Presenting…the Core!

Figure 5-1.

It was a classic moment in Philadelphia sports—and in the world of unintentional comedy.¹ There was Eagles wide receiver Terrell Owens (nicknamed “TO”), shirtless, lying on his driveway doing sit-ups and crunches (Figure 5-2), while his agent, Drew Rosenhaus, staged one of the most curious press conferences of all time.^{VID 2,3}

While Owens worked on his beach muscles, Rosenhaus shrewdly gave one-word answers to the assembled media (Figure 5-3), who were trying to find out when Owens was going to report to training camp. He punctuated each response with a terse, “Next question,” and unwittingly created a scenario that would be repeated by fans for years, often to howls of laughter.

Owens looked good knocking out rep after rep. His abs glistened in the summer heat, and he looked as if someone could hit him in the midsection with a baseball bat and he wouldn’t even cringe. The witnessing world mused, “What a core on that guy, huh?”

Maybe.

Owens had a tough stomach, to be sure.

Figure 5-2. TO doing sit-ups in his driveway. (Reprinted with permission from the Philadelphia Inquirer.)

Figure 5-3. Sports agent Drew Rosenhaus at the legendary press conference. (Reprinted with permission from the Philadelphia Inquirer.)

THE ABS ARE BUT ONE CONSTITUENT

But the core is much more than the beach muscles found in an abdominal 6-pack. You can’t blame regular folks for thinking the core is limited to the stomach area. That’s what they hear whenever core strength and fitness are discussed. Strengthen the middle and everything is fine. There’s nothing said about the other stuff—chest, upper thighs, rear end—and certainly nobody is talking about the genitals or pubic bone.

Ever since athletes, members of the military, or gym class students were forced to do calisthenics, there has been an interest in building a strong stomach. And as the fitness craze has boomed, trainers and other workout warriors have concocted new regimens to widen the area of attention. People are getting more powerful throughout their cores, and performance on all levels is improving.

As we mentioned earlier, the medical community has been reluctant to define and address the core. Because it incorporates so many different surgical disciplines—general, orthopedic, thoracic, neurologic, etc—no one person can handle all of it. It’s unreasonable to think someone who specializes in pulmonary concerns would know the first thing about handling muscle tears in the groin area. As a result, the specialists have stuck to their areas, and instead of being considered as one entity, the core has been attacked in a piecemeal matter. Of course, that’s why this book is so important and so essential to understanding the body’s control.

You are going to see the anatomy of the core in its totality. Keep 2 goals in mind: (1) comprehend each part of the core and how it works with the other parts; and (2) grasp the concept of the whole core and how it controls the rest of the body. With respect to the parts, think about symbiosis. In the past, we have thought about all the different physiologic systems in this part of the body as separate species.

It turns out that these species work together effectively as one cooperative species. Again, think about symbiosis.

The chapter is a thorough study of the whole region, and not cursory explanations of parts of it. We are talking about how the whole thing fits and works.

This isn’t just about sit-ups. It’s about the whole core.

Next question!

THE CORE

Here is the core. The center is the same as where da Vinci placed it, at or just above the pubis (Figure 5-4).

Figure 5-4. The classic da Vinci drawing with the boundaries of the core represented.

Figure 5-5 is the Vitruvian Man again and a deeper look into his core’s muscles and bones.

Now consider Vitruvian Man becoming an athlete (Figure 5-6). This visualization will help you conceptualize the functional anatomy that follows.

You got it? Da Vinci “got it” with his V-Man. This part of the body is our engine, transmission, hub…

Figure 5-5.

Figure 5-6.

The core has 4 parts (Figure 5-7): (A) the back, (B) the ball-and-socket hip joint with some distal femur, (C) the core muscles and the rest of the pelvic bones, and (D) all the other physiological systems and soft tissues.

Figure 5-7.

