Strength­en­ing your core

Your core muscles are essen­tial to sup­port your spine, but many people often for­get to exer­cise them.

     https://www.pressreader.com/malaysia/the-star-malaysia/20251207/282492895014630

By Dr SITARAMARAO NAGESWERARAV

7 Dec 2025

YOUR core is like Wifi – when it’s weak, everything dis­con­nects.

1 Dead bug with heel slide: 1. Lie on your back with both your knees bent at 90° in the air. exhale fully to engage the core, then bring one foot down to touch the floor. — Pho­tos: dr Sit­ara­marao nageswer­arav

A hun­dred sit-ups a day won’t give you a strong core.

That’s because the core isn’t just your abs (abdom­inal muscles) – it’s the net­work of deep muscles around your stom­ach, back and hips that keeps your body bal­anced, sup­por­ted and stable.

Your core is your body’s cent­ral sta­bil­iser, even your spine depends on it for sup­port.

Decreased move­ment or over­do­ing a move­ment, coupled with weight gain and poor nutri­tion, weak­ens the spine and con­nect­ive tis­sues, caus­ing the lat­ter to wear down.

This even­tu­ally leads to chronic lower back pain, disc her­ni­ation and poor pos­ture.

The four lay­ers of the core con­sist of:

> Deep core sta­bil­isers - the 

inner “cor­set” muscles > Super­fi­cial core movers - the vis­ible abs

> Lat­eral and pos­terior core - the core-to-hip con­nect­ors > Func­tional net­work - sup­port­ing sta­bil­isers for every­day move­ment.

A strong core:

> Keeps your pos­ture upright

and con­fid­ent

> Pro­tects your back from injury,

and

> Improves bal­ance and every­day move­ment.

When the core is weak, the spine loses its nat­ural brace.

Spinal seg­ments start to shear and com­press, lead­ing to chronic lower back pain, disc her­ni­ation and poor pos­ture.

Your pos­ture is a mir­ror of your health, so pay atten­tion to it!

Other effects include:

> A roun­ded upper back (kyphosis)

> Pel­vic tilt or exag­ger­ated lumbar curve

> Core inhib­i­tion and glu­teal amne­sia (yes, your butt can “for­get” how to work).

The longer you sit, the more your core muscles dis­en­gage, caus­ing your brain to “for­get” about them.

From the age of 35 onwards, muscle mass begins to decline.

The deep sta­bil­isers, such as the trans­versus abdominis, are often the first to weaken because they’re rarely activ­ated in daily life.

Even reg­u­lar gym-goers tend to train what they can see (e.g. arms, chest and legs), rather than what they can feel (e.g. the deep core).

However, you don’t need fancy machines to train your core. Try this instead:

> Tighten your abdom­inal wall (like bra­cing for a gentle punch) while walk­ing, climb­ing stairs or car­ry­ing gro­cer­ies.

> Sit tall, walk upright and stretch for five minutes every half-an-hour of sit­ting. Small adjust­ments in breath­ing and pos­ture make a big dif­fer­ence.

Two other power­ful core exer­cises you can do at home are:

> Dead bug with heel slide (deep core repat­tern­ing)

This exer­cise tar­gets the trans­verse abdominis, pel­vic sta­bil­isers and deep spinal flex­ors.

It retrains coordin­a­tion between the dia­phragm, core and your pel­vic floor – all cru­cial for pos­ture and spine sup­port. > Half-kneel­ing pal­lof press (rota­tional sta­bil­ity for real life)

This exer­cise tar­gets the obliques, mul­ti­fidus, glu­teus medius and trans­versus abdominis.

It builds anti-rota­tion strength – the body’s defence against twist­ing stress dur­ing daily activ­it­ies.

As uncon­ven­tional as these moves may seem, they’re backed by solid research and proven to improve func­tional strength and pos­ture.

The core doesn’t age – we do. Train it now or pre­pare to make friend­ship brace­lets with your chiro­practor later.

