Massage Techniques: How to do an Abdominal Brace for Core Activation

This core activation sequence teaches the sensation of
complete and efficient core activation.
The instructions are given in a three step progression with each step
building on the previous steps.  For most
clients the sensation of complete core activation is new.  After the initial awareness of complete core
activation is achieved, client’s will need to practice integrating this
sensation into daily activities.

Client supine.

Step 1.  Therapist
places one palm on each ASIS.  Begin a
gentle rocking motion with an alternating anterior to posterior pressure
applied to the ASIS.

Instruct the client to resist the rocking motion and to not
let the therapist move the client’s pelvis at all.  The client will recruit the necessary muscles
to resist the rotational force being applied to each side of the pelvis.  Profound weakness and an inability to resist
this rotational force indicate inefficient rotational stability motor control
patterns.

Step 2.  Abdominal
bracing is added to the rotational stability effort.  Ask the client to brace (contract) the
abdominal muscle to tighten the abdominals.
Provide a kinesthetic que to the client by fingertip raking on the area
of the internal and external obliques.
The client should not draw in the abdominals as is commonly
instructed.  The drawing in maneuver
(pulling the belly button toward the spine) contracts the transverse abdominus
but has little affect on the internal and external oblique muscles.  The stomach area should not unduly bulge
anteriorly.  There should be a slight
bulging as the abdominals brace and tighten.

Step 3.  Contract the
pelvic floor muscles.  Ask the client to
contract the pelvic floor muscles as if they were going to stop the flow of
urine.  Women will understand this as a
Kegal.

This three step progression activates the core from the
pelvic floor to the diaphragm.   There
are more than ten muscles included in the core.
Training clients to be aware of the sensation of complete core activation
will help them to integrate this sensation into daily activities.

Build the progression by adding one step at a time and have
the client practice several times to build confidence.  Some clients will experience this as hard
work with very strong concentration required.
Some will hold their breath.  With
a few practice repetitions it will get easier and require less perceived
effort.  An effort of 15-20% of maximum
is all that is needed for effective core activation for most activities.

Core activation is intended to be done IN ANTICIPATION of
movement.  It is the foundation of
movement prep.  Most people do not
activate the core unconsciously in preparation for every movement.  Failure to activate the entire core leaves
the lumbar spine unsupported and vulnerable.

Client homework is to practice creating this core activation
sensation before they do ANYTHING and EVERYTHING.  Over the course of 2 to three weeks it will
become more of a habit and will happen automatically, which is the goal.

Don Miller, MA LMT

August 20, 2011