Jon W Sports Injury

 

This is one of our favourite terms in the Sports Therapy world as it is discussed so often. A ‘buzz’ term if you like, but so often misunderstood.

What is Core Stability?

Core stability is the ability to utilise the muscles that are designed to stabilise the body, and when talking about core stability, the spine in particular.

The dictionary defines ‘core’ as “the part of something that it is central to its existence or character”. So in our bodies these are not the superficial visible muscles, but deep muscles within the body.

The second part of the term is ‘stability’. Roughly speaking, muscles can be classed into two groups ‘mobilisers’ and ‘stabilisers’;

Some muscles are designed to mobilise, or create movement of joints, whilst others are designed to stabilise the joint. There are muscles within the body, such as the gluteus muscles or rotator cuff muscles, which have a dual function and provide elements of both.

The role and function of mobiliser muscles are perhaps easier to understand. The bicep is a mobilising muscle as it flexes the elbow joint. The bicep muscle contracts and shortens and pulls our elbow into flexion bringing our hand towards the chest. Therefore, a common way of strengthening this muscle is performing bicep curls.

Stabiliser muscles, however, have a completely opposite role. This muscle group want to prevent movement of a joint and provide stability. In order to strengthen these muscles, we are required to do the opposite and NOT move the joint. This is where we believe core stability is misunderstood. When hearing the term ‘core stability’, often people believe they can strengthen their own core stability by strengthening the stomach muscles, perhaps by doing lots of sit ups. Performing a sit up is not an exercise for core stability. The sit up is an exercise that flexes the spine and therefore works the mobilising muscles that creates flexion of the spine, i.e. the rectus abdominus (six pack muscle).

So, How Do We Improve the Stabilisers?

To create stability improvements, the aim is to perform an exercise that would want the joint to move, but simultaneously engages the stabilising muscles, which work to prevent movement. A popular example is the ‘plank’.

Let’s compare a sit up with a plank; as discussed, the sit up flexes the spine, whereas a plank keeps the spine still. When performing a plank, you will know that it very quickly becomes difficult to keep the spine still, the easy option is to flex the spine to ease the pressure. That pressure you are experiencing is the stabilising muscles at work. You will experience a pulling sensation deep in the stomach (remember our earlier definition of core). You are therefore improving the ability of the stabilising muscles to perform their role.

So What are the Core Stabilising Muscles and Why Has Core Stability Become the ‘Buzz Term’ in Lower Back Pain Rehabilitation?

There are several key stabilising muscles in the core;

  • The two primary stabilisers for the spine are the Transverse Abdominus, a muscle that wraps around the spine in a corset like structure providing protection to spine. And the Multifidus, a long muscle that runs the length of the spine providing further stability to the spine.
  • Secondary core stabilisers include the Quadratus Lumborum, a square shaped muscle that runs from the top of the pelvis to the lowest rib. We regularly find in clinic that this muscle becomes tight and overactive as a result of the primary stabilising muscles not having the ability to provide enough stability. As a result, the Quadratus Lumborum does excessive work. When this is coupled with the Quadratus Lumborum being a dual function muscle that also creates mobility, it is easy to see why it can become very tight and create lower back pain.

Let’s consider two golfers; one with very good core stability and the other very poor. The golf swing requires excessive rotation. The golfer with the excellent core stability will have the ability to produce this rotation whilst stabilising the spine. The golfer with the poor core stability, will not be able to stabilise the spine so will use the secondary core stabilisers excessively and produce rotation of the spine itself. As a result, the latter golfer will be left with tight lower back muscles and excessive ‘wear and tear’ of the spine.

What Can We Do to Improve Our Core Stability?

We believe the key is to start very easy. The biggest mistake a lot of people make is to start with a difficult exercise – the conventional plank is a very difficult exercise! If the exercise is too difficult for the primary stabilising muscles, then they will simply ‘switch off’ and the secondary muscles will work excessively. Not only will this not help with your pain, but it will actually make things worse.

A good exercise we often begin with is done on your hands and knees. With a flat back, simply try lifting an arm whilst preventing the back from moving. Remember, the movement of the arm is not key, it is the stability of the spine that we are striving for! Repeat this movement 15 times on each arm. If this becomes too easy, the progression is to lift the arm and opposing leg simultaneously. Remember, the spine must not move!

There are many core exercises we can do but if any involve movement of the spine or create pain in the back, they are not beneficial for correct rehabilitation.

If you would like any further information or advice, please feel free to drop us a line or pop by and we would be happy to discuss a full and suitable core stability program with you.

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