Dr Sit­ara­marao Nageswer­arav is a gen­eral prac­ti­tioner (GP) and cer­ti­fied fit­ness trainer. This is the first of a three-part series, which will be pub­lished fort­nightly. For more inform­a­tion, email star­health@the­star.com.my.

The inform­a­tion provided is for edu­ca­tional and com­mu­nic­a­tion pur­poses only, and should not be con­sidered as med­ical advice. The Star does not give any war­ranty on accur­acy, com­plete­ness, func­tion­al­ity, use­ful­ness or other assur­ances as to the con­tent appear­ing in this art­icle. The Star dis­claims all respons­ib­il­ity for any losses, dam­age to prop­erty or per­sonal injury suffered dir­ectly or indir­ectly from reli­ance on such inform­a­tion.

7 Great Core Strengthening Exercises - Ask Doctor Jo  

896,950 views 22 Mar 2018

Core strengthening exercises are great for improving your core strength. They can help prevent injury, increase core stability, and improve balance. I start with some beginner core exercises & then progresses to harder ones. More core exercises:    • Swiss Ball Core & Back Strengthening Exerc...   Progress through these core strength exercises at your own pace. If this is your first time doing core exercises, you may not be ready for the last ones yet. It's better to do the easy ones first and then see how you feel the next day. The first exercise is a pelvic tilt. This is great to get the core moving, and strengthening the whole pelvic area. The second core exercise is going into a bridge. This not only works your core, but it also works your glutes and hamstrings. If two legs are easy, you can do them with one leg at a time. The third exercise is with a Swiss or therapy ball. A prayer plank on the ball is a great way to activate your core. You can do this modified or a full plank. Next you will do a trunk rotation lying down with your feet on the ball. This is great for your oblique muscles. You can also do the trunk rotation seated on the ball. Using a weight will give you an extra workout, but you don’t have to use one. Now for some harder ones for core strengthening. This one is in tall kneeling, and you will lean back slightly. You can have someone hold onto your feet, or you can place them under something for support. When you are ready, you can do them without any support. This works your core, glutes, hamstrings, and quads. Finally you will do a standing march with elbow tap. You can do this on the same side or opposite sides. Try not do bend your back forward, and use your core to lift your knees. Related Videos: Back Pain Core & Back Strengthening Exercises:    • Back Pain Core & Back Strengthening Exerci...   Exercise Ball Core and Back Strengthening Exercises (Moderate):    • Exercise Ball Core and Back Strengthening ...  

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Be cautious, students told as influenza wave hits schools and kindies

 

Photo courtesy of Pexels

PETALING JAYA: With schools and kindergartens not spared from the current influenza wave hitting the country, the alert is out for children to take extra precautionary measures.

Health experts want special emphasis given to children as most cases have been detected in schools.

Public health expert Prof Dr Sharifa Ezat Wan Puteh called for the affected schools to be closed after being sanitised.

She said children with influenza-­like illness (ILI) symptoms should stay home, while those with severe acute respiratory illness (Sari) should seek treatment at the hospital.

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• Influenza situation in Penang remains under control, says state govt
• Early treatment crucial to prevent severe influenza complications, says Health Ministry
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“Children are also encouraged to get a flu jab. Annual vaccination is necessary because influenza viruses change over time and the vaccine is updated each year.

“The vaccine is suitable for individuals aged six months and older,” she said when contacted.

The Health Ministry has repor­ted a nationwide increase in ILI cases, with 97 clusters detected in the latest epidemiolo­gical week – a sharp jump from just 14 the week before.

CLICK TO ENLARGE

Most outbreaks were recorded in schools and kindergartens, mainly in Selangor, Kuala Lumpur and Penang.

On Saturday, the ministry reminded that early treatment was important to prevent serious complications.

It said that while influenza was usually resolved without specific treatment, those who experienced symptoms such as fever, cough, sore throat, body aches or fatigue should seek medical attention, mainly children and those at high risk.

The ministry also urged the public to practise proper cough etiquette, maintain regular hand hygiene, avoid crowded places when unwell and wear face masks if they were symptomatic.

