Inverted Core Syndrome

Jan 21, 2016

Dan Miller, PT, MS -Director of Healing Motion Physical Therapy


“Core stability training” has become a buzzword in physical therapy and fitness training. But what does it mean and why is it so important?


Your body’s core consists of the major muscles within the abdomen, pelvis and mid and lower back. These muscles affect posture, breathing, balance, movement support and more. Consequently, fitness trainers and physical therapists often focus on exercises designed to stabilize the core.


If the core becomes compromised, it can affect many of our body’s day-to-day functions, such as breathing. When this happens, our reflexes enter survival mode. Our autonomic nervous system works to preserve and protect essential bodily functions. In this instance, our respiratory system begins to compensate for what the core can no longer support.


Because we don’t consciously know that our core has been compromised, we carry on. We continue to endure the physical and emotional stresses and strains of life without taking time to heal. Eventually, our primary core must divert its inabilities to our secondary, or inverted, core.


As the body begins relying on the inverted core, we experience even more stress. This stress further diminishes the capacity of the primary core from ever regaining its strength and function. This condition is becoming increasingly recognized as Inverted Core Syndrome, which affects individuals with varying severities. Common signs include:


  • Progressive slumping of posture, forward head
  • Progressive arthritis of the neck and lower back
  • Decreased range of motion and reduced flexibility throughout the body
  • Non-traumatic rotator cuff tears
  • Labored breathing or holding one’s breath during daily activities
  • Anxiety and depression
  • Restless or non-restorative sleep


These signs are often accompanied by diffuse to specific pain, muscle soreness/stiffness, fatigue and more. Because pain and fatigue are manageable symptoms, it’s often difficult to recognize the true source of the problem.


VNA’s Healing Motion Physical Therapy approaches Inverted Core Syndrome by recognizing that:


  • To restore order, we must first disrupt the disorder
  • Restoring the capacity to efficiently breathe is of utmost importance
    • Therapy must work to restore functions of the primary core without perpetuating the inverted core
      • Optimal rehab requires removal of compensatory patterns existing in breathing, walking and neck and shoulder movements
      • Persistence and patience are essential


Learn more about Healing Motion at



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