Why Crunches Don’t Build Real Core Strength

[0:01] Jason: All right, Kathy, if I told you that the core doesn’t exist, would you feel like your six-pack had just ghosted you?

Kathy: Spoiler alert, the core isn’t even an anatomical term.

Jason: Yes. In this episode, we’re going to pull apart the myths, the marketing, and the bro science behind the so-called core, and we’ll actually tell you what matters for strength, stability, and injury prevention.

This is the PTCH. What happens when a chiropractor and a physical therapist get together to make

[0:31] a health and wellness podcast?

Kathy: But chiropractors and physical therapists don’t like each other.

Jason: Oh, think again.

Kathy: I’m Dr. Kathy Lynch, physical therapist who likes to help people move and get stronger.

Jason: I’m Dr. Jason Young, an evidence-based chiropractor who uses humor just as much as adjustments to help people get better.

Kathy: Welcome to the PTCH Podcast.

Jason: Remember, there’s no I in PTCH. Okay, welcome back to the PTCH. I’m Dr. Jason Young.

Kathy: I’m Dr. Kathy Lynch. And today we’re gonna make up some stuff.

Jason: Now, this is the episode that goes viral.

[1:02] Kathy: Yes, it did. This is the one.

Jason: This is it.

Kathy: This — it’s going to happen now.

Jason: I can feel it.

Kathy: Right. Well, we’re well over — like, we’re in quadruple digits for followers, which we are so grateful.

Jason: Grateful.

Kathy: Yes. We’re also cherry full,

Jason: orange full. Yeah, we’re mostly grateful.

Kathy: Blueberry full.

Jason: Yeah. Blue raspberry full. Now, that’s an interesting question. Is there such a thing as a blue raspberry? I’ve never seen one.

[1:32] Kathy: Purple.

Jason: It’s a great flavor.

Kathy: It is a really good flavor.

Jason: Yeah. But yeah, sadly, that’s — that’s a topic for another episode. We’ll do that. We’ll do that in an episode on nutrition.

Kathy: Yeah.

Jason: Let’s bring Stacy back.

Kathy: She would love to answer that question.

Jason: Fruits and vegetables, real fruits, like Smurf berries, right?

Kathy: Yeah. But we are so grateful for all the people that have tuned in. And I think one thing that’s really nice — and it’s a little bit humbling — is

[2:02] there’s people that actually make this part of their routine.

Jason: Yes.

Kathy: Right.

Jason: Like I hear from people that listen to this while they go for a walk.

Kathy: Yeah.

Jason: We were a little bit late a couple weeks ago getting an episode online and

Kathy: I got a text.

Jason: You got a text. He got a text and it’s like, “Is there no PTCH Podcast this week?”

Jason: Yeah. I’m going to shout out —

Kathy: Yeah.

Jason: This is a shout out to Coach Dan.

Kathy: Yeah, Coach Dan. You know,

Jason: from the jump.

Kathy: Yes.

Jason: Has been listening.

Kathy: Yes.

[2:32] Jason: Let’s go, Spartans.

Kathy: Yes. Thank you so much, Coach Dan. And we’re here for you. I’m sorry that we were late. That was — that was my fault. It will not happen —

Jason: It won’t happen, sir. No. Okay.

Kathy: Well, Jason, what are we talking about this week?

Jason: This thing called the core.

Kathy: Oh, the core.

Jason: Oh, the core.

Kathy: Got a weak core. Oh, my core.

Jason: Yeah, I know. Like, do patients come in and talk to you about this all the time?

Kathy: And they do it so apologetically.

Jason: Yeah. There’s a lot of shame around it.

Kathy: So much shame.

[3:02] Jason: Yeah. I feel bad for them.

Kathy: Yeah. People don’t come in bragging about their core.

Jason: I have a couple.

Kathy: Hey Doc, can you help me? I have an amazing core. Right. It’s just —

Jason: You’ve never seen a core like this.

Kathy: It’s very robust.

Jason: Yet I still have all these problems.

Kathy: Yeah. No, it’s basically a shame cannon.

Jason: It is.

Kathy: It really is, right?

Jason: Oh, your core. I saw how you walked in.

Kathy: Must be the core.

Jason: Well, and here’s one of the frustrating things about it for me is sometimes when you hear some of these people talk

[3:34] about it — there’s one — is he a chiropractor? I don’t know. Yeah. No, I think he probably is, right? ‘Cause he’s on Instagram. We’re all on Instagram. Man, I can’t remember what kind of provider he is, but

seriously, like he sits there and he’ll watch videos and talk about people doing stuff and he’s just pointing out things, naming anatomy. He’s like, “Oh yeah, and this and this and this and oh, and they got one of these.” And it’s like, “Bro, everybody’s got one of those. What are you seeing?” And he’s like, “Oh, yeah. Look, when

[4:04] they move into extension, what are their hips doing?” It’s like, “Their hips are doing what your hips do with extension.” Yeah. So I feel like the core gets thrown around a lot.

Kathy: A lot.

Jason: And sometimes I think that people say “the core” just so that they can sound like they know what they’re talking about, right?

Kathy: Yeah.

Jason: It’s like, you’ve heard of the core?

Kathy: Well, I’m talking about the core. Like, you need to train your core, bro.

Jason: Must be it.

Kathy: Yeah. So yes, the core is a

[4:34] victim of bro science.

Jason: Yeah. No doubt about that.

Kathy: Yeah. So what is bro science?

Jason: I think I see that on TikTok

Kathy: all the time. Yeah, it’s like —

Jason: you can’t say bro science. You say bro science.

Kathy: Bro science.

Jason: Hey bro,

Kathy: let’s go.

Jason: Right. So people who are, you know, snorting lines of creatine, which we like — we like creatine, don’t snort it.

Kathy: No. But yeah, it’s just — you have some

[5:05] gymologists, you know, guys who are huge.

Kathy: I like that. Yeah.

Jason: Right. And a lot of them maybe aren’t natural, right?