Health Minister Datuk Seri Dr Dzulkefly Ahmad said his ministry will discuss with the Education Ministry on further action to contain the spread of the virus in schools.

He also sought to reassure the public that the situation remained under control despite a concerning number of outbreaks.

Prof Sharifa Ezat, who is Univer­siti Kebangsaan Malaysia’s School of Liberal Studies dean, said high-risk groups in­­cluded the elderly, those with comor­bidi­ties, cancer patients and pregnant women.

She added that other groups, such as healthcare workers, teachers with high student load and those handling work which involves meeting a lot of people, should also mask up to protect themselves.

Malaysian Medical Association (MMA) president Datuk Dr Thiru­navukarasu Rajoo urged the public to take sensible precautions with cases of Influenza A and B continuing to rise nationwide.

He said the increase in flu clusters being detected by the Health Ministry was not unusual during this time of the year, but stressed that vigilance is key to preventing a further spread.

“Good hygiene remains our best defence – wash your hands frequently, cover coughs and sneezes and wear a mask if feeling unwell or in crowded areas,” he said.

Dr Thirunavukarasu advised those with persistent high fever, severe cough, chest discomfort or breathing difficulties to seek immediate medical attention, especially if symptoms did not improve after a few days.

President of the Association of Private Hospitals Malaysia Dr Kuljit Singh said the resulting increase in demand for flu vaccines is still manageable.

“We have stock from suppliers, despite the surge in cases,” he said, adding that demand for the jab usually goes up during the flu season.

Former Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah also said there is enough stock of the vaccine at the moment.

“Many are coming in for vaccines due to the influenza outbreak,” he said.

Related stories:

• Flu surge puts Penang on alert as authorities urge residents to stay cautious
• Influenza situation in Penang remains under control, says state govt
• Early treatment crucial to prevent severe influenza complications, says Health Ministry
• Health Ministry investigates death of 4-year-old in Sarawak linked to Influenza

Boosting your metabolic rate

 

Engineering marvel: The Huajiang Grand Canyon Bridge, the world’s highest, is seen in China’s southwest Guizhou province. — AFP

The world’s highest bridge has opened to traffic in the country, state media said, capping an enginee­ring feat three years in the ma­king and snatching the record from another bridge in the same pro­vince.

The Huajiang Grand Canyon Bridge towers 625m above a river and vast gorge in the country’s rugged southern province of Guizhou, also home to the 565m Beipanjiang Bridge that is now the world’s second highest.

Live drone footage broadcast by state media yesterday showed vehicles traversing the immense structure, its blue support towers partially engulfed in clouds.

Crowds of onlookers including project engineers and local officials gathered on the bridge for a ceremony to mark the occasion, with several expressing their pride and excitement in live interviews to state media.

“The opening of the Huajiang Grand Canyon Bridge reduces travel time between the two sides from two hours to two minutes,” Zhang Yin, head of the provincial transport department, said at a press conference on Wednesday.

Its opening makes “enormous improvements to regional transportation conditions and (injects) new impetus into regional economic and social development,” she said.

China has invested heavily in major infrastructure projects in recent decades, a period of rapid economic growth and urbanisation in the country.

The hilly province of Guizhou in particular is crisscrossed by thousands of bridges – which now include the world’s two highest.

State news agency Xinhua said on Wednesday that nearly half of the world’s 100 highest bridges are located in the province.

The Huajiang Grand Canyon Bridge took more than three years to complete, Xinhua reported.

Its 1,420m main span makes it the “world’s largest-span bridge built in a mountainous area”, it added. — AFP

This bridge is a vivid projection of China’s new development philosophy

An aerial drone photo taken on Sept. 28, 2025 shows the Huajiang Grand Canyon Bridge in southwest China's Guizhou Province. Photo: Xinhua

On Sunday morning, the Huajiang Grand Canyon Bridge - the "world's tallest bridge" and the control engineering project of the Liuzhi-Anlong Expressway in Southwest China's Guizhou Province - was officially completed and opened to traffic. This engineering marvel, which ranks "world No.1 both vertically and horizontally," not only sets a new record in bridge construction with a vertical height of 625 meters and reduces a two-hour mountain journey to a two-minute drive, but also embodies the concept of adapting to local conditions and pursuing integrated development, offering the world a new dimension of China's high-quality development. The Huajiang Grand Canyon Bridge is far more than a simple engineering breakthrough; it is a three-dimensional projection of China's new development philosophy featuring innovative, coordinated, green, open and shared development deep in the mountains and valleys, and a concrete manifestation of the transformation from "Made in China" to "Created in China."

