthen opposite arm and leg as you breathe out. Focus on engaging the core and pulling the bellybutton in to spine as you lift and hold. This will help eliminate any sagging in the lower back. Breathe in as you come back to the starting position and change to the other side. Do 10-12 repetitions with control.


5. Modified side plank

The side plank is a great exercise for the obliques, a number of back muscles and shoulders; making it a great all-rounder. You will improve your balance and use the glutes and hip muscles as stabilisers, with plenty of modifications to make it more challenging as you progress. You want to make sure your hand is placed on the floor below your shoulder and hips are stacked one over the other. Start with the lower leg bent on the floor and reach your top arm up towards the ceiling to hold. Push your hips up towards the ceiling and hold for 15-30 seconds on either side. Build up to a 30-60 second hold on either side. You can make this move more challenging by having both legs straight and stacked, as you lift up to hold.

This is a great sequence to return to after being sedentary for some time. It is a safe and effective sequence to do after birth, when dealing with back pain or if you have diastasis recti. Do these exercises regularly, 3-5 days per week, to improve your core strength. Everyone is unique and only you know when you are ready to progress to more challenging exercises. Building up core strength isn't done in a day; it takes time and commitment to get stronger. And with strength comes a more toned physique, an improved posture and an able body that is in it for the long run.

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