The Importance of Deep Core Strength in Injury Rehabilitation
When we talk about the "core," most people immediately think of six pack abs. But the reality is, true core strength runs much deeper. The deep core muscles—such as the transverse abdominis, multifidus, diaphragm, and pelvic floor—act as your body’s built-in support system. They don’t just help you look strong; they stabilise and protect your spine, hips, and pelvis, making them essential for both injury prevention and rehabilitation.
Why the Deep Core Matters
The deep core muscles differ from the surface-level muscles that drive movement. Instead, they provide the stability your body needs as a foundation for safe, efficient movement. When these stabilisers are weak or not firing properly, other joints and tissues are forced to compensate. This often leads to poor movement patterns, ongoing pain, or even re-injury. Research consistently shows that deep core activation is a key factor in successful recovery, especially for people with lower back pain or pelvic issues.
Benefits of Deep Core Training in Rehab
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Spinal Protection – A strong deep core helps reduce pressure on spinal structures, lowering the risk of further injury.
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Better Movement Control – Stability through the trunk allows the arms and legs to move more efficiently, which is vital in returning to sport or work.
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Pain Reduction – Improved stability reduces unnecessary compensations, which can help ease pain.
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Breathing and Posture – The diaphragm and pelvic floor are part of the deep core, so strengthening them improves posture, breathing, and overall movement quality.
How We Train It
Rebuilding deep core strength is not about heavy weights or hundreds of sit ups. It’s about precise, controlled activation. Some of the exercises we often use in clinic include:
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Diaphragmatic breathing – reconnects breathing with core stability
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Abdominal bracing or hollowing – to gently activate the transverse abdominis.
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Dead bugs, bird dogs, and modified planks – to challenge stability without overloading.
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Pelvic floor training – particularly important for postnatal clients or pelvic injuries.
Progression is gradual. We start with small, low-load movements and build toward more functional, dynamic exercises as your control improves. The goal is to retrain these muscles so they automatically switch on during daily life, exercise, and sport.
The Bigger Picture
While rehab is always about the whole body, a strong deep core provides the foundation for lasting results. Focusing on these stabilisers early in your rehab journey not only speeds up recovery but also helps prevent future setbacks.
Author
Georgia Patchett - Exercise Physiologist
References
Hodges, P. W., & Richardson, C. A. (1998). Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. Spine, 23(4), 524–531. https://doi.org/10.1097/00007632-199802150-00016
Akuthota, V., Ferreiro, A., Moore, T., & Fredericson, M. (2008). Core stability exercise principles. Current Sports Medicine Reports, 7(1), 39–44. https://doi.org/10.1097/01.CSMR.0000308663.13278.69
Yoon, T. L., Park, S. Y., & Oh, J. H. (2013). The effects of lumbar stabilization exercise on the thickness of transversus abdominis and multifidus muscles in patients with chronic low back pain. Journal of Physical Therapy Science, 25(12), 1451–1454. https://doi.org/10.1589/jpts.25.1451
Arumugam, A., Beith, I., Nairn, L., & Al Saeedi, S. (2021). Effectiveness of core stabilization exercises and McKenzie exercises in non-specific low back pain: A randomized controlled trial. BMC Musculoskeletal Disorders, 22(1), 858. https://doi.org/10.1186/s12891-021-04858-6
Kibler, W. B., Press, J., & Sciascia, A. (2006). The role of core stability in athletic function. Sports Medicine, 36(3), 189–198. https://doi.org/10.2165/00007256-200636030-00001
Vikne, J., Oedegaard, A., Laerum, E., & Raastad, T. (2023). Core muscle function in runners: A systematic review. BMJ Open Sport & Exercise Medicine, 9(1), e000556. https://doi.org/10.1136/bmjsem-2019-000556