Innovation is a pragmatic breakthrough driven by problems. Faced with complex terrain, geological and climatic conditions, the builders adopted an innovative "asymmetrical anchorage design," wind-resistance measures tested through physical wind tunnel experiments, and a fourth-generation "intelligent cable hoisting system." These efforts enabled new breakthroughs in complex bridge engineering, including millimeter-level precision docking of key steel structure joints at an altitude of more than 600 meters. Such innovation was not pursued for its own sake, but arose from the tireless efforts of China's engineers to address the pressing challenge of "turning natural barriers into thoroughfares." It is a concrete example of the principle of the "problem-oriented approach" in China's development philosophy and is a direct expression of the country's new quality productive forces. In this process, the spirit of perseverance embodied by Chinese engineers, akin to the story of "the foolish old man who moves mountains," was fully demonstrated. Through their actions, Chinese engineers have proved that "serving the people" is by no means an empty slogan. 

Coordination is the key engine that activates regional development. Coordinated development is not about mere balance, but about achieving breakthroughs at key nodes to drive overall progress. The opening of the bridge has shortened the journey between Anshun and Liupanshui from two hours to just two minutes. What appears to be a simple shift in time and space is, in fact, a restructuring of the region's economic system. 

While strengthening links between the region and its neighbors, the bridge also creatively integrates infrastructure with cultural tourism through a "bridge plus tourism" model. Projects such as a cloud-top café and a 625-meter bungee jump are incorporated into the bridge complex, linking with surrounding geological landscapes, ethnic minority traditions and red revolutionary sites to generate scale effects and open up new growth points. In due course, under the driving force of the bridge and the comprehensive economic system built around it, a new pattern of regional economic development is bound to emerge.

Green has become an integral element of development that is already embedded in our memory. In the ecologically sensitive karst landscape area, the builders creatively combined the canyon's rock formations with the bridge design, integrating the bridge structure with the canyon landscape. The entire construction process utilized "zero excavation" technology to minimize damage to the native vegetation. This steadfast commitment to the principle that "the ecological red line cannot be crossed" is a vivid manifestation of China's philosophy that "lucid waters and lush mountains are invaluable assets." The construction of the Huajiang Grand Canyon Bridge demonstrates that high-quality development can achieve a win-win situation for both economic and ecological benefits. This process of Chinese modernization reshapes the relationship between human activities and the ecological environment and represents an important contribution of China's green development philosophy to the world.

Openness and sharing represent the mutual learning of civilizations, allowing us to share and admire the beauty of each civilization. The bridge significantly enhances the efficiency of transit in southwest Guizhou, directly benefiting approximately 500,000 residents along the route. It connects essential resources for education, healthcare, and employment, embodying the principle of "shared development outcomes for all." China uses modern engineering technology to open up the "veins" of economic development and pave a "pathway to happiness" for the people. In this process, it also refines itself and engages with the world. The bridge's opening not only injects new momentum into domestic regional development but also provides a replicable and scalable model for the globe, contributing a "Chinese solution." This openness and sharing are not merely a simple transfer of technology; they encompass comprehensive collaboration and integration of design concepts, construction standards, and management experiences, reflecting a global vision of "building a community with a shared future for humanity" within the framework of shared development. As reported previously by the European website Modern Diplomacy: When the bridge is inaugurated, "it will not just be Guizhou or China celebrating, but the world witnessing a new milestone in civil engineering and technological innovation."