Kathy: No,

Jason: they have been hitting the juice, but they are happy to let you know all the science behind everything. And a lot of it’s just made up, you know, and it’s anecdotal things that maybe work for them, but probably won’t work for you if you’re not

Kathy: injecting steroids. So that’s bro science.

Jason: That’s definitely bro science.

[5:35] Kathy: And just to be fair, there are some women that do bro science.

Jason: Oh, absolutely.

Kathy: But it’s typically, you know, some roided-out guy named Jared or something like that

Jason: with a wig on.

Kathy: Yeah. Right. Yeah. ‘Cause he’s got early male pattern baldness from

Jason: from doing too much testosterone. Yeah. Anyway.

Kathy: Okay. So

Jason: we get on that tangent.

Kathy: Yeah. You mentioned during our open though that the core — people are gonna — you’re gonna be shocked to

[6:05] Jason: Find this out. The core is not an anatomical structure.

Kathy: Oh.

Jason: Is that right?

Kathy: Tell me more.

Jason: Yeah. So, the core — there is no part of the human body called the core. Right. We’re not apples.

Kathy: Wait, they taught me that in PT school.

Jason: Yeah.

Kathy: The core is your apple.

Jason: Yeah. So, there’s not like real agreement about what are all of your core muscles.

[6:35] Now, the first muscle that people think of when they think of core is they think of abs, right? And when they think of abs, they’re not even thinking of the most significant or powerful abs, right? They’re just thinking of the sexiest abs, right? So, you have a muscle that goes from your sternum down to your pelvis. That’s called your rectus abdominis. This is where your six-pack comes from. Maybe your eight-pack — or I am covering it up with a keg. So,

[7:07] that’s how the bills get paid.

Kathy: That is how the bills get paid. Right. And there’s so many products out there about how to get your six-pack. And I’ll tell you, when I was 18, I fell for this.

Jason: Absolutely.

Kathy: I totally fell for this. There’s like — I don’t know — I think it’s like the abdominizer or something. Yeah. Some sort of crazy name, but have you seen those things where like you wrap and it’s got the electrodes and it

Jason: Yeah.

Kathy: contracts and relaxes your abdominal

[7:37] muscles and so you’re able to build a six-pack of abs while you sleep.

Jason: Just sleep.

Kathy: Yeah. Sleep right through it. When I was 18, I hit this thing so hard. So hard. You know what I ended up with?

Jason: Burns?

Kathy: Had a really sore stomach. Yeah.

Jason: You slept.

Kathy: Oh my god. Oh yeah. Every night. Every night.

Jason: Yeah. I didn’t even get an

[8:09] extra beverage in my six-pack. So, yeah.

Kathy: You didn’t get a seven-pack?

Jason: Yeah. So, just so you know — and these things are making the rounds again.

Kathy: Yep. They’re making the rounds. I had a patient who was like, “What do you think of this?” And they pulled it up on Amazon. I was like, “Don’t buy that.” Right. So,

Jason: yeah. Now, aesthetically, very nice muscle. Sure. If you don’t know what I’m talking about, go out and watch the excellent movie 300.

Kathy: Oh,

Jason: yes. If you want to see what a rectus abdominis looks like, that is that

[8:41] muscle. Yeah. So, but as like actions go, it’s not the most important abdominal muscle you’ve got. And, just to dispel a myth off the jump here, there is no health or fitness benefit to having a six-pack. It is like purely aesthetic and mostly genetic. So there’s some people that they can’t get those really defined

[9:11] six-pack abs. Yeah. And it’s genetics, right? But you can have a perfectly healthy, strong, super functional rectus abdominis and that’s great news.

Kathy: So we can blame the parents.

Jason: You can blame your parents. Yeah. Or their parents. So thanks, grandma.

Kathy: Yeah. Thanks a lot.

Jason: Right.

Kathy: So basically, stepdad — you just took the shame out of people not having a six-pack. Thank you for that.

Jason: Yeah. You don’t need to have one. And a lot of times it’s not a matter of

[9:41] that muscle getting bigger. It’s about losing abdominal — like superficial abdominal fat — so that people can see it. So,

Kathy: that’s not what I thought this episode was going to be.

Jason: No.

Kathy: Yeah.

Jason: Wait, what did we want to talk about?

Kathy: I just ruined your beach bod. Sorry. Yeah. So, but we want to talk about what the actual core is.

Jason: Yes. And so I would say, here’s my definition of it. You have your abdominal muscles, and abdominal muscles are of course your

[10:11] rectus abdominis, which we just wasted way too much time talking about — like we have an infinite amount of time, right? And then you have your obliques, right? And then you have a very important muscle called the transverse abdominis, which we’re going to get to. And then — it’s not all just right here in your belly. You also have some muscles in your back. There’s your erector spinae that go right along your vertebrae in your spine. You have your pelvic floor,

[10:42] which we did an excellent episode with Carrie Boy.

Kathy: Yes.

Jason: Who talked to us about pelvic floor therapy. But that’s part of your core as well. And we learned that there’s a diaphragm there.

Kathy: That’s what I was going to throw in there. Yeah, as well as another diaphragm on the top. So

Jason: that’s your core.

Kathy: That is it.

Jason: All right. Should we wrap up the episode?

Kathy: That’s it. Thanks for listening.

Jason: Thanks, kids.

Kathy: Yeah. So, in your work as a therapist of the physical nature.

Jason: Yes. In physical therapy.

Kathy: Yes.

Jason: Therapitude.

Kathy: Yes.

Jason: Physical therapy.

Kathy: Yes. Why does the core matter? Like, why do these muscles make a difference?

Jason: I don’t know. I should look into this.

Kathy: I thought I was going to learn something today.

Jason: Yeah. Before the episode, Kathy was

[11:43] like, “Hey, I don’t know anything about this. You’re just going to have to talk about it.” And I was like,

Kathy: “What?

Jason: What?” She’s like, “I’m a physical therapist. Of course I know about this.” All right. You got me. You got me twice. Yeah, we’ll play this back and look at the panic on my face. Why is it? Why is it?

