Training and Strengthening the Deep Muscle System ("Inner Core")

The transversus abdominis, pelvic floor, deep lumbar multifidi, and diaphragm muscles form our deep muscle system, known by many as the inner core. For more information on these muscles, please refer to my blog post, “The Deep Muscle System (“Inner Core”). The transversus abdominis, pelvic floor, and deep lumbar multifidi muscles have been found in research studies to stabilize our spine before movement of the legs and arms occur. However, their activation is often delayed or absent and the muscles may contract too much or too little. They may also fail to work together as they should. If these co-contraction patterns aren’t corrected, they may lead to degeneration of the underlying joints due to loss of stability and control of motion. The activation patterns of these muscles generally won’t change without guidance from a trained professional such as a physical therapist.

The Deep Muscle System ("Inner Core")

The terms, "inner core muscles", "inner core", and "the deep muscle system", are often used interchangeably in rehabilitation, fitness, and wellness settings. However, what does one really mean when he or she refers to this group of muscles? A Google search shows many different descriptions, lists, and explanations of muscles that make up our deep muscle system.

Many physical therapists refer to the deepest muscles located in the region between our pelvis and diaphragm as "the inner core" muscles. When we help patients train and strengthen these muscles, we focus on the following: the breathing diaphragm in the upper most part of the core; the deep and superficial muscles of the pelvic floor located in our pelvis; the transversus abdominis in the front abdominal muscle wall; and the deep lumbosacral multifidi in the low back.

A Physical Therapy Approach Using The Thoracic Rings

Physical therapists are known to sink our hands into clients’ armpits during assessments and treatments. Why would we do such a thing, you ask? We are feeling rib positions at rest and assessing their mobility with specific movements, as advocated by LJ Lee, PhD, BSc, BSc(PT), FCAMT, MCPA, a well-known international lecturer and Canadian physiotherapist. LJ developed the “The Thoracic Ring Approach,” an assessment and treatment paradigm that is a popular and effective approach used by physical therapists worldwide to find and treat pain and dysfunction throughout the body.

The thoracic rings reside in the thorax, the area of your body between the neck and low back. 136 joints are found in this region. They should be aligned properly and move normally for optimal, efficient movement and to allow transfer of forces through our system with movement of our trunk, arms, and legs.

Manual Therapy and Its Role in Physical Therapy

Physical therapists often use manual therapy in their treatment of patients with musculoskeletal dysfunction. This treatment paradigm incorporates skilled hands-on techniques to evaluate and treat spinal and extremity joints, muscles, tendons, and ligaments.

How Do Physical Therapists Use Manual Therapy In Treatment?

On a patient's initial visit to a physical therapist, his or her medical history is reviewed and a comprehensive physical exam is then completed. Based on the history and clinical exam findings, a treatment plan of care is designed which may incorporate manual therapy techniques to help modulate and reduce pain, increase mobility, decrease inflammation, and facilitate tissue repair. A typical physical therapy goal of treatment is to achieve optimal clinical and functional outcomes via improved pain free mobility and movement. Research shows this is best achieved when other treatment procedures, such as therapeutic exercise, neuromuscular control, and alignment and movement training are combined with manual therapy to help the patient achieve their functional activity goals.

The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) for Back and Neck Pain

Do you know of someone who had back, neck, or extremity pain and worked with a physical therapist who helped resolve their pain using the McKenzie Method? Did this leave you wondering what the McKenzie Method of Mechanical Diagnosis and Treatment entailed? The McKenzie Method, also known as Mechanical Diagnosis and Therapy (MDT), is an evidenced based assessment and treatment program for neck, back, and extremity pain. It is used world-wide by physical therapists and their patients. The approach involves a comprehensive and logical process to evaluate the patient’s problem. It begins with a thorough patient history and proceeds with testing of postures, sustained positions, and repeated movements to identify distinct patterns of pain and movement responses that are objective, reproducible, and reliable.

The McKenzie Method of Mechanical Diagnosis and Therapy - Three Steps to Success

If you, a friend, or a loved one has pain in your back, legs, neck, or arms, the McKenzie Method of Mechanical Diagnosis and Treatment is a treatment method that may lead you back to optimal health and function. It is a comprehensive treatment approach to the spine and extremities based on sound principles and fundamentals that when understood and followed are very successful.

I have been using the McKenzie Method for over 35 years and was fortunate to complete an internship following PT school in 1981 studying and working with patients under the mentorship of two legacy McKenzie faculty members. I also spent one week in New Zealand observing Robin McKenzie’s colleagues treat patients.

The McKenzie Method has three steps to success:

Introduction to the McKenzie Method of Mechanical Diagnosis and Therapy (MDT)

Without doubt, no one likes to be in pain. Every year, Americans and their insurance companies spend billions of dollars on back pain diagnosis and treatment, much more than on most other procedures for musculoskeletal pain. The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is one of the world’s most effective physical therapy approaches to help people with musculoskeletal disorders become pain-free. As an alternative to medical interventions such as MRIs, spinal injections, x-rays, and in some cases, surgery, MDT can save you money by potentially eliminating the need to pay high co-pays and co-insurances for unnecessary diagnostic testing and procedures.

Studies have proven MDT eliminates back, neck, and arm / leg pain in as little as three visits. Evidence also suggests MDT intervention helps patients skip surgery altogether. An excellent resource for those interested in this novel approach is the McKenzie Institute USA's website. Watch Danny’s story describing how he used the McKenzie Method to recover from acute neck and arm pain while avoiding surgery. View a short video describing the McKenzie Method and watch an interview with the late Robin McKenzie. If you’re wondering if you or someone you know is a candidate for this approach, view the section, “Patient Briefs: Is MDT for me?”