From the Zhaozhou Bridge and Luoyang Bridge, which embody the wisdom of ancient Chinese engineering, to the Beipanjiang Bridge, the Hong Kong-Zhuhai-Macao Bridge, and the Huajiang Grand Canyon Bridge, the history of Chinese bridges is a continuous story of breaking through limits and transcending boundaries. This bridge, which spans the canyon, not only establishes a "development corridor" between Anshun and Liupanshui but also conveys to the world in the most direct way that China's development has never been about surpassing others. Instead, it is about achieving a better version of itself, while providing more choices, better paths, and more beautiful visions for the common development of humanity in the process. - Global Times editorial

Unhealthy sleep patterns

 

Here are six signs that your sleeping pattern is out of whack, and how to improve it.

T0ssing and turning throughout the night, even if you're not really conscious ot it, it is a sign of poor sleep

WE all experience the occasional late night or restless sleep, but when these nights become frequent, it can begin to take a toll on your health and overall well-being.

Britain’s The London General Practice sleep and circadian rhythm specialist Dr Katharina Lederle has outlined six key signs that indicate that your sleep pattern may be offbalance.

She has also shared some helpful tips and tricks on how to reset your routine to help you wake up feeling refreshed.

1. Waking up in the night

Frequently waking up too early or having regular interruptions during the night is a clear sign that your sleep has been disrupted.

“Waking up and going to the toilet once and then falling back asleep within a couple of minutes is fine, but if you are having a lot of toilet trips or just think ‘why have I been awake for such a long period of time’, and then struggle to get back to sleep, that suggests there might be a problem,” she says.

2. Restlessness

“If it takes you longer than 30 minutes to get to sleep on a regular basis, there could be an issue.

“One sign of poor sleep is restlessness – tossing and turning at night,” she says.

“You might not necessarily wake up fully and think I have been tossing and turning a lot, but the next day there may be an awareness of restlessness.

“Or if you have a sleeping partner, they might comment on your restlessness during the night.”

3. Busy mind

A busy mind can be a symptom of a poor sleep schedule, and vice versa.

“Stress can psychologically lead to busy thoughts – worrying about the future and replaying scenes from your day – which can make it harder to get to sleep,” says Dr Lederle.

“Stress can also physiologically lead to raised cortisol levels and a raised heart rate.

“However, what we actually want/need for sleep is the exact opposite. We need relaxation to allow ourselves to let go of everything.”

4. Low mood

Feeling low or down during the day can be another indication that your sleep pattern has been disrupted.

“The resources in the brain are all finite and need to be rebuilt.

“So, if your prefrontal cortex [which plays a crucial role in executive functions and higherorder cognitive processes] is sleep deprived, it can’t fulfil its regulatory role,” explains Dr Lederle.

“This often results in low mood, anxiety and irritability, which can then quite quickly lead to conflict or disagreements.”

5. Struggling to focus

“A lack of motivation and struggling to concentrate are some more signs of disrupted sleep that you may notice during the day,” she says.

“When the prefrontal cortex

nd hasn’t had the chance to rebuild all its resources, concentration can become hard.

“Seeing the bigger picture, attention to detail and switching attention intentionally can also become harder.”

6. Excessive tiredness

Feeling excessively tired throughout the day is likely to be a sign of disrupted sleep or accumulated sleep debt.

“Waking up and still feeling tired and groggy is sleep inertia, which we all experience to some extent.

“But if you repeatedly feel excessively tired without an

explanation, that could indicate a bigger problem,” says Dr Lederle.

Reset your routine

Here are some strategies to help your sleeping pattern get back on track:

>Expose yourself to light in the mornings

“When you wake up in the morning, let the light in and go outside,” she recommends

> Make your bedroom room dark and cool in the evenings

“Try to keep your sleeping environment quiet, dark and cool,” she advises.

Go to bed and wake up at regular times

“It’s okay to have some late nights when we go to the theatre or to a party, but on the whole, it’s important to keep your sleep and wake times as regular as possible,” says Dr Lederle.

> Expose yourself to light in the mornings

“When you wake up in the morning, let the light in and go outside,” she recommends. > Make your bedroom room dark and cool in the evenings

“Try to keep your sleeping environment quiet, dark and cool,” she advises.

