Core stability plays a vital role in how our body performs and copes with everyday life. Poor core stability can lead to a number of injuries, particularly those involving the back, groin, hamstrings and knees. Physiotherapists regularly prescribe core stability exercises for injury rehabilitation purposes, but also as part of an injury prevention strategy, particularly in the case of athletes.
Core Stability Exercises
Within the repertoire of ‘core stability’ there is a large range of exercises that can be prescribed by your physiotherapist, the suitability of which will vary according to the injury and therapeutic needs of each individual patient. There are three major groups of core stability exercises:
Recruitment orientated exercises – focus on the strengthening of the small deep lying stabilising muscles, transversus abdominis and multifidus. These are often clinical pilates based exercises.
Static bodyweight exercises – focus on developing stability and/or strength endurance in certain postures, and require co-contraction of the small stabiliser and larger mobiliser muscles. These are exercises such as the popular ‘plank’ (see figure 1).
Dynamic strength exercises – focus on the prime movers (muscles) of the trunk. These exercises are often performed on the floor or Swiss ball.
Where physiotherapy treatment aims at core stability, commonly practitioners will have their patients start with recruitment orientated exercise, and progress to strength work once stability has been achieved and symptoms are progressing. (strength is improving?)
The Importance of Core Stability in Exercise
Physiotherapists, sports medics and strength and conditioning coaches also recommend that athletes perform regular core stability or trunk strength exercises to prevent injury.
The rationale for ‘prophylactic’ training is that increased recruitment of the stabiliser muscles and increased strength of the prime movers will carry over into better posture and more control, both in daily life and sporting movements. Athletes tend to have a list of three to five core stability exercises targeting various muscles or positions that they are required to perform regularly as part of their training program.
Whilst this ‘prehabilitative strategy’ is well intentioned, it has two limits:
The first: Core stability exercises can quite quickly become ‘bore stability’! It takes self-discipline to do 20-30 minutes of the same exercises three or more times a week over a long period. As a consequence, adherence to the preventive program can be an issue.
The second: is physiological; the principles of specificity and progression apply to core work in the same way as they do to any other body training. It is quite common for an athlete to perform the same core routine over a long period and get very good at four or five movements or ‘holds’. But teach the same athlete a new core exercise and they will find it difficult, simply because it’s a new stimulus; the message is that progression and variety are key to optimising benefits of a strengthening program.
LESSON TO BE LEARNT
Core stability should be a focus not only for athletes, but for everyone looking to improve the way their body copes with everyday life demands on a musculoskeletal level. Don’t be a victim of ‘bore stability’ and principles of specificity by varying your exercises and therefore varying the targeted core muscles.
For assistance in developing an exercise program targeted at the core muscles simply contact our clinic to speak to one of our physios.
Reference: Rachel Brandon; Sports Injury Bulletin; Nov 2005; Issue 4: The Core Training Menu System 1