By Dr Chung Wan Ling

At IYAC Medspa, we believe ageing gracefully isn’t just about the skin—it’s about supporting the deeper systems that help us move, feel, and live well. While aesthetics may be the visible side of ageing, the core is the silent foundation: a complex network of muscles that includes the abdominal wall, lower back, and pelvic floor.

These muscles are essential for posture, stability, bladder control, balance, and overall energy. Yet they are often overlooked—until weakness, discomfort, or dysfunction appear.

As we grow older, it’s normal to notice a decline in flexibility or stamina. However, some of these changes are not inevitable. By addressing back and pelvic floor strength proactively, we can maintain mobility, prevent discomfort, and support overall vitality.

Why Core Strength Matters More with Age

The term “core” often brings to mind abs and fitness routines—but medically, it refers to a deep system of muscles that stabilise the spine, pelvis, and trunk. These muscles:

• Maintain upright posture
• Support internal organs
• Stabilise the lower back and hips during movement
• Help urinary control
• Assist with breathing and intra-abdominal pressure during physical tasks
  

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  As we age, these muscles naturally weaken. Pregnancy, childbirth, menopause, sedentary lifestyles, and surgical interventions can further reduce core integrity. When the pelvic floor and back muscles underperform, we may experience:

• Lower back pain or stiffness
• Pelvic organ prolapse
• Urinary leakage or urgency
• Difficulty with balance or walking
• Fatigue when performing daily activities

Unfortunately, many only seek help when symptoms are advanced. At IYAC, we encourage early evaluation and conservative care to support functional ageing—the ability to live independently and actively, regardless of age.

Sarcopenia: The Hidden Muscle Loss That Comes With Age

One of the most overlooked causes of core decline is sarcopenia—the gradual loss of skeletal muscle mass and strength. Sarcopenia begins as early as our 30s, with adults losing 3–8% of muscle mass per decade, accelerating sharply after 60.

This explains why our grandparents often seem smaller, lighter, or shorter than they were in their prime. It’s not just “shrinkage”—it’s muscle loss affecting both structure and strength.

Sarcopenia not only contributes to frailty and poor posture but also impairs metabolism, stability, and tissue regeneration. It can affect the back and pelvic floor muscles, further reducing their ability to support the spine and organs.

While age-related muscle loss is natural, it is not irreversible. Studies show that with the right interventions—resistance training, adequate protein intake, and targeted rehabilitation—muscle strength and function can be preserved or regained at any age.

Strengthening Through Guided Physiotherapy

One of the safest and most effective ways to retrain weakened muscles is through physiotherapy-led rehabilitation. This involves customised programmes led by professionals trained in assessing and activating the deep core and pelvic muscles.

Here’s what a physiotherapy programme may involve:

• Pelvic floor physiotherapy: Teaches how to identify, engage, and relax the pelvic muscles. This is key for improving continence, organ support, and sexual function.
• Back and core exercises: Target stabilising muscles that support the spine and posture. These exercises are often gentle, functional, and adjusted for each individual’s needs.
• Breath and posture training: Helps coordinate breathing and abdominal pressure for core control, especially useful in postpartum recovery or post-surgery cases.
• Biofeedback tools: Provide visual or tactile cues to help patients understand how to activate the right muscles.
• Education on movement habits: Advice on how to move, lift, or sit in ways that reduce strain and promote long-term muscle support.

This guided approach not only helps relieve symptoms but also retrains the neuromuscular system, improving awareness and coordination of underused muscles.

Enhancing Muscle Activation with Electromagnetic Stimulation

At IYAC, we offer electromagnetic functional stimulation (EMS) for selected patients who may benefit from deeper core muscle activation.

This non-invasive technology uses high-intensity focused electromagnetic (HI-FEM) waves to induce supramaximal muscle contractions—with the capacity to deliver up to 50,000 contractions in a 30-minute session —targeting the pelvic floor, abdomen, or back muscles. These contractions are often difficult to achieve through conscious effort alone and help engage deep stabilising muscles that are otherwise hard to activate.

Key benefits include:

• Muscle activation without joint strain: Ideal for individuals with joint pain, mobility issues, or difficulty exercising
• Improved circulation and muscle tone: May support recovery in postnatal or post-surgical patients
• Deep stimulation of hard-to-reach muscles: Especially useful for targeting the pelvic floor and lower abdominal stabilisers

However, EMS is not a standalone treatment. It works best when combined with physiotherapy, which helps patients understand and integrate muscle control into daily movements.

This combination supports both passive and active retraining of core systems, particularly in those with long-standing muscle deconditioning or difficulty identifying core engagement.

When Should You Start Core Strengthening?

There’s a misconception that pelvic floor training is only for new mothers or older adults.

In reality, anyone can benefit from learning how to activate and care for their core system.

Consider seeking help if you experience:

• Lower back tension or recurring stiffness
• A sense of heaviness in the pelvic region
• Urinary leakage with coughing, sneezing, or exercise
• Feeling unstable or fatigued during walking or standing
• Recovering from childbirth, abdominal surgery, or menopause-related changes

It’s never too early—or too late—to start. A well-functioning core can protect against future injury and help you move with confidence as you age.

A Pro-Ageing Philosophy at IYAC

At IYAC, we believe that health and beauty are interconnected. Looking good begins with feeling strong, and core health plays a pivotal role in how we move, rest, and function throughout life.

We don’t believe in quick fixes or overly aggressive treatments. Our pro-ageing approach focuses on supporting the body’s natural systems conservatively and thoughtfully—whether that means strengthening muscles, supporting collagen, or rebalancing the skin.

Working with women’s health physiotherapists and offering evidence-informed technologies like electromagnetic functional stimulation, we aim to support our patients on their journey to age with comfort, dignity, and resilience.

Interested in Learning More?

We can help connect you to qualified allied health professionals for physiotherapy-based back and pelvic floor rehabilitation. For suitable individuals, electromagnetic stimulation may be included as part of a conservative, personalised programme.

Visit us at IYAC Medspa to learn more about how our approach to smart ageing fits into your wellness journey.

This article is intended for general education. It is not a substitute for medical advice, diagnosis, or treatment. Please consult a qualified healthcare provider for personalised assessment.

References

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3. Cruz-Jentoft AJ, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019;48(1):16–31.
4. Rosenberg IH. Sarcopenia: origins and clinical relevance. Journal of Nutrition. 1997;127(5 Suppl):990S–991S.5.
5. Sacco E, et al. Efficacy of 3 Tesla Functional Magnetic Stimulation for the Treatment of Urinary Incontinence. Journal of Clinical Medicine. 2022;11(7)
6. Silantyeva E, et al. A Comparative Study on the Effects of High‑Intensity Focused Electromagnetic (HIFEM) Therapy vs Electrostimulation for the Pelvic Floor. Female Pelvic Med Reconstr Surg. 2021;27(4):269
7. Long C‑Y, Lin K‑L, et al. Effect of High‑Intensity Focused Electromagnetic Technology in Treatment of Female Stress Urinary Incontinence. 2024;12(12):2883