> Think about what might be causing your stress

“Identify where your stress is coming from and think about what you can control,” suggests Dr Lederle.

“Think about: how can I recover? How can I let go of my work? How can I relax? How can I get a sense of autonomy or control?”

Engaging in an activity you enjoy before bed can provide a sense of autonomy and control, which may help lower your stress levels and help you drift off to sleep.

“It could be that your goal is to meditate and you start with doing five minutes every evening,” she says.

>Adjust eating times Stay active Seek help

“Eating late or eating sugary foods before bed can impact people’s ability to fall asleep,” she says.

“The general rule of thumb is to try and eat dinner at least three or four hours before you go to sleep.

“Having caffeine in the evening, or drinking too much during the day, can also make it harder to fall asleep.”

>Stay active

“Make sure you are moving throughout the day and try to avoid sitting on a chair for hours on end,” says Dr Lederle.

“Try to do some exercise to help release tension and stress from the body.”

“If we have a stressful event, it’s quite normal to have poor sleep.

> Seek help

“But if you are struggling to sleep for more than two weeks, start to think about what might be impacting your sleep,” she says.

“Then if your sleep hasn’t resolved after that, I would suggest speaking to a specialist.” – PA Media/dpa

By CAMILLA FOSTER

New medical innovations to address rising cancer burden in Malaysia

 

The Hospital Picaso medical team is showcasing a cutting-edge, minimally invasive therapy for patients with prostate cancer 

Prostate, pancreatic and liver cancers remain among the most pressing health challenges in Malaysia, with late-stage diagnoses continuing to impact patient outcomes.

Prostate cancer is one of the most common cancers affecting Malaysian men, with many cases detected only at advanced stages.

Liver cancer is also one of the most common cancers among Malaysians, while pancreatic cancer remains one of the deadliest due to late detection and limited treatment options.

In Petaling Jaya, Hospital Picaso – a dedicated centre of excellence for advanced surgery and integrated oncology – is responding to these challenges with next-generation treatment options.

It is the leading hospital in Malaysia to offer Irreversible Electroporation (IRE), a non-thermal ablation technique that targets cancer cells while sparing healthy tissue.

This innovation represents a significant advancement in prostate cancer care, giving patients more precise options with fewer long-term complications.

“This technique gives us a targeted way to treat prostate cancer, while reducing damage to surrounding structures,” said Hospital Picaso consultant urologist Datuk Dr Loh Chit Sin.

“This treatment can help patients to retain urinary continence and preserve erectile dysfunction.

“These outcomes address two of the biggest concerns men face – maintaining quality of life while seeking effective care.”

Known as Irreversible Electro­poration (IRE), this technique utilises high-voltage electrical pul­ses to destroy cancer cells without the use of heat.

This method allows treatment near delicate structures, such as nerves, ducts and blood vessels, making it suitable for tumours in the prostate as well as liver, pancreas and kidneys.

It reflects a more personalised approach to cancer care that supports both survival and post-­treatment well-being.

Building on this advancement, Hospital Picaso is also introducing the Electrochemotherapy (ECT), further expanding its interventional oncology capabilities.

ECT combines short electrical pulses with localised chemotherapy to enhance drug absorption directly into tumour cells.

It is particularly effective for difficult-to-access or previously unresponsive tumours in the liver and pancreas.

By concentrating treatment where it’s needed most, while limiting systemic side effects, ECT offers new hope to patients with limited options.

New technologies are expanding what’s possible but early detection is still key to better outcomes.

“When we detect prostate, pancreatic or liver cancer early, we’re able to offer options that are less invasive and more targeted,” said Dr Loh.

“With techniques like Irreversible Electroporation and Electrochemotherapy, we’re not just treating the disease – we’re giving patients more control over their treatment journey.”

At Hospital Picaso, these innovations represent more than medical advancement.

They mark a shift in how cancer care is delivered – giving patients better options, making treatments more precise and helping people live more fully during and after recovery.

KKLIU: 2321/EXP 31.12.2027