Kathy: Yeah. Well, most importantly, they’re postural muscles. Coming from an athletic background. And also in life.

[12:13] Is that a Nazareth basketball university?

Kathy: Nice. Very good. Yes. A former college athlete here.

Jason: Former. Yes. Yes. Much former. The core connects your upper body and lower body. Yeah. And it helps to transfer force from your upper body to your lower body. So when you’re doing rotational sports, throwing, kicking, things like that, the core helps to transfer

[12:43] that force from upper body to lower body, lower body to upper body. Really important. Yeah. Think of a sport where you don’t need to do that.

Kathy: That’s a really good point. Right. All of them are rotational.

Jason: Yeah. So like running.

Kathy: Yeah,

Jason: definitely. Basketball, golf,

Kathy: of course.

Jason: Golf, that’s basically all you’re doing.

Kathy: That’s all you’re doing.

Jason: That’s all you’re doing, right? Baseball, football, tennis.

Kathy: Mhm.

[13:13] Kathy: Pickleball. Jason: Yeah. Kathy: So, Jason: I didn’t make that face. Kathy: I don’t know. Jason: Yeah. But for the regular everyday person, too, rolling over in bed. Kathy: Yeah. Oh my gosh. Jason: If your core is not working, Kathy: totally. Jason: only your legs are going to move over and then your upper body is still flat on the Kathy: Yeah. Jason: on the on the bed. Kathy: Totally. And yeah, there’s all kinds of things. So, Jason: if you do dishes, Kathy: Yes. Jason: you’re going to need a healthy core. Kathy: Yeah. So, this concept of I’ve got a

[13:46] weak core. Jason: Yes. I don’t know. What do you think? Do most people have a weak core or? Kathy: That is a good question. If you walked into my clinic, your core is doing okay. Jason: Good enough, right? Kathy: It’s good enough. Jason: Yeah. People are like, “Oh, my core sucks.” Kathy: Like, that’s all my prob — I just don’t have any core muscles. Jason: Yeah. Kathy: It’s like, Jason: you’re sitting up. Kathy: That’s pretty good. That’s — that’s like

[14:16] that’s like freshman level core. Jason: Yeah. How’d you get out of bed today? Kathy: Yeah. Yeah. Jason: Did someone have to lift you out of bed today? Kathy: Mhm. And there are people that legit don’t have core strength and they are not vertical. Jason: That’s correct. They are not vertical. Kathy: Yeah. So if you’re vertical, you can celebrate at least freshman core. Jason: Exactly. Kathy: That’s good stuff. Jason: Freshman level for sure. Kathy: Yeah. But it’s frustrating to me though that people are told that they have a problem with their core, but nobody’s ever more specific

[14:47] than that. And so people are left to try and strengthen their core. And it’s like — I don’t know what to do. I don’t even know — some people don’t even know what it feels like to contract your core, right? Which I think everybody does, but it’s like you need to know how to identify — these are the muscles that are working. Jason: And I think there’s definitely a difference between like good efficient core contraction and

[15:19] like the mostly unconscious process that people go through whenever it comes to the core. So Kathy: I had a professor in PT school — it’s a little bit of a tangent — Jason: hated that it was called the core. Kathy: Yeah. So she made us call it the trunk, and I use the trunk a lot because of that. Jason: Yeah. And that’s a great term for it. It’s actually — if you’re looking at the literature, Kathy: Yeah. Jason: that’s what you’re going to find most of the time is the trunk. Kathy: Mhm. Trunk stability. Jason: Mhm. Mhm. Well, what now?

[15:50] Kathy: Wow. I just read ahead. Jason: You did? Kathy: I just saw that you — Jason: Hey. Yeah. Look at that. Kathy: I stole that from ahead. Sorry. Jason: Well, should we — no. And it’s good. Hey, all this stuff is true all the time, right? Not like the other podcast, right? Kathy: I stole this from the future. Trunk stability. Jason: Yes. Your mind. So should we get into some of these myths about the core? Kathy: Yeah. I think that we already did the first one, which is six-pack abs equals strong core. And yeah. So let’s just skip

[16:21] that one. We did it. Yeah. Let’s save everybody some time. Jason: Yeah. Kathy: Everything comes from the core. Jason: It’s all the core. Kathy: Yeah. It’s all the core, right? My earache was because my core was weak. It was weak. So, sometimes it’s like a real chicken and egg thing, right? Sometimes I think that you can get things that over time kind of manifest in your core because Jason: you could have a core problem or a trunk

[16:51] problem, which we’ll call it. You could have a trunk problem from a knee injury, right? And so now you’re not transferring weight efficiently because you have a knee injury. And so it’s like — Kathy: and I think it’s worth addressing the concept of weakness versus dysfunction. Jason: Right. Kathy: Right. Because most people have strong enough muscles. Jason: Yeah. Kathy: And they have enough muscle mass,

[17:22] but coordination is a thing. Like the analogy I like to use is if you had — if you didn’t have any background in basketball and you were told that you were going to get a bunch of really tall athletic people and that was going to be your basketball team, but they had never heard of basketball before Jason: and you were going to go and play in a basketball league. How successful is your basketball team going to be? Kathy: Not very good. Jason: Not very good. Right. And it’s not

[17:53] because you don’t have athletes. It’s because they don’t know what they’re doing. They’re not a team, right? And I think you could train those people to be a team. You could teach them about basketball. You could practice. You could run plays and things like that, and then all things being equal, you should dominate that league because you have a bunch of really tall athletes. And I think that’s a really good analogy for what we experience whenever it comes to dysfunction versus weakness — I think a lot of people have

[18:23] all the parts that they need, but they just need to get those parts working together. Kathy: Yeah. Jason: Yeah. With a good strategy. Kathy: Yeah. So Jason: I think the easiest target too with people with back pain Kathy: is they’re told that they have a weak core. Jason: Yeah. And I don’t know how the core got blamed for all of that Kathy: back pain. Jason: Yeah. Yeah. And there is a correlation, right? There’s definitely a correlation, Kathy: but it’s not always your core. Jason: It’s not always the core, right? It could be things like, I

[18:55] don’t know, you trying to lift a refrigerator by yourself, or, you know — so, and what you find sometimes is if you’re just leaving somebody to do core exercises, they don’t get really good outcomes for their back pain, right? That’s not to say that exercise is not effective for back pain, but just generally trying to strengthen your core — Kathy: not the answer. Jason: Not doing it. Right. And so that’s why if you have

[19:25] problems like that, it’s really good to work with a professional like, you know, a chiropractor, a physical therapist, an exercise expert or something like just somebody who has some training in kind of breaking down what those problems are. But just pushing the core button and saying you’re weak.

