Misconceptions of “The Core”

Core strengthening, training, and stabilization have become popular terms in exercise discussion.  However, they are often misused or referred to incorrectly.  Core exercises are often thought of as exercises of abdominal muscles (crunches, etc), or back muscles (lat pulls, rows, roman chair, etc.).  Although these are great for strengthening certain muscles of the trunk, they are not true core exercises.  Core muscles are not the abdominals, back extensors, or “prime movers” of the spine.  They are much smaller and more specific “stabilizers” of the spine.  Their responsibility is to control the vertebral movement, not initiate it.  These muscles reduce the amount of shear force at each vertebral level and give the spine balance and control.  They consist of the transverse abdominus, multifidus, pelvic floor muscles, and many of the smaller muscles that link each vertebrae together.  Training these muscles is not only essential for spine rehabilitation, but for functional training and activities of daily living. 


To truly work the core stabilizers, one must first learn to fire them volitionally, and once that is mastered they must be trained in an unstable environment.  This can be accomplished through a great deal of therapeutic ball use and balance oriented training to stimulate these muscles to centrally control the spine.  The improved functioning of the core muscles will result in “prime mover” strength being enhanced, more efficient, and the spine becoming more protected.


Therefore, understanding the use of the term “Core” is very important in understanding how spine rehabilitation progresses.  SLIERS therapists understand the core and are committed to correctly training and rehabilitating spine patients for the rigors of working and activities of daily living.  




Don’t lose out on therapy because of tough financial times!

What can you do if you have pain but you are afraid of generating a big medical bill?


Look for free services offered in the community.  SLIERS has free screenings available. Although this is not a substitute for seeing your doctor if you have a serious condition, it may be just what you need to learn a few tips or exercises to alleviate your pain. 


Look for low cost exercise classes.  Sometimes just getting moving helps your body to get stronger and more flexible and can help reduce pain and stiffness.


Look for free seminars. For example, support groups or web sites that are specific to your diagnosis or problem.  Chatting with others who have your same condition can help you to learn practical tips that work for them. 


Look for prevention programs.  These usually take the form of education or instruction in exercises.  For example, SLIERS has a Skiing Injury Prevention course with lectures by physicians and exercise programs crafted by physical therapists that was free and presented to the community in early Fall.


If you need to see a therapist here are a few tips that can make your experience short and sweet.


Be prepared for your first visit.  Fill out paperwork in advance if possible.  You will have more time to think about the questions and you can look up things like medications, surgeries giving the therapist a good knowledge base to start from.


Choose the direction of your treatment.  Make sure you identify your main issues and emphasize your goals.  Don’t waste time on what is not important to you.    


Let the therapist know what your preferences are.  The final outcome of treatment should include an exercise program.  Make sure it fits your lifestyle.   Do you belong to a gym? Do you want exercises that you can do at home?  If something has worked well for you in the past, tell your therapist so time is not spent on treatments that may not be as helpful. 


Make sure your schedule reflects your treatment needs.  If you can do exercises at home, do them there.  Use treatment time for advancing exercises, treatment components you can’t do on your own or learning self management techniques that help you achieve your goals.


Take an active roll and let your therapist know in advance of your desire to get the most out of your treatment in the least number of visits.


Susan Gordon

SLIERS, Downtown


Winter Aches and Pains

With the colder season in full swing, many of us no longer engage in the activity we used to in the summer.  That, combined with the changes in weather can often cause arthritis to flare up.  There are many ways to help prevent these winter aches and pain from getting the better of us.  One of the best ways is to perform gentle exercises in your home on a daily basis.  Exercise will help maintain the health of your joints, the flexibility of your muscles and increase your energy levels.  Staying active is important during the winter, especially if you are experiencing Seasonal Affective Disorder.  The SAD symptoms will often lead to less activity, strength and tolerance for your favorite hobbies causing a downward spiral into poor health.

            If you happen to be experiencing a flare up of arthritic pain, either from weather changes or lack of activity there are many gentle alternatives to regular exercise, such as isometrics.  Isometric exercises maintain a steady position while you flex your muscles for a short period of time.  Since your arm or leg isn’t moving, you will not get irritate the arthritis.  Your muscles stay strong and your joints stay stability and your circulation increases.  Always remember to breathe continuously during exercise and stop if it causes any discomfort.

            During painful flare ups you need to protect your joints, but that doesn’t mean sitting and resting all day; you have to stay active.  When you are active during a flare up, be sure to:

  • Protect the smaller joints – use the big ones instead
  • Avoid repetitive activity – if you have to get a big project done, do it in small parts throughout the day instead of all at once
  • Avoid awkward positions – these can slowly take their toll, so don’t hyper-extend or hyper-flex your joints.


If you have any questions call your doctor or physical therapist.

Arthritis Tips: Make your car more user friendly!

Is you car a pain?  Not just because of gas prices but because it makes you literally hurt to use it? Let’s start with simply unlocking and opening the door which could be painful if you have arthritis affecting your hands.  There is adaptive equipment to help you enjoy going for a ride in the car.

This device comes in handy for opening your car

This device comes in handy for opening your car



This tool can making ulocking the door or turning the ignition a snap

This tool can making ulocking the door or turning the ignition a snapwww.dkimages.com/.../Security/Keys/Keys-02.htmlThis gives leverage to make turning any key easier



This device will help make getting out of your car easier

This device will help make getting out of your car easierwww.aidsforarthritis.com/catalog/clearance.htmlYou can add a satin pillowcase to your seat to make sliding in and out easier OR and heated seat cushion


This gas cap wrench makes it easier to fill up, at least easier on the hands not necessarily the wallet.
This gas cap wrench makes it easier to fill up, at least easier on the hands not necessarily the wallet.

Also, remember to keep a Ziploc bag in the glovebox if your joints are swollen to use ice.


Neosporin Allergy

Knicks and cuts are a part of everyday life; cutting veggies for supper, yard work, kids falling and scraping their knees are all very common this time of year.  Cleaning the area and using medication are an important part of taking care of these cuts, so they don’t get infected.  Often, we go to the medicine cabinet and grab the trusty Neosporin (triple antibiotic).  But, did you know that about 20% of people are allergic to one of the ingredients in Neosporin?

“Neomycin” is the ingredient responsible for most allergic reactions to Neosporin.  How do you know if you are allergic?  Cuts that don’t heal usually mean there is an allergy.  If this is the case you should gently cleanse the wound and re-apply new bandages and contact your doctor.  You should also monitor the area for any signs of infection.  Look for the following changes:

·        Increased redness

·        Increased pain

·        Increased drainage

·        Foul smell

·        Red streaking around the area

If you notice any of these changes, you should follow up with your medical provider.

The good news is that there are other medicines that will work just as well, without the risk of allergy.  “Bacitracin” and “polysporin” are antibiotics that will heal those small cuts and scrapes so you can keep having fun in the sun without having to worry.  Happy summer! 


Tyler Jepson, PT, DPT

Emergency Department