Last month I was invited to review the book Master Your Core by Dr. Bohdanna Zazulak, a noted sports medicine researcher who specializes in the disparity in injury rates between men and women. The central claim of the book is that, despite massively increased spending and advancements in sports medicine, high injury rates persist due to a lack of core stability. As a solution, the book proposes a four-phase system known as Core BASE which offers curated sets of activities and exercises, ranging from focused breathing to planks to squats and lunges, to strengthen and stabilize your core.

I’m a fan of fitness, obviously, since fitness is what allows me to pursue the outdoor hobbies that have been so central to my life and given me so many amazing memories. As I get older, and as I pursue more injury-prone activities (trail running, most recently, and hopefully bikepacking/mountain biking later this month if I can get my hands on a bike), injury prevention becomes ever more front-and-center to my thinking. My hope is that the advice and programming in this book, which is broadly applicable to all sorts of physical and outdoor activities and not limited to organized sports, will allow me to maintain my serious-injury-free streak for the next few decades. As someone who waited to have children until later in life, this is especially important to me so that I’m able to share experiences with my son as he grows older.

Unfortunately, my Core Score is only 6 out of a possible 21 points (more on this later), so I’ve got my work cut out for me.

Injuries

The introduction of the book provides an exhaustive list of predictors for injury, with notable entries including a fear of injury, ignoring pain, hormonal fluctuations, over-training, inflexibility, poor balance, and, of course, impaired core stability. Although the book is primarily focused on the core, it briefly covers prevention methods for several other causes. It would have been nice to see some numbers behind the various predictors to get a sense of which ones were more serious than others and by how much.

Men vs. Women

Dr. Zazulak’s specialty is investigating the difference in injury rates between men and women. Women in general suffer many more physical injuries than men. As an example, ACL injuries are 4-6 times more common in women. The nature of injuries is also different: most men’s injuries are “contact” injuries (banging into things or people) whereas women are mostly injured due to a loss of control during, say, a rapid change in velocity or direction.

But why? The book discusses several possible and known causes for this discrepancy:

In the old days it was hypothesized that female hormones were somehow to blame. Interestingly, it was discovered that female hormones may negatively affect proprioception, balance, and agility, but these are all trainable skills (see below) and thus any effect can be completely mitigated. During puberty, men automatically acquire a larger neuromuscular “engine” powerful enough to control their increased muscle mass whereas women’s engine is somewhat underpowered. Again, this can be addressed through training.

Emotional stress was listed as another factor that predicts injury. Women have higher rates of fear, anxiety, depression, and eating disorders than men, which may also explain part of the disparity.

There’s even a genetic component: genes which are responsible for the proteins which build strong ligaments are expressed differently in injured women vs. injured men. It’s important to note that genes are not destiny and that our lifestyle choices can significantly alter gene expression.

The Core

The first part of the book is devoted to the discussion of the core, the musculoskeletal component of what most people refer to as the trunk, meaning, your abdomen, butt, and back. Medically speaking, the core consists of 35 muscles located in the abdomen, back, pelvis, and glutes. It also consists of 3 skeletal structures: the spine, pelvis, and hip joints. The muscles are further broken down into “local” muscles which lie closer to the bone (also known as stabilizers) and “global” muscles which are closer to the skin.

With names such as quadratus lumborum and multifidi, many of the core muscles are ones I’ve never even heard of, let alone have any familiarity with. After listing them out, the book includes a number of activities to help you locate and feel the activation of these muscles. This isn’t just for fun, however: it’s an important first step in building conscious awareness and activation of muscles we normally don’t think about. Further chapters elaborate on the connection between the core and the mind as well as the core and the heart.

Core Stability

Core stability, then, is the ability to use your core muscles in order to move the rest of the body, intentionally and in a controlled manner (to paraphrase the definition from the book). It also applies to what you could call unintentional or subconscious movement, such as regaining your balance after tripping over a rock. However, core stability isn’t just about muscle strength and control, it’s also about your mind’s awareness of your body’s position in space, known as the “sixth sense” of proprioception.

In day-to-day life, core instability typically doesn’t lead to injury since one muscle group can often compensate for the inadequacy of another. It’s during strenuous or sudden activity, where forces are many times stronger, that it becomes a problem.

