5 - Training the Core and Preventing Lower Back Pain Flashcards
Anatomical core
Axial skeleton and all soft tissues that originate from it regardless of whether soft tissue terminates on axial or appendicular skeleton
the core as a cylinder
- Diaphragm at the top
- multifundus and transverse abdominus in the middle
- pelvic floor at the bottom
Anterior and lateral core muscles
- External abdominal obliques (side and front of abs)
- Transverse abdominis (under obliques, deepest ab muscles that wrap around spine for protection and stability)
- Internal abdominal obliques (under ext obliques, running up and back)
- Rectus abdominis (at the front; “6 pack”)
Posterior core muscles
Muscles in the spine that help to stabilize it
- semispinalis thoracis
- Iliocostalis thoracis
- Longissimus thoracis
- Iliocostalis lumborum
- Multifidus
- Quadratus lumborum
- Erector spinae muscles
Function of ‘core’
Protect spine and internal organs and musculature in static and dynamic movement to prevent injuries
- is initiated before joint movements
Core strength vs stability
Strength: ability of muscle to exert or withstand a force
Stability: ability to control ROM of a joint
- active stabilization of spine is achieved through regulation of forces exerted by surrounding muscles
- need core endurance to exert/withstand forces for prolonged time to ensure stability
Back health
People who sit for long periods of time, are older individuals, are pregnant/obese and do repetitive motions are at risk for LBP
- asymmetrical strength and movement patterns
- Stiff hips
- Below average back endurance score
- Tight hamstrings
- greater abdominal endurance than back endurance
- prolonged sitting
Preventing LBP
Encourage good spine hygiene, activate correct muscles for the exercise and avoid painful movements
Open scissors position
- Hyperactivation of spinal erectors
- Poor abdominal activation
- Elevated/flared ribcage
- Pelvic floor and diaphragm not parallel to each other
Spine hygiene
Perform exercises that emphasize core endurance and with good biomechanics
- teach the hip hinge and squat movements
- Brace core during ADLs
- Limit movements of rapid, repetitive, weighted and end range flexion of spine
- Take care lowering heavy object from over head
Core training
Best core training programs require spine held in neutral position while breathing and moving arms and legs in movements that mimic functional ways the core can be stressed in a given sport/activity
Training hierarchy
Start with…
Breathing»_space; Bracing»_space;Anti-movement» Bodyweight flexion»Loaded carries
Diaphragmatic breathing
Inspiration:
- thoracic cavity expands
- External intercostal muscles contract
- diaphragm contracts (moves down)
Expiration:
- Thoracic cavity reduces
- External intercostal muscles relax
- Diaphragm relaxes
Diaphragmatic breathing + pelvic floor
“connection breath” or “piston breath”
- Coordination of core and pelvic floor
- Pregnancy, scar tissue, surgery may prevent this connection
Box breathing
Sitting on chair or flat on floor
Inhale for 4sec, hold for 4sec, exhale for 4sec, and hold for 4 sec
- focus on breathing thru the belly