Kathy: Yeah.

Jason: Get out there and — yeah. And plank you very much.

Kathy: You know, that’s — it’s not going to do it.

Jason: Yeah. What about myth number three? Crunches are the king of core training.

[19:55] Kathy: Well, you kind of already — you touched on it. The rectus abdominis

Jason: is really the dominant

Kathy: muscle. The cruncher.

Jason: The cruncher.

Kathy: Yeah.

Jason: Yeah. And that is — like you said, not one of the most important ab muscles that we have. It’s important. Helps you get up. It helps you sit up.

Kathy: Yeah. Absolutely. Well, yeah. If you’re doubting how important rectus abdominis is, talk to a pregnant woman, right? Because when you’re pregnant, your

[20:26] belly gets big, it stretches out that rectus abdominis, and all of a sudden there are no sit-ups.

Jason: Yes. There are no — you got none left. Yes.

Kathy: Yeah. There’s a roll over and roll downhill, right?

Jason: But they’re still standing and walking. How is that possible?

Kathy: Well, because you know, it’s not the only core muscle there, right?

Jason: Okay. Okay. So yeah, and honestly, like a muscle that does this —

Kathy: Yeah —

Jason: he’s doing the sit-up move.

Kathy: Yeah, for those not watching.

Jason: Yeah, thank you. Like that’s good

[20:57] and it’s useful, but it’s also what we spend a lot of time doing anyway because we’re slumping,

Kathy: and so —

Jason: Yeah.

Kathy: Yeah. What about training the core prevents all — oh, we already talked about that.

Jason: Well, let’s dive into it a little bit more though. Why do we think there’s a correlation between training the core and all back pain?

Kathy: Because there is. Now, even though I kind of walked it back on that,

[21:27] I will say this: most people, if you have a back injury, will core exercises fix your back injury? Maybe, maybe not.

Jason: Right.

Kathy: But will having a stable, functional core help you to prevent your next back injury? Yes,

Jason: probably will. Exactly. Yeah,

Kathy: all things being equal.

Jason: Now, there’s some people that are doing some really extreme things, and

[21:57] you’re just going to get a back injury. So it’s not completely avoidable, but it’s going to give you a really good chance of improving.

Kathy: So, one of the — there’s a really good study that was done on this that kind of was enlightening to this whole concept of does the core matter?

Jason: Yes.

Kathy: And it was in 1996. I don’t want to get the guy’s name wrong.

Jason: I think it’s Hodges.

Kathy: Yes.

Jason: Hodges. Yeah.

Kathy: Yeah. Hodges. P.W. Hodges.

Jason: Yes. 1996.

[22:28] And what they studied was the transverse abdominis, which turns out to be a very important core muscle. It goes — it wraps around your belly. And what they found was that they studied people who had lower back pain and people who did not have lower back pain. And what they found was that, without exception,

Kathy: people who had lower back pain had a

[22:58] delay in engaging their transverse abdominis.

Jason: Which is pretty interesting for this study because when you study things, it’s hard to find something that’s 100%. In this case, 100% of the time, people who had lower back pain had a delay in activating their transverse abdominis. And so they inferred that there is a correlation between that, which —

Kathy: pretty good chance, and I think it’s been borne out in some other studies —

Jason: that when you are having late activation of that transverse abdominis,

[23:31] it’s associated with back pain. I say associated

Kathy: because it’s not necessarily the cause, right? Sometimes it’s the effect.

Jason: Yes. I have a disc herniation or I have a strain in my back, and so now that transverse abdominis is inhibited.

Kathy: And if we go back to what you were saying earlier,

Jason: if I have an inhibited core, I’m now having trouble transferring energy and power from my legs to my upper body,

Kathy: right?

Jason: Which is just about everything you’re doing all day.

Kathy: Including like driving, for example.

[24:02] Jason: People don’t think about this, but — actually, don’t do this — but imagine doing this. Imagine driving without your feet on the floor.

Kathy: Wow. Yeah. Don’t do this. But —

Jason: yeah, it wouldn’t be easy, right? If you had your feet up off the floor the whole time and you’re trying to take corners —

Kathy: yeah. Right. Because that’s a situation where you’re not thinking about, oh, I’m using my core, I’m using my legs, because you’re sitting there. You’re literally sitting there. But there’s

[24:33] a reason why Formula 1 race car drivers have to be in excellent shape.

Jason: Yes.

Kathy: Because they are resisting those forces, and that’s a thing that they focus on — is core and abdominal and back strength —

Jason: because you need that stability in order to do even that kind of driving, right? So, there’s something called the canister model, and it’s a really kind of simple way of thinking about these core muscles. If you picture a

[25:03] soda can —

Kathy: yeah. What’s your favorite soda?

Jason: Coca-Cola.

Kathy: Wrong answer. We shouldn’t be drinking soda. Coca-Cola. Okay. So, you got a can of Coca-Cola. And let’s say you wanted to crush this can. Is it easier to crush a full can of Coca-Cola or an empty can of Coca-Cola?

Jason: I’m gonna say empty.

Kathy: Yeah. It’s very easy, right? And the reason is because there is very little pressure inside that can that you’re pushing against. And so because it’s empty and there’s a hole in it, when you push down the top of it, all

[25:33] the air goes out of it and it’s very weak.

