The tarp goes down before the tent! --preparing a strong core

A patient came to the office this week with pain in her right hip.  After reviewing her experience--pain during running, pain walking up stairs, and soreness in her thigh--and a full examination, I recommended to her we begin some core rehab beginning with Transverse Abdominis (TA) recruitment.

We will refrain from a long academic tangent about the TA muscle.  She felt my analogy was more helpful: one way of thinking of the TA is like the tarp on a camping trip.  Just like the tarp, proper core control begins with the TA muscle.  Optimally, our TA is like a firm belt--supporting the spine, pelvis, torso, and other abdominal muscles.  Our TA is located about the same place a large belt buckle would be, firming and strengthening nearly every motion of the body.

When camping, you start with the tarp, and it will help prevent moisture from ruining a good night's sleep and protect your tent.  A tarp is often an afterthought yet regretted when forgotten.  Just like the TA--an afterthought until it's a problem.


As you are considering "core workouts" and resolution of back, hip, or knee pain.  It is a great idea to investigate whether you are able to engage and utilize the Transverse Abdominis.  It may be the answer to your symptoms.

At home test: touch the bony prominences in the front of your pelvis (6" to the side of a belly button and 3" down).  Now move to the center 1" and down 1".  While lying on your back, and holding 2 fingers at that spot, gently firm the muscle under your fingers.  Did you feel it?  Many of my patients have a tough time finding this, so do not dispair!  It is important to be able to hold that muscle firmly while still able to breathe deeply, letting your belly rise and fall.  Many patients bring their "six-pack" muscles into it, and this is not optimal.  Continue to contract and relax these muscles in a gentle rhythm.  You are now working the TA and helping your brain become more aware of this muscle!  If you have difficulty performing this contraction, or draw other muscles into it, it may be a sign of TA dysfunction leading to other symptoms.  Consider it as you seek to reach your pain-free goals!