THE FOUR PARTS OF THE CORE

The Back (Figure 5-8)

Think of the back as still a vast unknown. Not nearly enough attention has been paid to the back. For the most part, neurosurgeons and orthopedists concentrate on the spinal cord and nerve roots and to some degree fusions and curvatures. One of the main purposes for the back is the tunnel that contains the spinal cord, which needs a lot of protection. Maybe we should call those specialists tunnel-thinkers? Okay, bad joke. Whatever the case, tunnel-thinking ignores enormous other aspects of the back. How many people in the world have undiagnosed back pain? How much of this pain is caused by pure musculoskeletal and not spinal cord problems? How much does undiagnosed back pain cost to the world? The productivity loss from that resultant absenteeism alone hurts the GDP. And think of all the emergency room and disability costs. Suffice it to say that the back is a huge and important part of the core. It deserves more attention.

In one sense—and for the purposes of this book—consider the back as a big unknown in need of much more research. Nobody has yet provided much evidence for how the muscles and bones of the back relate directly, not via nerves, to the rest of the body. Think of the back as a huge muscle mass full of important force. And think of us all as incredibly naïve for not knowing more about it.

Figure 5-8. The back.

TABLE 5-1 IMPORTANT CORE DEFINITIONS
Core	The entire region of the body from mid-chest to mid-thigh; in core parlance terms, from “nipples to knees.”
Hip	Just the ball-and-socket joint and immediately adjacent bone.
Core muscles	All the skeletal muscles within the core, plus the pubic bone and all pelvic bones not considered part of the hip.
Back	The back, ribs, and all contiguous tissue within the region defined as the core.
“Everything else”	The fourth part of the core. All tissue within in the core not belonging to the other 3 parts (hip, core muscles, and back). The fourth part includes all the systems (eg, gastrointestinal, gynecological, genitourinary, vascular, lymphatic).
Core injury	Injury involving one or multiple structures within the core.
Core muscle injury	Injury involving one or multiple core muscles. Most core muscle injuries involve more than one muscle.
Harness or “harness and bridle”	The central core functional unit arising from the 2 rectus abdominis and 6 adductor muscles (3 on each side) and the pubic bone.

But the back is there, taking up a lot of space within the core. And like Coach Bill Belichick says, “It is what it is,” so we have to deal with it. So, for now, think of the back in the following way. It is the whole region depicted in the following figures. In the core, the back includes the vertebral column from the mid-chest on down. We chose “the mid-chest” arbitrarily as an upper limit; this may be wrong. But as we see it now, the back unites with the chest and abdomen there in so many movements with the pelvis and thighs. This arbitrary upper limit makes sense. Of more importance is to accept that the back includes 2 main things besides the spine: (1) the massive muscle mass surrounding the vertebrae, and (2) all those anterior rings made of bone and interconnecting muscles that we call ribs.

The Hip (Figure 5-9)

This one is simple. We are talking about just the ball-and-socket hip joint. Okay, so there is a little bit of muscle in that joint…but we are not including any of the muscle outside of that joint. For the purposes of covering all the bone in the core, we accept the femur as part of “the hip” down to its mid-shaft.

The Core Muscles (Figure 5-10)

This part of the core is also easy to comprehend. The core muscles are simply all the skeletal muscles from the mid-chest to the mid-thigh, including the “internal” skeletal muscles (eg, levator ani) and the back muscles. For clarity, we usually exclude the back muscles from the discussions, because they belong to the aforementioned, still mysterious back. See Table 5-1.

Figure 5-9. The ball-and-socket hip joint. Note the difference between what we call the hip here and Figure 5-7B, which includes the rest of the femur.

Figure 5-10. The core muscles and rest of the pelvic bones.

The “Other” Tissues (Figure 5-11)

The fourth part of the core is really, really complex yet easy to comprehend. It is a grab bag and includes everything nonmusculoskeletal that we have not yet mentioned or have forgotten to mention in this book (see Table 5-1). For the sake of comprehensiveness, this fourth part includes the gastrointestinal, genitourinary, and gynecologic systems; lymphatics; blood vessels; and nerves. Of course, we are including only those portions of these systems that reside in the core. Most of the gastrointestinal, genitourinary, and gynecologic systems do. Do not minimize the importance of these other tissues in the science of movement. You shall see numerous examples of why you should not underestimate the importance of this fourth component of the core with respect to movement and athleticism.