Jason: Okay.

Kathy: Now, you can stand on a can of soda and not crush it, right?

Jason: You can. I can’t.

Kathy: Okay. This is true. But yeah, and you know, people can go out and try this experiment. Go get a can of soda, stand on that can of soda, and if you’re below a certain weight, you can stand on a can of soda and it doesn’t

[26:03] You can’t do that on an empty can of soda. Like, I almost don’t care how much you weigh, right? You can put a child on a can of soda and it’s going to crush.

Kathy: Yeah.

Jason: And that’s kind of the canister model — this idea like a soda can is a canister, and that pressure, if you’re building up pressure inside of it, it’s going to give you some stability.

Kathy: Stuart McGill —

Jason: Stuart — now Stu McGill has a championship-level mustache.

[26:33] Kathy: It is — like, go out and Google Stuart McGill.

Jason: Yes, he’s done a lot of research on this kind of stuff. Pretty amazing guy. Championship-level mustache. And I’m pretty sure that his logo for his stuff — the mustache — has, yeah, it has the mustache and some glasses.

Kathy: Didn’t know that.

Jason: Yeah. Now I can’t even remember what I was going to say about it.

Kathy: You’re talking about a can of Coke.

Jason: Yes. Yes. So I’m talking about this canister model, and that’s one of the things that they kind of looked at — oh, buckling of the lumbar

[27:05] spine. So when you don’t have good core muscle engagement, what happens is your lumbar spine kind of buckles, right? It’s kind of like the walls of that soda can would buckle

Kathy: if you didn’t have any pressure.

Jason: So sometimes people get injured because they’re doing something that’s kind of high stress or high force and they haven’t engaged those core muscles

Kathy: and created some — it’s called IAP, or intraabdominal pressure —

Jason: and then it leaves them in a situation

[27:36] where their spine buckles.

Kathy: Ouch. It sounds painful, right?

Jason: It really sounds painful. And it’s kind of an oversimplistic way of thinking about it, because a lot of times when people are thinking “buckle,” they’re like, “Oh no, the supports on that bridge buckled — no, the whole bridge fell down.” Like, it gives the image of crumbling spines. But it’s that movement where it kind of gives away or just doesn’t have

Kathy: enough —

Jason: enough strength. Yeah. Right. So there is this idea of spinal

[28:06] stiffness, or lumbar stiffness, which intuitively sounds bad — like, I don’t want a stiff lumbar spine. But if you’re going to be lifting something, carrying something, swinging something, you want stiffness and stability in that spine.

Kathy: Stiffness. Yes.

Jason: Yeah. And so creating intraabdominal pressure is a way to increase your spinal stiffness.

Kathy: The way that you increase intraabdominal pressure is

Jason: your core muscles. That’s

[28:36] right.

Kathy: Bad news, kids. So you’re all in trouble.

Jason: Yeah. And so they’ve shown over and over and over that if you have the ability to produce good intraabdominal pressure, the spine can be stiffer, and there’s all kinds of good things that come from that.

Kathy: Mm-hm.

Jason: You mentioned athletics.

Kathy: Yes.

Jason: So there are multiple studies that show that you can generate more of just about any kind of force that you want to.

[29:07] Whether that’s rotational force like a karate chop, or a golf swing — I don’t know why I’m talking like this.

Kathy: I don’t either.

Jason: Yeah. You can drive any of those kinds of things. You can create more force when you have spinal stiffness than you can without it.

Kathy: Right. When I talk with patients about this, one of the examples that I give is — have you ever been like to the lake,

[29:38] like in a canoe?

Jason: Mm-hm.

Kathy: And then you’re going to jump off of the canoe into the water.

Jason: No, don’t do it.

Kathy: Sometimes you can get a big — there’s this video.

Jason: Oh,

Kathy: have you seen the video of the girl jumping into the lake off the back of the boat and the dog?

Jason: No.

Kathy: Oh my gosh, it’s so funny. Okay. She’s standing on the back of a boat and she goes to like jump into the lake, but she like slips

Jason: and flips head first.

Kathy: Oh no.

Jason: And her foot catches the dog and the dog gets launched.

Kathy: No.

[30:08] Jason: Fortunately, nobody’s injured in the making of the video, but yeah.

Kathy: Okay. The dog can swim. Dog’s all right.

Jason: Dogs are a type of fish, I think. So yeah, everybody was fine, but it’s a funny video because they put it in slow motion, so you see the dog.

Kathy: Yeah. Anyway,

Jason: okay. But yeah, so if you’re on a canoe or raft and you want to jump into the water,

Kathy: especially the more narrow your canoe is or anything like that, it’s tough to generate the force to like really jump

[30:38] and make a good dive. That’s because the canoe is so wobbly.

Jason: Right.

Kathy: Right. Whereas if you have a diving board that is attached solidly, stiffly to the side of a pool, or a high dive, you can do all kinds of amazing things off of that, because it is so stable and you can generate force.

Jason: Same thing in the human body. And I think there is the association with back pain — when your back pain is caused by instability,

[31:09] that’s when the core, a stronger abdominal trunk musculature, can help with back pain.

Kathy: Absolutely.

Jason: That’s the piece of the puzzle, I think. But sometimes as soon as somebody’s told they have back pain, they’ve been told, “Well, you better strengthen your core.”

Kathy: Mm-hm.

Jason: When on the flip side, people come in and say, “Ah, back pain. And I get it, especially when I’m leaning over to do the dishes.”

Kathy: Yeah.

Jason: Yeah. That’s not from — well, that’s not from weakness in the muscles on the front of your body. It’s

[31:41] poor endurance from the erector spinae muscles that we’ve talked about. Yeah. And so that’s the other side of the core that I don’t think is trained enough — is the erector spinae, yes, muscles. They’re endurance muscles. And when you’re halfway between bent over and standing up, those muscles have to be on all the time to keep you from falling over.

Kathy: Yes.