Core BASE

The second part of the book details the Core BASE, a four-phase activity regimen designed to strengthen and stabilize your core. The phases are Breathing, Awareness, Stability, and Empowerment, and each phase is to be mastered before moving on to the next. According to the book, “You’ll notice significant positive results from the Core BASE training within a few weeks, because that’s what the research shows.”

It’s important to note that Master Your Core takes a holistic approach: it isn’t just a rote list of physical exercises but also includes mental and spiritual well-being. The quotes throughout the book include philosophers and Bible verses, and topics covered range from focused meditation to side-squats to sleep and nutrition to straight-up laughter.

Breathing

The breathing phase focuses on proper breathing technique, specifically controlled breathing through the nose and from the belly. It consists of activities such as deep, controlled breathing (4 to 10 breaths per minute) and the Turtle Shell, where you lie face-down and focus on breathing into your belly and observing how it raises your back. It also counsels on what not do do when it comes to breathing, specifically, holding your breath in an attempt to increase stability during exercise. Instead, you should begin exhaling (which engages your inner core) prior to movements such as raising the bar during a bench press. This phase also includes inner and core toning exercises which are intended to build a conscious connection to your core muscles. Finally, it concludes with a set of 7 core stretches.

Awareness

The awareness phase centers on boosting the awareness of your mind and body. For your mind, it introduces meditation and the repetition of mantras. For your body, it discusses distinguishing between discomfort (a sign you’re challenging yourself aka “feeling the burn”) from pain (a sign you’ve gone too far and are at risk for injury). It also discusses delayed onset muscle soreness or DOMS, the aches you get 1-2 days after exercising your muscles in a novel way. You can combat DOMS by engaging in light exercise (walking, cycling, etc.) in order to get more blood flowing through the affected muscles. As far as over-training, most professional athletes spend most of their time in the green zone, a relatively easy level of exercise where they can still carry on a conversation. Non-professionals often push themselves too hard to the point of injury. Instead, you should limit the increase in amount of intensity to 5-10% per week. The phase concludes with 7 awareness-increasing exercises, each with potential modifications for added difficulty.

Stability

The stability phase includes a plethora of activities designed to boost stability as well as balance, a lack of which is another predictor for injury. Your balance is informed by three mechanisms: the inner ear, proprioception, and vision. There’s a classic balance challenge that involves brushing your teeth while standing on one foot, and the vision component explains why it’s so much more difficult when you close your eyes. Note that your sense of balance degrades over time, which is why older folks fall more frequently. This is where the book really opens up as far as exercise routines: this phase includes 7 exercises each for balance, medicine balls, BOSU balls, plyometrics (jumping), and suspension (TRX).

Empowerment

The last phase, empowerment, is more of a choose-your-own-adventure. The idea is to continue building up your core with fun, real-world activities such as yoga, martial arts, laughter (no, really), and spending time in nature (e.g. trail running, mountain biking, paddle boarding, etc.). There’s even a section on activities for kids. I’m obviously a fan of spending time in nature (although backpacking wasn’t mentioned anywhere) but I think it may be time to finally look into yoga (my wife will be thrilled) and I’ve always wanted to learn a martial art.

Core Score

Finally, the book concludes with a method of evaluating your core stability known as the Core Score. It consists of 7 (always 7!) positions, each with three levels of difficulty (worth 1, 2, and 3 points accordingly) which must be held in good form for 30 seconds each. The maximum score is 21 points, and, as mentioned at the top of the review, I managed to score a measly 6. Flexibility has never been my strong point, but apparently neither is (core) strength.

Other Topics

The breadth of the book is pretty astounding, and there are a few other topics which I wanted to touch on briefly:

Symmetry

The concept of a dominant hand or eye is probably familiar, but dominance can also extend to legs or muscle groups in general. Your preference for using one side or another of your body for physical activity leads to muscular asymmetries which increase the chance of injury. To counteract this, try using your non-dominant side instead. Activities which focus on one side of the body (say, kicking with a single leg) are actually more effective at restoring symmetry than activities which use both sides of the body equally (say, a squat).

