Archive for the ‘Rehabilitation’ Category

‘Core Stability’ is probably one of the most used and abused terms floating around health clubs, amongst health professionals and personal trainers. But what does it mean and how does it affect us?

A few years ago when we talked about the core we thought of our stomach muscles and everyone was doing lots and lots of abdominal work in isolation, working on their six pack to improve their core strength. Then in the early nineties a clever group of physiotherapists in Australia managed to isolate a dysfunctional muscle in the deep abdominal muscles in a population of low back pain sufferers, and this has subsequently become the basis for many postgraduate courses looking into low back stability and core stability, in the fitness world this has spilled into things like pilates. With this approach, muscles are taught how to activate in isolation to rehabilitate or activate them which make them work more normally and in theory this would give your core stability.

These ideas have now been developed further and new ideas have come out of this and we don’t focus necessarily on single small muscles but rather look into how the body is working in functional positions and identifying the weak links in the chain.

The core muscles does not only consist of the abdominal musculature, but also consists of the trunk muscles, pelvic muscles and quite importantly the muscles of the hips and shoulders. You see it is already getting quite complicated. These muscles have the specific role of providing stability for the limbs to be able to do highly specific and detailed tasks, and in sports this quite often means the ability to transfer forces from the centre out to the limbs as seen in activities such as running kicking and throwing. But also this transfer of power is also evident in things like pushing a door open, hoovering and ironing. If certain muscles or muscle groups become weak and inefficient there becomes a weak point in the chain which may cause either a poor alignment of the joints causing stress onto structures and muscles around those joints, this is often seen in runners who have ITB problems or shin splints, as well as not being able to support the spine in performing functional activites such as lifting.

To give you some numbers, the hip and abdominal musculature account for about 50% of the energy used during throwing, if the just one muscle involved in this energy transfer that occurs between the hips and the shoulder is not doing its job there will be a less efficient movement in the chain and there will have to be some compensation to achieve the same task. In a study by Kibler published in 1996 there was an analysis of a tennis serve and they reconed if there was a 20% deficit in the core muscles, then there would need to be 34% more arm speed or 80% more shoulder muscle mass to compensate for this. Interestingly in another study they found that 49% of athletes who had torn their roator cuff in their shoulder demonstrated poor flexibility around the hip and weakness in the hip abductors which they thought was linked to the poor power transfer causing the shoulder to over compensate.

If you are suffering from any upper and lower limb injury as well as pain in the spine, your functional core stability needs to be assessed and an appropriate rehabilitation program needs to be set. This should be very individual to you and work with your lifestyle whether your problem is doing the house work or if you are an elite athlete. The program needs to be progressive and as soon as you have mastered one activity it needs to be progressed to ensure a quick return to your sport or activities.

If you have any questions of how we can help you with the problems you are facing or you would like to improve your core stability for performance reasons we will be more than happy to help you reach your goals of a happy and health lifestyle.