Jason: So if you can imagine that posture when you’re leaning over the

[32:12] dishes, those erector spinae are just kind of holding on. Jason: Yeah. Kathy: And then Jason: trying to keep you from breaking your nose. Kathy: Yeah. Exactly. Jason: Don’t fall over. Kathy: Don’t fall over. Yeah. Exactly. So, they’re trying to keep you upright. And if they’re not strong, that’s when they start to cramp and get tired and fatigued. And that’s the pain that people get. Jason: So that’s a different kind of back pain. Kathy: You get some buckling. Jason: You get — oh, there’s buckling. Kathy: Yeah, there’s buckling. Yeah. Jason: Yeah. Kathy: Well, and I think that’s a really, really good point, and the other place that we see people injure

[32:42] themselves is actually a training error trying to fix that. Jason: Yeah. Because sometimes — and this is the risk with telling people that they have weak muscles and that’s their problem, you have a weak core, you have a weak back — Kathy: is people think, well, how do you get a stronger back? By contracting it, right? So, they go out and they try and do like these reverse — like sit-ups and stuff, which, you know, that’s an okay exercise, but if that’s what you’re using to try and fix and rehab your spine, Jason: you have a good chance of actually

[33:13] injuring those muscles even further. So, what kind of exercises would you recommend for people, instead of just going out like finding a bench, grabbing that plate, and doing those back extensions? Kathy: Yeah, that’s not the one I would start with. Jason: Yeah. Like, what’s a good place to start, do you think? Kathy: Generally, what I’ll start with is the — the superman. The pro — superman. Jason: Yeah. Kathy: Where you’re just laying on a bed. It’s kind of fun to do, actually. Jason: It is. Yeah. Kathy: And you lift your hands, you lift your feet up in the air, and you hold.

[33:43] Jason: Yeah. Kathy: It’s a lot. Give it a try. Yeah. It’s not as easy as it sounds. Jason: It’s some work. Kathy: It is a lot of work. Jason: It’s some work. Yeah. Kathy: Yes. Jason: And the thing that’s nice about that and different than, you know, that other one is you have to coordinate several Kathy: groups of muscles, Jason: right? Kathy: That really — you’re not training them for strength. You’re training them for synergy Jason: and cooperation with these other muscle groups. So that when you need a movement — like we need to move in extension — all those things are firing together. It’s not just relying on a group that

[34:14] you’ve focused on. So, I think that that’s a really good one. And the thing that I like about it is it’s a very safe type of muscle contraction, which is an isometric contraction. Kathy: So, isometric — I think we’ve gone over this before, but iso means same, metric means length. So, you’re contracting a muscle, but you’re not shortening it or lengthening it. You’re just holding it in one position. So any of those types of moves tend to be really pretty safe and effective for developing some

[34:44] of that core strength. So think like a plank or like a bird dog exercise. Those types of things. Those help us to develop some — let’s move away from saying core strength to trunk stiffness. Jason: Yes, trunk stiffness. I like that. Kathy: Yes, trunk stiffness. That’s Jason: that’s a good term for it. And then something that we — a theme that keeps coming back over and over and over, and how it plays into our trunk stiffness.

[35:14] Remember our soda can analogy. It’s filled with soda. Kathy: When we’re talking about the trunk, I’m not talking about filling it with soda. Jason: That is — that is a strategy that you could use. Kathy: Not recommended. When you’re trying to — when you’re trying to hit a baseball, you might not have time to slam, you know, an entire case of mineral water. Jason: Right. Right. Kathy: So, the thing that we have to fill our canister with is air. Jason: Yeah. Kathy: And so, then we have the theme that I talked about that we keep coming back to

[35:44] is breathing. Jason: Yes. Kathy: Yes. So, if you want a good functional, stable, stiff trunk core, Jason: you need to train your breathing. Kathy: Yes. Jason: Yeah. You have to — I mean, a lot of — we’re thinking about the front of the can. We’re thinking about the back of the can, the sides of the can. The top and the bottom of the can need to work too. Kathy: Yeah. Jason: Because honestly, when you’re losing pressure, Kathy: those are the first places that you lose it, Jason: right? Because it’s the smallest

[36:14] surface area, so it’s the weak link in the chain. There are people when they sneeze, right, that like they pee a little or something like that. Kathy: Yeah. Jason: And that pressure — you know, that is the leaky valve there, right? Kathy: It’s got to go somewhere. Jason: Exactly. So, training your pelvic diaphragm, training your diaphragm that you use for breathing. If you don’t know, the diaphragm is the muscle that basically separates your

[36:44] chest cavity from your abdominal cavity. It is shaped like a blanket — or like an umbrella — and it attaches from your spine around the inside of your ribs. If you take a deep breath and you poke your belly out, you are contracting your diaphragm, right? And so having good control of your diaphragm is key to being able to develop some trunk stiffness. I could prove that to people.

[37:14] Kathy: Yes. Jason: Oh, I’m intrigued. Kathy: Yeah. So when you go and you want to lift something heavy. Jason: Yeah. Kathy: The — what people do is they do something called a Valsalva. Jason: Yeah. Kathy: So — let’s see — the technical way to describe a Valsalva: like you take a deep breath and then you close your glottis. Jason: I didn’t know we were going glottis today. Kathy: Glottis. Yeah. Jason: I did not know we were going there. Kathy: I told you I was giving you the technical explanation. Um, so here’s

[37:44] a simple way to describe a Valsalva maneuver: you take a good full deep breath Jason: and then you hold it and you kind of bear down like you’re trying to have a bowel movement or something, or you’re going to lift something heavy — just that kind of — that. Kathy: Mm-hmm. Jason: Right. Kathy: Right. Jason: And so we do this when we’re lifting something heavy because inherently we know trunk stiffness Kathy: gives us power, strength, stability. It’s going to protect us from injury. Jason: Yes. Kathy: All those types of things. And so,

[38:15] that is an important one. Jason: Yeah. When — so, you own a gym. What’s the name of your gym? Kathy: Is that in Corvallis on N Street? Jason: Ninth Street in Corvallis. Kathy: Okay. Right behind Togo’s. Jason: Togo’s. Kathy: Yeah. Now, Togo’s owes us money. They do Jason: for advertising. Yeah. We clearly advertise for them. Kathy: Go get a Togo’s sandwich. Or don’t, if they don’t give us our money. Jason: That’s right. Kathy: Yeah. So, what kind of instructions at your gym are they giving people around breathing?

