Just because we can doesn’t always mean we should. Over a decade ago, I learned in school to cue navel to spine or draw in your belly button as a treatment, but over the last decade, the new research that’s evolved has convinced me that this might not be the best piece of advice we give, and in a lot of cases, could be quite harmful.
I’m an orthopedic physical therapist that specializes in women’s health, treating issues like pelvic floor leaks and diastasis. I’ve also been in the exercise world for longer than I’ve been a physical therapist, which gives me a unique view on not just fixing people, but getting them stronger, and I’ve come to the conclusion that drawing in as a primary core activation method is bad for the long-term health of your body.
Let’s establish what we know:
Drawing in does preferentially engage the transverse abdominals. When is this a good cueing option? If a client cannot draw in, then they need to learn how. We need to be able to control the muscles in our body, but just because we can do something doesn’t mean it’s the best way to get stronger.
Drawing your belly button in for some exercises is not bad but drawing your belly button in for all exercises and it being the only activation pattern you use to train your core, is bad.
Can your client draw in their belly button? Great! Time to move on. If they can’t, work on this, body control is important.
If we want to truly help people, we have to look at how the system works together, not just in isolation. The cue ‘navel to spine’ isolates and decreases the body’s chances of working as a unit.
What’s the harm with navel to spine?
#1. It destabilizes your spine. Yes, drawing in your belly button actually causes spinal instability. “But, what if it relieves my clients back pain?” There is a better way. Let’s look at why it relieves the pain.
Your client probably has overactive paraspinal muscles that are causing either muscle pain or compression in the little joints of the spine (facets). When you draw in, you help to shut down those paraspinals, but it’s robbing Peter to pay Paul, not fixing the issue through balance. Just because one side of the body is pulling hard in a certain direction doesn’t mean we should pull hard in the other. It means we should find balance and teach them to hold in the middle without over-activating any one muscle group. Treating back pain by drawing in will come back to haunt them down the road and here is why.
When you draw in, you do not create balance in the core, you preferentially fire the TAs and Internal Obliques, but your “core” is more than that, especially when it comes to repeatedly lifting a heavy car seat or groceries out of a trunk.
Do a quick test: Put something heavy on the floor and bend over and pick it up by first drawing in your belly button, then try again utilizing bracing with a hip hinge. Did you feel a difference?
Drawing in does not stabilize the spine for a load because it doesn’t recruit all of the core muscles.
#2. Drawing in shuts down the diaphragm and causes a shallow breathing pattern. Further shutting down the external obliques and causing the ribs to flare. This breathing pattern is detrimental to core stability. 80% of the patients I see for dysfunction have a habit of drawing in their belly button. Both pelvic floor issues and diastasis cannot be fully resolved without proper diaphragm activation. When you draw in, you shut down the diaphragm. It puts too much pressure in the middle. Think about squeezing a juice box in the center. That’s putting a lot of pressure up on your diaphragm and down on your pelvic floor. This stops both from functioning like they should.
When you constantly put pressure down on the pelvic floor, it responds by becoming too tight. Only about 25% of women have “weak” pelvic floors, the rest that leak actually have pelvic floors that are too tight. In that regard, too much intra-abdominal pressure from over bracing is also a bad thing. Balance is the key!
Is there some good to be found in drawing in? Absolutely! It helps with motor control. Should it be the primary strengthening method and habitual posture habit? No.
A much better habit is coming tall. Pretending that you have a string attached to the back of your head that connects to your pubic bone and pulls you up toward the ceiling. This lengthens the core and drops the ribs.
A bad habit people get in is arching their back more or pulling their shoulders back to come up taller. This puts excessive stress on the spine and pooches out your belly, making you want to draw in. If you think about coming up tall from your pubic bone through the crown of your head tucking your chin slightly, this will relieve all the stress off your back as well as naturally bring in your belly some without having to cue it but still leaving it a little soft for deep breathing. Yes, by coming up taller you get a little natural TA activation without having to forcibly draw in. This slight natural activation still allows your diaphragm to function.
Training the core should be focused on creating a dynamic system that allows your ribs to drop and diaphragm to provide stability so your entire core will work seamlessly together to provide stability to spine.
Take the belly button challenge:
https://www.youtube.com/watch?v=XXkjAgC1feU
A wife, mom and adventure sports athlete, Sarah is a women's fitness specialist that takes functional training to a whole new level. In her unique approach to treating patients, she believes in teaching. Fully understanding every aspect of the body is a necessity to complete healing. She integrates functional movement with cutting edge exercises to bring you a results driven online program for postpartum recovery, with an emphasis on the pelvic floor and abdominals. When she is not hanging off the side of a mountain, Sarah enjoys writing and presenting at http://www.CoreExerciseSolutions.com and figuring out how her patients can continue to pursue their dreams and lead a strong, adventurous life.
She also has a 3hr Pelvic Floor PMA CEU Course: Find Out More http://www.coreexercisesolutions.com/online-pelvic-floor-ceu-course/
References:
Grenier SG, McGill SM. Quantification of lumbar stability by using 2 different abdominal activation strategies. Arch Phys Med Rehabil 2007;88:54-62
Vera-Garcia FJ1, Elvira JL, Brown SH, McGill SM. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations.J Electromyogr Kinesiol. 2007 Oct;17(5):556-67.
Kavcic N1, Grenier S, McGill SM. Determining the stabilizing role of individual torso muscles during rehabilitation exercises. Spine (Phila Pa 1976). 2004 Jun 1;29(11):1254-65.
Kyndall L. Boyle, Josh Olinick, and Cynthia Lewis. The Value of Blowing up a Balloon. N Am J Sports Phys Ther. 2010 Sep; 5(3): 179–188.
Bordoni B1, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. J Multidiscip Healthc. 2013 Jul 25;6:281-91.