‘The core’: Understanding it, and retraining its dysfunction

Summary“Core stability training” is popular in both the therapeutic and fitness industries but what is actually meant and understood by this concept? And does everyone need the same training approach?This paper examines the landscape of ‘the core’ and its control from both a clinical and research perspective. It attempts a comprehensive review of its healthy functional role and how this is commonly changed in people with spinal and pelvic girdle pain syndromes.The common clinically observable and palpable patterns of functional and structural change associated with ‘problems with the core’ have been relatively little described.This paper endeavors to do so, introducing a variant paradigm aimed at promoting the understanding and management of these altered patterns of ‘core control’.Clinically, two basic subgroups emerge. In light of these, the predictable difficulties that each group finds in establishing the important fundamental elements of spino-pelvic ‘core control’ and how to best retrain these, are highlighted.The integrated model presented is applicable for practitioners re-educating movement in physiotherapy, rehabilitation, Pilates, Yoga or injury prevention within the fitness industry in general.