I always thought the hula-hoop was a fun thing to do when I was a kid, along with hopscotch and jump rope competitions in our neighborhood and at school. We would play for hours and would always have a new twist to the game. I never remember being sore or tired from playing all these games, and I never remember having any back pain. I mean, we never even thought of going to the gym to work out or taking a fitness class: we just played outside everyday, and that was just our lifestyle.

Now our lives are just so busy that we forget to have physical activity be part of our everyday lifestyle, so we need things that are easy, quick and fun. The core muscles of the trunk are essential to what we need to be well, and you can't forget what Janet A. Hulme, MA, PT, describes as the Pelvic Rotator Cuff, which stabilizes the back, facilitates balance, and maintains bladder and bowel health, along with the internal abdominal organs. This area includes the pelvic floor and the hip muscles: specifically the muscles that do rotatory work patterns during ambulation.

Rotation is the most important workout pattern for this region and the most challenging of all. Unfortunately, it is usually the last one to be done. When we train, we often train in the sagittal and frontal planes and forget about the rotational or transverse plane. This plane is where all the pelvic rotator cuff muscles really work well. Often it is not that we are so weak in this region: it is that we have lost the muscle control patterns that make the motions occur with ease and fluidity.

Muscle control issues are different than muscle weakness issues. Muscle control happens with practice and repetitive activities. There has to be a rhythmical balance of rest and work cycles. These muscles do not work alone but in synergy in order to have reflexive action for continence, support for the abdominal organs, stability for the lumbo-pelvic and sacro-iliac region, and balance for standing and walking.

One of the easiest exercises to begin with is standing figure eights of the pelvis region. It is a fabulous starting point to train in the transverse plane with a rhythmical pattern for pelvic girdle strength. In the standing position, you start with a slightly bent knee and rock and roll the hips in a figure eight pattern. Begin with 10 reps to the right and then 10 reps to the left, then alternate one to the right and one to the left 10 times. It takes concentration and slow control movements at first to do it; after a while, you can pick up the speed.

It's quite an incredible tool to keep the low back, pelvic floor and hip motor control patterns working well. Your balance and ambulation will improve as well, along with keeping your bowel and bladder function regular. So start with figure eights and then see your physical therapist to begin a good progression for lower core trunk health. Your bloated tummy and your back will thank you.

Sheree DiBiase, PT, and her staff can be reached at Lake City Physical Therapy in Coeur d'Alene at (208) 667-1988 and in the Spokane Valley at (509) 891-2623 for a full evaluation of your core trunk health.