[38:47] Jason: We don’t. And that is why I get so much business from Helix. Kathy: How do you think I get patients at Encore? Jason: It’s never hold your breath. Kathy: Stop breathing. Jason: Stop breathing. Generally, the rule of thumb — what I try to tell people is, the hardest part of the exercise is when you should be exhaling. Kathy: So on a squat, when you go to

[39:19] stand up, that’s your exhale. Jason: Yes. Kathy: Inhale on the way down, exhale on the way up. Jason: I’m so glad that you said that because it sounds like the opposite of what I just said, right? Kathy: Yeah, it does. Jason: Yes. And there’s a reason though that you would want to exhale with a heavy lift. So first of all, if you do a Valsalva maneuver and you hold it — like you really hold it, like you’re really squeezing — Kathy: you’re going to pass out. Jason: Yep. Kathy: Yeah. Jason: Yeah. We don’t want people passing out.

[39:49] Kathy: Yes. Exactly. And there’s — you could waste so much time on YouTube — just Google “deadlift pass out.” Jason: Oh lord. Kathy: There are so many people doing a really heavy deadlift and then they let go and they fall down. It’s really funny. Jason: Unless somebody died, then it’s not funny. No, that’s not funny. Okay. Kathy: But if they don’t, then it’s funny. Okay. But yeah, so that’s a common training error, because you need oxygen.

[40:20] And so, in order to get some of that energy exchange and that gas exchange and that oxygen exchange, you get to a point where you’re getting that maximal contraction, you’re building up that stiffness. And then you’ve got to kind of release the pressure valve, right? And as you’re exhaling — and it’s not just like, you know — no, Kathy: no, Jason: no. You don’t let it all out quickly. Yeah. Kathy: It’s usually like a hiss, right? Like — yeah. Or a — right. Like

[40:50] Jason: Yeah. Or if you’re in a boxing gym or something like that, you’re trying to generate some power, you hear a lot of — Kathy: Yeah. Jason: When my kids were taking martial arts — hey, listen. If you’re listening and you train my kids in martial arts and you want to be mentioned on this show, I’m done giving out free mentions today. I’ve given out so many. Yeah. Nazareth basketball. Kathy: Yeah. If you know who you are, right? If you want to be mentioned on this show, hit me up. But my kids all did martial arts and I just —it

[41:22] was so cute. Like they’re like, “Hey, Dad, when you hit somebody, you’re supposed to say ‘ice.’” Kathy: “Ice,” Jason: “ice,” right? Kathy: Well, and think about that. Like, try it right now. Some of you are walking your dog Jason: and say “ice” — just really contract your — yeah. It gives you power. So if you do something where you have to generate a lot of force, like that little hissing exhale, Kathy: it creates tension in your trunk. That’s all it’s doing. It doesn’t put

[41:53] power in your arm, right? There’s no magical something coming out of your fingers. The only thing it does is create tension in your core, Jason: and you can get a tighter contraction out of your core, which means that you can transfer more energy into a punch, a swing, anything like that. I use this literally all day, every day because when I’m adjusting people, it’s high velocity, low amplitude. So I need the ability to generate really quick pressure and

[42:23] force. If I’m doing that with a lazy core, I will hurt myself. Kathy: Yeah. Jason: I spent the whole first year of practice learning this lesson the hard way. Kathy: Are you bragging about your core right now? Jason: No — mine is like — it’s substantial. No, but it’s part of the skill set: learning to generate force using energy from your core. Other traditions will take this to another level and they’ll call it like channeling your chi, or things

[42:54] like that. I don’t know if it’s the same thing. But we’re going to have an acupuncturist on, and she can tell us, right? Kathy: She’ll tell us all about that. But it’s a really important skill to be able to channel that energy. That exhale is really good. So next time you’re trying to do something — like if you’re trying to lift some weights or something like that — give it that hiss. And you’re going to find, Jason: you know, I annoy my sons whenever I go lift. They’re like, “Dad, shut up. Kathy: Shut up. Nobody wants to hear that. Embarrassing.”

[43:24] Jason: Like, what are you doing? I’ll tell you what I’m doing. I’m bench pressing twice what you are. That’s what I’m doing. Boom. Come at me. Yeah. Kathy: So, Griffin just got taller than Al. Yeah. Just a little bit. Yeah. Just a little bit. And so, little brother is now the big little brother. Right. Jason: And so Al’s comeback is: I still bench more than you. Kathy: Come talk to me when you can bench more than me. Jason: So, Griffin, if you’re listening,

[43:54] you’ve got to hit that “ice.” Kathy: You got this, buddy. Jason: “Ice” — and then yeah. Then you can be taller and stronger. Hey. I think that we need to get to the game. Kathy: I think it’s time for the game. People have been waiting for it. Jason: Well, I don’t think there’s anybody left listening, so Kathy: I hope they got to the last segment. Jason: Yeah. Okay. Let me get to it here. This one is kind of fun. All right. Planker Prank. That’s the name of this game. Okay. So I’ve got 10 exercises

[44:25] here. Kathy: Okay. Jason: Some of these are real exercises. Some of these are fake. They’re all going to sound real. And it might be that some of them are real, but they go by a different name. You’re going to have to identify which one has the wrong name, or anything like that. So I’m going to read to you the description of the exercise. Then I’ll read to you the name of it, and you tell me: is this plank, or is it a prank? Kathy: All right. Jason: Ready? Kathy: Let’s go. Jason: Here we go. A side plank variation with one leg

[44:56] supported on a bench that targets the adductors. This is called the Copenhagen plank. Kathy: It’s a plank. Jason: That is a plank. Very good. Very good. This is an expert. This is an expert right here. Kathy: All right. Here we go. Spread angle. Spread angle. Jason: Spread eagle plank. Kathy: Okay. Jason: On your back, arms and legs extended. Okay. So, it’s kind of like a reverse Superman. This is called a reverse starfish plank.