Office Ergonomics

Now that I’m working from home full-time aka fully remote, office ergonomics and near and dear to my heart. In the context of improving your core alignment, the book lists tips for sitting (while mentioning that you should prefer standing) at a desk, which I’ll repeat here:

  • The top of your monitor should be at eye level
  • The monitor should be about 18 inches from your face
  • The monitor should also be tilted upward about 10 to 20 degrees such that the bottom is closer to you than the top
  • Your elbows, hips, knees, and ankles should all be at right 90-degree angles
  • The top of your head should be directly above your hips
  • If your chair lacks dedicated lumbar support, place a small pillow behind your lower back

Hydration

The daily recommended fluid intake is 11.5 cups for women and 15.5 cups for men. Drink a couple cups before and after exercise, and a half cup every 15 minutes during. Losing just 1% of your body fluids can make you feel drowsy, and 2-4% (mild dehydration) results in dark-colored urine. Symptoms of moderate dehydration (4-8% fluid loss) are dry mouth, lips, and skin. Severe dehydration kicks in after you’ve lost 8% of your body fluids, and anything beyond 10% is life-threatening.

In Brief

There’s so much more I could talk about, but in the interest of time and brevity I’ll close with some factoids which are sprinkled throughout the book:

  • Sit-ups are bad for you. They apply compressive forces to your spine, leading to pain and injury Instead, do standing crunches (knee to elbow).
  • When someone gives you a shove from behind, the leg that you use to catch yourself is your dominant leg.
  • Mouth breathing is bad. It reduces oxygenation, increasing your risk of infection and may even cause learning disabilities, among several other slightly-less-bad things. Breathe through your nose, and your belly (rather than your chest) should expand as you breathe in.
  • Meditation is good for you. Specifically, Focused Attention Meditation, Open Monitoring Meditation, and Transcendental Meditation.
  • To combat negative self-talk (which can lead to a lack of confidence which in turn is a predictor for injury), write down your negative thoughts and try to flip them around into positive affirmations. Focus on incremental progress towards goals.
  • Gratitude is a positive contributor to mental health.
  • Your vagus nerve is connected to your vocal cords, and stimulating this nerve helps you relax. This is why chanting “om” is actually effective in calming you down.
  • Steady cardio is an effective all-around fat burner for men, but women will need to include interval training in order to effectively burn belly and lower body fat.
  • Prefer naps to caffeine. A 20 minute nap will restore mental sharpness and motor skills, 50-90 minutes introduces deep REM sleep, allowing your brain to build new connections.
  • Recent research links blue light from screens to all sorts of serious health problems, including an increased risk of cancer and vision loss. It also disrupts your circadian rhythm, making sleep difficult.
  • So-called “closed chain” exercises (e.g. lunges and squats, push-ups and pull-ups, leg presses) are more functional because they more closely mimic real-life movement than “open chain” exercises.
  • Sleeping on your stomach strains your neck and compromises blood flow to your brain.

Conclusion

At first, for a blog which is allegedly about backpacking, I wasn’t sure if Mastering Your Core would be relevant material. Boy was I wrong. If it was just a curated selection of core exercises, or even just a guide to injury prevention, I think it still would’ve been useful (at least personally). Where Mastering Your Core really shines is in its breadth: it combines a wealth of information on a wide variety of topics into what is perhaps best described as a wellness manual with a core focus. Holistic, some might say, although I’m not a huge fan of the word. Everything from blue light to why chanting “om” works to office ergonomics to multifidi to, well, actual core exercises. It’s a lot to take in.

As a result of reading this book I’ve already made some positive changes e.g. setting all my screens to “night mode” (amber) 24/7. Negative self talk is something I’ve struggled with my entire life so I’m excited to give the techniques from the book a shot. I’ve tried breathing-focused yoga before but am curious about trying the three kinds listed above. And tomorrow I’ll be fixing up my home office to more closely align with the book’s recommendations. Also, planks. Lots and lots of planks.

It’s one thing to read a book about exercise and bettering yourself, it’s another entirely to put it into action. So here’s what I’m going to do: I’m going to take this seriously and actually commit to working my way through the Core BASE over the remainder of the summer. Succeed or fail, I’ll report back in a couple of months with the results.

Stay tuned!

Oh, and last but not least, I’d like to thank the fine folks at TCK Publishing for the opportunity to review this book.