What are stabilization exercises and how can they help you manage pain?

Our stability muscles tend to run deep and close to our joints. They aren’t usually the strongest muscles in our body but they have a vital role of stabilizing our joints and protecting them during movements. 

Some primary examples of these muscles include the diaphragm, transverse abdominus, multifidus, deep rotators of the hip,  pelvic floor, deep neck flexors, intrinsic muscles of the feet, serratus anterior, and the rotator cuff. These muscles might not mean much to you but they all play a vital role in injury prevention. 

With our current society where most are sitting a large period of the day these muscles can get weak,  or with injuries they can get “turned off” causing larger muscle groups to take over resulting in spasms, dysfunction, or the sensation of  your “back going out”. 

A physical therapist can help guide you on proper ways to activate these muscles in connection with your injury or limitations. I’m a huge believer in training individuals to utilize these deep stabilizers in isolation and then progress to adding bigger functional movements. Once you learn how to engage these muscles it makes it much easier to do harder, dynamic exercises safely and feel more confident in completing them well. 

So how do we do this? We can look from top to bottom on correcting postural habits, improved breathing mechanics, and retrain any of these muscles that are weak from your neck, shoulder blades, spine, core, hips, knees, and feet. This is why we believe in a full body approach for physical therapy. We have to look outside of the injury area to get optimal results. 

For example, with back injuries training the multifidus is super important. For back instability or spondylolisthesis where the vertebrae have slipped forward we can do this on hands and knees for this scenario since we want to focus on more flexion based exercises.  Versus with a disc bulge we typically want to focus on more extension based exercises, so we could perform this lying on your stomach. Engaging the small little muscles along the side of your spine can be done by drawing slightly upwards with your belly button and then imaging a slight “puff” in your back. You most likely won’t see anything happen or feel a major activation since we are talking about a deep muscle. Learning to get your brain connected to these muscles can be super frustrating and challenging but I promise it pays off in the end! We also want to coordinate our breath to make the exercise even more optimal. 

Another hugely important muscle is the serratus anterior which is also commonly neglected in strength programs. This muscle runs deep on the front side of your scapula and your ribs,  deep to your pectorals. It is a primary scapula stabilizer and plays a huge role in dynamic scapula control with overhead movements, and with posture. There are many ways to activate this muscle, one example is lying on your back with arms up towards ceiling at a 90 degree angle. Keep elbow straight as you punch to the ceiling and then lower shoulder blade down to table keeping elbow straight. Adding a weight is helpful for control during this exercise. 

If you have any joint hypermobility, ehlers-danlos syndrome, or chronic pain activating these muscles in a safe way is even more important.

Hopefully this sheds some light on why stabilization exercises are a buzz word in the physical therapy and fitness world! Reach out if you have any questions or need any guidance on managing an injury or want to get on a solid program for injury prevention!