[45:26] Kathy: Are you like suspended between benches? What are we doing? You’re just laying on the floor with your arms perhaps. I’m going to call that a fake. Jason: That is a prank. Very good. Kathy: Oh, prank. Okay. Jason: Okay. What about this one? Short lever plank developed by Russian kettlebell challenge emphasizes maximum tension. That’s called the RKC plank. Kathy: RKC. It sounds official. I’m going to say it’s real. Jason: Oh my gosh, you are three for three.

[45:57] Here we go. A plank with feet on a hoverboard to increase instability called the hoverboard plank. Kathy: Where is — oh, yeah. Let’s go with that. That’s a real plank. Jason: Ah, that is actually a prank. Kathy: I’m going to try it. Jason: But it could end with a real ER visit. Kathy: I just need a hoverboard. Jason: Yeah, I know. Jeez, those things are so good for business. All right, what about this one? A common variation of a plank, dropping the hips towards the

[46:28] floor and then lifting back up. That is a side plank with a hip dip. Kathy: Oh, yeah. That’s a real thing. Jason: Yeah, I know. You did that all day. Here we go. But this rocking side to side while holding a plank like a penguin on ice — it’s called the penguin plank. Kathy: I’m going to say no on that one. Jason: That is also a prank. You’re very good at pranking. All right. It’s a supine core exercise. So that is on your back, with alternating arm and leg lowering stabilizing the spine. That is called a

[47:00] dead bug. Kathy: That is real. Jason: That is real. It’s the realest, right? Kathy: It’s the realest. Jason: Yes. We’re giving dead bugs the worst. Kathy: Yeah. I thought about not even putting that one because it’s just like, eh. Jason: But yeah, you nailed it. Kathy: All right. Curved banana-shaped hold lying on the back with arms overhead and feet lifted — called a banana plank. Jason: You’re laying on your back. Kathy: Uh-huh. Jason: Curved like a banana. Kathy: Yep. Jason: And it’s a banana plank. Huh. Kathy: A banana plank. Jason: Oh. Or a boat hold. Similar.

[47:32] Could be banana plank. Kathy: Oh, banana plank. I’m going to start calling that a banana plank. But I think you’re pranking me. Jason: It is a prank. Very good. Kathy: But I think there’s similar things like a hollow hold. Jason: Yeah. Kathy: Or I think there’s a yoga posture like that too, right? I’m going to have to go back and watch the episode with Nicole and Jen. Jason: Yeah. Kathy: All right. What about this one? A forearm plank on a stability ball making circles with your arm called —

[48:02] Stir the pot. Jason: Yeah, that’s right. That is real. Kathy: Very good. And then finally, a plank with alternating high leg kicks over to the opposite side — sorry, like tail whip style. That’s called a scorpion plank. Jason: Yes. Real. Kathy: That is actually a prank. Jason: Well, we’ve done it at Helix. So — Kathy: Yes. I don’t know if that’s — you’ve been pranked. I’m just kidding. I’m kidding. Jason: Yeah. Sometimes that can be good for business, too. All right. So, very good, man. You killed that section.

[48:33] Kathy: Yeah. Thanks for throwing me some softballs. You’re amazing. You’re amazing. So, and if you want to hit those softballs harder, increase that trunk stiffness. That’s right. Jason: Stiffness, trunk stability. Kathy: All right, Kathy, take-homes. Jason: Let’s go. Oh, I had one. I love the canister analogy — metaphor, analogy. Kathy: I wish it was mine. Jason: Yeah, I know. But it’s still a really good one. Kathy: Yeah, it’s a useful one. It is very

[49:04] useful. The core is not a real anatomical term. Jason: Yeah. Kathy: Yeah. And I think the take-home for me — I really like the point that you shared about energy transfer and how important the trunk muscles are in order to make anything happen in our upper body while our lower back or lower body stabilizes, and vice versa. So whether you’re kicking something, whether you’re throwing something, lifting something,

[49:35] washing a dish — sons, if you’re listening — picking up your clothes from my bathroom floor after you take a shower, you know, cleaning your room, getting your backpack out of the hallway — Jason: strong core — Kathy: you need — maybe that’s the problem. Jason: That’s it. Kathy: Okay, that’s my take for today. Jason: All right. Well, before we go, thank you again for joining us. This was fun for us because we’re nerds.

[50:06] Kathy: We are total nerds. Jason: But it’s also fun to hear what matters to you. So please leave us a comment. Get in touch with us. Let us know — what are your favorite parts? What do we need to talk to you more about? What can we do better? Kathy: Yeah. Jason: Yeah. Kathy: What do you want to hear about? Jason: Absolutely. So, yeah, who are the guests that you want to see us bring in? And, you know, we can even swing big — like throw a big name out there and we’ll invite them.

[50:36] So we can come back and just tell you, “Yeah, they said no.” Kathy: Yep. They said what? Jason: Yeah, they said we don’t know who you are. So, yeah. And as always, like, subscribe, share this with somebody who is annoying you talking about how weak their core is or how bad their posture is and things like that, because I think that this could really help them. They just need to be a full can of soda. Kathy: That’s it. Jason: And they’ll — I think they’ll be a lot better. Kathy: Six-pack soda. I mean, it’s all

[51:09] correlated. Jason: Yes, it’s correl — oh my gosh. Kathy: Oh, that was a good one. And I’m going to give you a point back on the game. Yeah, because that’s a winner. Jason: So, and Kathy, I think that there’s just one more very important piece of information that we could share with our viewers and listeners today, and that is there’s no “I” in PTCH.

[51:41]