The Role of Transversus Abdominis as Part of a Functional Core

You’ve probably heard that the transversus abdominis (TvA) is essential for core stability. You’ve heard right, but that’s only a small part of the whole story. The truth is, the TvA is *part* of a dynamic core (referring to the entire region from your neck to your hips).

When healing a diastasis after birth, the transversus abdominis (TvA) gets a lot of attention. It is in the deepest layer of the abdomen and its function is to narrow and flatten the abdomen, which sounds pretty good to most people. A 1999 study by Hodges and Richardson concluded that in subjects with low back pain, they did not activate TvA as quickly as those without low back pain (1). The conclusion was drawn that we therefore must train people to activate TvA in an effort to decrease low back pain. But that extrapolation wasn’t fully accurate because further research showed us that nearly all muscles in the core show dysfunctional firing patterns when pain is present (2). This is because the core is a UNIT comprising multiple layers and muscles with various actions that need to work synergistically. If one or more part(s) isn’t working, the entire system falters.

Cueing the individual muscles doesn’t actually fix the system. We need to use the whole system! Isolating any of the players in the system prevents the team from working together. Sports analogies are ubiquitous, but they seem to resonate with people, so here goes: yes, you need a strong quarterback, but if the defensive line isn’t doing their job, it doesn’t really matter how well the QB throws. When the team works together, then each individual has greater success. When one side/player is weak, then the whole team suffers.

We now know that isolation of the muscles of the core doesn’t add up to full core function. The solution? Use your core the way you were designed. Step one in stopping the isolation is to STOP SUCKING IN. Check in with yourself right now: are you (inadvertently) preventing your core from functioning as a unit by holding your stomach in? If so, let it go and let yourself take a full diaphragmatic breath. (While you’re at it, you might as well unclench your jaw.)

When’s the last time you saw a toddler practice kegels in order to potty train? Or suck their belly button to their spine in order to figure out how to upright themselves? These are learned patterns that we practice rather than our innate movement patterns that are intuitively part of our human expression. The way we have evolved to move as bipedal creatures leaves us with our diaphragm on top of our pelvic floor and an intra-spinal stabilization system that allows us to brace in a task-specific way.

Did you know babies are born with a diastasis of their rectus abdominis? If you think about the core as a functional unit, it makes sense that theirs isn’t fully developed at birth. Despite the fact that the diaphragm is formed around 6 weeks in utero, babies don’t truly utilize their diaphragm until they are earthside. The diastasis closes in the first few months of life as the diaphragm begins to work synergistically with the rest of the core (3, 4, 5). Knowing that at one point in your life, you’ve already closed the gap of a diastasis, wouldn’t it make sense to use the same principles (breath and innate movement patterns) to do so after giving birth?

If you’re a professional and this doesn’t sound like what you learned in school: join the club. A lot of out-of-classroom studies, DNS courses, and patient care led us to stop sucking in and start using our core to its full potential (6, 7). Get signed up for the BIRTHFIT Education right away to learn more!

If you’re not a professional and this all sounds a little too esoteric, then get to a BIRTHFIT Leader ASAP and work with them one-on-one or set up a consult with one of our core and pelvic floor consultants. You have all the tools you need, and we’re happy to help you figure out how to use them!

Lindsay Mumma, DC
BIRTHFIT Leader
@lindsaymumma @trianglecrc

Citations:

1. PW Hodges and CA Richardson. “Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds.” Archives of physical medicine and rehabilitation 80 (1999): 1005-1012. http://www.ncbi.nlm.nih.gov/pubmed/10489000
2. Dionne, C. “How Are We Still Getting It Wrong: Abdominal Hollowing vs. Bracing”. Breaking Muscle. http://breakingmuscle.com/mobility-recovery/how-are-we-still-getting-it-wrong-abdominal-hollowing-vs-bracing
3. https://birthfit.com/blog/2016/05/27/diastasis-recti-abdominis-filling-gap-part-1/
4. https://birthfit.com/blog/2016/06/07/diastasis-rectus-abdominis-filling-gap-part-2/
5. https://birthfit.com/blog/2016/06/20/diastasis-rectus-abdominis-filling-gap-part-3/
6. https://www.rehabps.com/REHABILITATION/Home.html
7. https://birthfit.com/blog/2017/08/31/love-things-good-stop-sucking/