Biomechanics | Core Stability | Injury

In the sports fitness industry we have probably been seduced by more fads than any other industry.  They seem to come and go so quickly you can hardly remember the last one.  Is core stability training one of those fads or is it here to stay?Recently (in sports fitness training) it has become vogue to perform core stability exercises.  Some of this came from research, some from commercial exercise companies, but it has certainly caught the imagination of the industry and some of the public too.  As with any ‘new’ (to the sports fitness industry) exercise concept there will be a variety of ways that the exercises are prescribed, some of which are less effective than others, but as science has embraced the concept, it is becoming generally better taught and used.In fact, apart from the more commercial claims, core stability training has been shown to be a very important part of your client’s exercise program(1,2). Studies have shown that there is no better way of re-programming your motor strategy.  In other words it is very good at getting your muscles to work properly not only to stabilise your spine but also to provide it with the platform upon which your body can perform other movements more effectively and safely.

But therein lays the problem.  A few years ago I did a series of presentations at Fit Camp, Lydia Campbell’s excellent annual exercise summit for the fitness industry.  I presented on the merits of understanding biomechanics prior to embarking upon an exercise program.  Before our presentation the audience was taking part in a Pilate’s class.  I saw the class, it was excellent.  When the audience came into my presentation, I asked them how many of them had back pain.  Over 75% of them put their hand up.  Previously only a couple of them had noted back pain prior to the Pilate’s class.  I called some of the audience down and tested their biomechanics and all of them had marked deficits, which is actually quite common.  So it wasn’t that the class had caused the pain, it was the fact that they weren’t biomechanically prepared to enable them to do the class properly.  If there are biomechanical issues with your client’s spine and pelvis, it is very difficult for them to be able to engage their core, as they are in (often sub clinical) muscle spasm, which inhibits engagement of the core.  This then makes it much harder for your clients to engage their core effectively.  How many of you find it’s hard for your clients to engage their core properly?  Actually there are quite a few who can’t do it.  The reason is often that their biomechanics is not allowing them to.  If you sort out their biomechanics, core engagement is actually remarkably simple.  Core stability training teaches the client how to engage their trunk muscles in such a way that they stabilise the spine in its natural position.  But if your pelvis is rotated and you have a leg length discrepancy and you have a slightly curved (scoliotic) spine to compensate for this, do we really want to stabilise our clients in this biomechanically incorrect position?  Probably not.  What would be the likely outcome of stabilising someone in the ‘wrong’ position?  Would the risk of pain increase? Probably.  What we need to do is:

1. Provide the body with the building blocks for ‘normal’ movement, in other words reduce any sub clinical muscle spasm (Tardieu & Tarbary, Janda 1993),
2. Mobilise any immobile nerves (3)
3. Make sure the pelvis is functional, with no leg length discrepancies4, and once we have our clients in good biomechanical shape, then core stability training provides them with a high degree of stability in a good biomechanical position.  Once that stability is refined and becomes functional then you can start working on the functional patterns that we know are important to achieve many of your client’s goals.

So, core stability training is probably here to stay and rightly so. But let’s just think about how we use it and when.  Stuart McGill PhD, says that core stability training helps some people and hurts others (2006).  We know anecdotally that is correct. With some thought and understanding of biomechanics, not only can we understand why this is, but also we can help our clients reduce the risk of injury and help prepare them more thoroughly than ever before.Martin Haines DipRGRT MCSPMobilis PerformanceThe Intelligent Training™ Company www.mobilisperformance.com 

References

1. Boyle M (2004), Targeted Torso Training and Rotational Strength. Functional Training for Sports, Mike Boyle. 88-89
2. Bergmark A, Stability of the lumbar spine. A study in mechanical engineering. Acta Orthop Scand (suppl). 230:20-24, 1989.
3. Shacklock M, Muscle imbalance dysfunction. Clinical Neurodynamics. 68, 2005.
4. Giles LGF, Taylor JR: Low back pain associated with leg length inequality. Spine 6:5, 510, 1981