Back pain is one of the leading reasons why people seek physical therapy care.  GOfit is no exception as we see many patients who experience back pain. There can be numerous causes of back pain from myofascial to spondylogenic and discogenic, just to name a few.  Regardless of the source of pain, there seems to be a similar response of the deep core stabilizer in the presence of pain; it shuts down. 

Well, “shuts down” may be a bit of an exaggeration. It doesn’t stop working altogether, but it does begin to atrophy and lose its coordination or muscle timing. Plenty of studies have shown that specific exercises can cause hypertrophy of this muscle but only a few have looked at how specific exercise effects the timing, or coordination of this muscle. As they say ‘timing is everything.’  Pure muscle bulk is great but muscles needed to be coordinated in their activity so they can activate at the right time to support the structure of the back.  A delay in activation of the transversus abdominis of even a few milliseconds could be the difference in pain free and painful functioning.

The authors of this study looked at the effect that specific exercise had on the timing of transversus abdominis activation.  Subjects of the study performed three exercises of increasing difficulty (abdominal drawing in maneuver, side planks, and bird dog) two times a week for four weeks. After four weeks muscle activation timing of the transversus abdominis was retested.  The authors found that muscle timing of the transversus abdominis improved significantly in the experimental group compared to controls.

So, what does this all mean? First, it means that we can improve the activation timing of one of our deep core stabilizers through some pretty simple exercises. Muscle timing is an important part of coordination. Having a coordinated and strong core will undoubtedly lead to reduced pain and improved daily functioning.


Selkow NM, Eck MR, Rivas S. Transversus abdominis activation and timing improves following core stability training: A randomized trial. Int J Sports Phys Ther. 2017;12(7):1048-1056.