Before Dr. X became an M.D., homeboy had it goin’ on! He was fit, he played all kinds of sports regularly, went to the gym often, and even let it drop to the ladies that his six-pack was in fiiiine shape. But with the long study hours, the all-consuming focus on medicine, and the insane hours of lectures, rotations, and residency, everything changed. And he started to notice changes around his middle, as his rectus abdominis slackened and (gasp) love handles started to appear. His low back had even started to hurt.
He was determined to get his groove back. He called me up and bemoaned the physical changes, asking for advice. Talking to the ladies was not feeling the same. He still had at least six years left of residency and fellowship – what to do?
Here’s what I told him:
“If you want to get your core back, you need to stop thinking about exercise as separate from your time in the hospital. You need to start thinking about your core during your day.
When you have a break between patients, I want you to stand up against a wall. Feel the natural curves of your spine up against that wall. Now take a big inhale and feel your belly puff out. That’s right I said puff out. Now exhaaaaale and suck that gut in. As you breathe in and breathe out, start to pull your low belly in, the place below your bellybutton and above your pubic bone.
Is your spine moving too, are you arching to do this? If your vertebrae are moving, chances are you aren’t working the muscles properly. So try it again, keeping your spine super still. As you pull in your low belly, keep holding it in this time, and see if you can picture the feeling of putting on a pair of jeans fresh out of the dryer. Now pull your belly in even more, and pull your waist in to pull that imaginary zipper up. But the jeans still don’t fit! So suck in your belly more, and pull in the waist more.
If you’re doing this right, you’ll feel your low abs kickin’.
Sound simple? It is. You’ve been working your six-pack abs (rectus abdominis) for years, bro! But what about your deeper abdominal muscles? If your transversus abdominis (TVA) was neglected before, now it’s disappearing before your very eyes. Make the time, and you’ll feel the difference.
As you find the time to do this simple move between rounds, you’ll notice your abs working more as you work. You’ll start naturally engaging your core as you walk around, rather than collapsing into your low back.”
Three weeks later
Dr. X checked in and told me that he is feeling his core (thank you, TVA!), has a date with a yoga instructor, and even made it back to the gym last week. I told him that deep ab work can be so transformative…so keep on working!
Priti Radhakrishnan is a Pilates teacher at Kinected, in New York city. In addition to her journey as a Pilates teacher, Priti has worked for nearly a decade as an attorney fighting for access to affordable medicines for patients living in poverty in the developing world. She loves to combine therapeutic Pilates with her experience working in clinical and low-income settings: her dream is to ensure that Pilates is available to everyone, regardless of economic status.