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Core Beliefs

June 26, 2024

Your core. A simple phrase with a surprisingly varied degree of understanding, definitions and misinformation. To some it is the muscles in your abdomen or tummy area, the ones that stabilise your trunk and form that iconic 6-pack of abs. To some it has layers, deep core, superficial core, pelvic floor. To others it follows the idea of the anatomy trains and spiral lines.


Whatever your definition these are usually identified as the muscles that must be worked and strengthened to reduce back pain. A strong and stable core equals less back pain and less back injuries. This is a statement I have come to loath over time. It is not that this statement is necessarily incorrect, rather the way it is educated to patients and the way it is implemented to treat back pain. I prefer; a mobile core leads to healthier movement patterns and reduce back pain.


Our spines are designed to move. It is not a rigid pole but a series of small parts that make up a whole which work together to twist and bend and rotate around themselves. Often, I will see core training implemented in a way that holds minimal value to a person’s day to day movements. Hold a plank, lie on your back and crunch, keep a straight back while you squat or lift a weight from the floor. All lines I’m sure have heard before and many of us, including myself, have used before.


A strong, stable and rigid core is not as meaningful as a mobile core. A mobile core being strong and controlled through movement. A heavy focus on core training where positions are held or repetitive movements to contract the muscle can actually increase back pain. The reasons for this come from the patient feeling the need to tense their abs throughout the day and close the space between their ribs and pelvis. The patient then has increased abdominal pressure and limits their movement throughout the day being more rigid – negative movement patterns.


Core muscles should be included as a part of whole body. Core vs the rest is a mentality that trivialises the body and can inhibit recovery while leading to adoption of negative movement patterns. The core is interconnected with the rest of the body and should be treated as such. With regards to lower back pain, there are many other know contributing factors. Especially non-specific lower back pain (NSLBP) which accounts for an overwhelming majority of back pain, up to 90% of cases depending on your source of reference. Psychological and Psychosocial factors play a large role in recovery of these injuries and conditions. An incredibly important aspect of treatment and one that is worth mentioning but a topic for another day.


I challenge you to explore lifting through movements that are not “textbook.” Remember we work with patients, not competing athletes who must stick to strict rules (although sometimes these do align). Squat with flexion, lift with imbalanced weights and encourage twisting. As with any exercise start simple, start small and build up to heavier and larger movements as your patient progresses. 


Cameron Addison

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

     



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Meet Rowan 50% of our new QLD AB squad. Hello everybody, I’m Rowan, Accredited Exercise Physiologist at Absolute Balance. I studied in sunny Townsville at James Cook University, graduating in 2014. Shortly after, I landed a position at a local chiropractic clinic as the sole Exercise Physiologist among chiropractors, physiotherapists, and massage therapists. After a year, I transitioned to Max Employment as a Health Services Officer, covering Townsville, Ingham, Ayr, and Charters Towers. In this role, I helped job seekers secure suitable employment, an unexpected shift from my previous experience but one that ignited my passion for the role of exercise in mental health. After a few years, I decided to move to Brisbane, where I ventured into the occupational rehabilitation field. However, I soon realized that vocational rehabilitation wasn’t the right fit for me. This realisation led me to focus on pre-employment medical assessments, including functional capacity evaluations, drug testing, and lifting capacity assessments. Fun fact: I encountered every drug in the tests except cocaine—it's puzzling why people would use methamphetamines the weekend before their employment screenings! Eventually, I traded in corporate attire for shorts and joggers as I embraced a role in the gym environment. I enjoyed working directly with Medicare, DVA, NDIS, and private patients, so much so that I decided to start my own business (2021) with Meagan, the other 50% of the new Queensland team. As we launched our company, I found myself asking, "What the hell do I do now?" That's when I reached out to ol’ Derek Knox to be our business mentor. My experiences with Derek likely echoed those of many others: he was constantly emphasising my "why" and the "red brain-green brain" concept, all while sharing his extensive industry knowledge, and taking time out of his busy schedule just to hear me say things like, ‘nothings really going on this month’, and ‘red brain is bad right?’. Now, I find myself back in the WorkCover space—though this time, I'm not involved in vocational work—and I'm thoroughly enjoying it. If you’ve made it this far, thank you very much for your time, but let’s finish up with 2 truths and a lie, feel free to email me your answers: I hid on a plane, causing a lot of problems, when I was 5yrs and travelling alone from Sydney to Hobart. I was shipped off to military boarding school in Sydney for 9 years. I caused $40,000 worth of damage to a hotel because I left the kitchen sink tap on. Rowan Dicks Workers Compensation Specialist (AEP, ESSAM) Exercise Rehabilitation Services ‑ QLD
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