When it comes to fitness, the six-pack — those visible abs known as the rectus abdominis — gets all the glory. But from a physical therapy and spine health standpoint, it’s time we set the record straight: having a 6-pack is overrated.
At Cohen Health and Performance, we frequently work with active adults and athletes who want to prevent or recover from back pain, improve their core stability, and get more out of their workouts. A key misconception many bring in is the belief that the rectus abdominis is the holy grail of core strength.
Let’s break that myth down.
What the Rectus Abdominis Really Does
The rectus abdominis runs from your ribcage to your pelvis, right down the front of your abdomen. It’s the most superficial abdominal muscle — meaning it’s closest to the surface — which is why it’s the one you see in the mirror. But it’s not the most functional when it comes to spinal support or back pain prevention.
Its attachment points on the ribcage and pelvis are small and weak compared to deeper abdominal muscles. This means it doesn’t do a great job controlling how your ribcage and pelvis align — a key part of keeping your spine supported during movement.
The Real Core Stabilizers: What Actually Helps with Back Pain
At Cohen Health and Performance, where we provide sports physical therapy in McLean and Bethesda, we focus heavily on training the deeper core muscles that make a real difference:
-Transverse abdominis: The deepest abdominal muscle, wraps around your torso like a corset.
-Obliques: Help with rotation, side bending, and crucially, stabilizing your ribcage and pelvis.
-Diaphragm and pelvic floor: Work in sync with your core to manage internal pressure and support the spine.
These deeper muscles have stronger connections to your ribcage and pelvis and play a much greater role in controlling spinal position — making them essential for back pain relief and injury prevention.
How We Teach Patients to Engage the Right Muscles
Many people struggle to “find” or activate these deeper muscles because they’ve been trained — often unknowingly — to only rely on superficial muscles like the 6-pack.
One of the first drills we teach many of our physical therapy patients in Bethesda and McLean is something you can try at home:
1. Lie on your back with knees bent and feet flat.
2. Breathe in through your nose.
3. Exhale slowly through your mouth — as long as you possibly can.
4. As you exhale fully, you should feel your ribs draw down and in — and your deeper abs engage.
5. Hold that feeling for 5 seconds at the end of the exhale.
6. Try to quietly breathe in without losing that muscle engagement and repeat this cycle 5 times
This is often the first step toward building true core control — and a key part of our rehab process for those dealing with chronic or recurrent low back pain.
How This Applies to Movement and Exercise
Once you learn how to activate those deeper muscles, we help you bring that control into movement:
-Lifting one leg at a time while lying down
-Overhead arm motions while continuing to feel your deep abdominals
-Transitioning to standing drills like squats or deadlifts
-Returning to sport or high-level athletic performance
This progressive, intelligent approach is what sets our physical therapy practice in Bethesda and McLean apart — and what helps our patients get long-term results, not just temporary relief.
Struggling with Back Pain? Want Smarter Core Training?
If you’ve been dealing with low back pain, poor posture, or feel like your workouts just aren’t translating to improved performance or comfort, it may be time to train your core smarter, not harder.
Our Doctors of Physical Therapy in Bethesda and McLean can help you:
-Eliminate chronic or nagging back pain
-Improve core strength and stability
-Optimize your breathing and movement patterns
-Return to sport, the gym, or simply a pain-free life
Ready to Get Started?
If you are looking to move and feel better, don’t waste time chasing six-pack abs. Schedule an appointment with our team at Cohen Health and Performance in Bethesda or McLean, VA and start building a strong, functional core that actually protects your back and enhances your performance. Click here to get started!
